Combined use of CO₂ laser and tissue glue versus conventional surgical techniques for circumcision - A prospective study

Objective: Use of a CO₂ laser for cutting and coagulation during circumcision has been reported to give excellent results, and tissue glue has been reported to have advantages over sutures for approximation of wound edges. Most previous studies have focused on the comparison between use of a CO₂ laser and scalpel, or between tissue glue and sutures. This study compares results and complications between the combined use of a CO₂ laser and tissue glue, and standard surgical techniques for circumcision. Subjects and methods: Thirty boys were divided into two groups. Group 1 (n=17) underwent circumcision using a scalpel with approximation of the wound edges using chromic catgut sutures. Group 2 (n=13) underwent circumcision using a CO₂ laser with approximation of the wound edges using tissue glue. Patient age, indications for surgery, operation time, wound swelling, bleeding, wound infection, local irritation, pain score, and cosmetic appearance were recorded. Results: Group 1 (scalpel+sutures) had a significantly longer operation time (p=0.011), a higher rate of local irritation (p=0.016), and poorer cosmetic appearance (p<0.001) than Group 2 (laser+glue). Bleeding occurred in one patient in Group 1 only. There were no significant differences in pain score, wound infection rate, or the cost of surgery between the two groups (p>0.05). Conclusions: The combined use of a CO₂ laser and tissue glue has advantages over standard surgical techniques for circumcision, with a significantly shorter operation time, lower rate of local irritation, and better cosmetic appearance. The cost of surgery is similar in both groups.