To investigate the safety and effectiveness of circumcision suture device in patients with diabetes mellitus.

A retrospective study was conducted on the clinical data of 89 diabetic patients who had undergone circumcision and met the inclusion criteria admitted to Suzhou District of BenQ Medical Center, Affiliated BenQ Hospital of Nanjing Medical University from December 2019 to February 2022. According to the different surgical methods of circumcision, they were divided into the circumcision suture device group (n= 36) and the traditional circumcision group (n=53). After the patients were admitted to the hospital, the routine test and examination before operation were accomplished and the blood glucose was controled. The corresponding type of disposable circumcision suture device was chose to cut and suture the foreskin in the circumcision suture device group. In the traditional circumcision group, the excess prepuce was cut off with tissue scissors at a distance of 0.5-1.0 cm from the coronal sulcus. After hemostasis by electrotome, the patients were sutured intermittently with absorbable thread. Patients in both groups were treated with gauze and elastic bandage. After surgery, patients in both groups received oral second-generation cephalosporin antibiotics for 3 days to prevent infection. Gauze and elastic bandage were replaced on the first day after surgery, and then replaced every 2 days until wound was healed and gauze and elastic bandage were removed. The average operation time, average intraoperative blood loss and postoperative complications were compared between the two groups, and the number of cases of balanus injury caused by stapling device in the circumcision suture device group was recorded. Data were processed with Mann Whitney U test, chi-square test and Fisher′s exact test.

The average operation time [10.0 (6.3, 14.8) min] and intraoperative blood loss [1.0 (1.0, 2.0) mL] in the circumcision suture device group were significantly lower than those in the traditional circumcision group [28.0 (23.0, 33.0) min] and [2.0 (1.0, 5.0) mL], and the differences were statistically significant (Z=-7.787, -3.884; P<0.05). There were 8 cases (22.2%) of wound ecchymosis in the circumcision suture device group after operation, which was higher than that in the traditional circumcision group [2 cases (3.8%)], the difference was statistically significant (χ²=5.583, P=0.018). There were 5 cases (13.9%) of wound hematoma, 5 cases (13.9%) of wound infection and 5 cases (13.9%) of total wound dehiscication in the circumcision suture device group, which were higher than those in the traditional circumcision group (0, 0, 0), the differences were statistically significant (P=0.009, 0.009, 0.009). There was no local wound dehiscication in the circumcision suture group, compared with the traditional circumcision group [1 case (1.9%)], there was no statistically significant difference (P=0.596). Ecchymosis of the wound was more common and would subside spontaneously. Postoperative wound hematoma could disappear after 2 days of compression dressing based on increasing the number of elastic bandage layers. For wound infection and total wound dehiscication, all foreskin staplers and silicone spacers should be removed and then disinfected and bandaged. After wound infection was controlled, absorbable thread was used for resuture. Partial wound dehiscication was needed local disinfection with benzalkonium chloramine. None of the patients in the circumcision suture group had balanus injury caused by stapling device during operation.

It is safe and feasible for patients with diabetes mellitus to receive the circumcision suture device after strict screening and communication before operation, and it has the advantages of convenient operation and good surgical experience.