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Background: The World Health Organization has recommended voluntary medical male circumcision (VMMC) as an essential component of HIV prevention in countries with high a HIV burden. Current VMMC methods are relatively expensive and have limitations when it comes to scaling up at a national level, this has led a number of promising new VMMC methods. One such method is the Unicirc method, a closed procedure which uses a disposable surgical instrument which can used with a topical anaesthetic and cyanoacrylate tissue adhesive.
Methods: The study was a non-blinded randomized controlled field trial with 2:1 allocation ratio comparing open surgical circumcision under local anesthetic with suturing versus Unicirc disposable instrument under topical anesthetic and wound sealing with cyanoacrylate tissue adhesive. Seventy five men seeking VMMC were recruited by posters and word of mouth from three clinics associated with Andrew Saffy Memorial hospital, serving the Lonmin group of platinum mines, situated in Rustenberg, North West Province, South Africa, from July 15 and August 7, 2015. The primary outcome was intraoperative time, while the secondary outcomes were intra-operative pain, post-operative pain, incidence of adverse events, proportion of wounds that had healed at four weeks, patient satisfaction and cosmetic result.
Results: The intra-operative time and blood loss were less with the Unicirc method, median duration 12 versus 25 min (p < 0.001) and median blood loss 1.5 versus 40 ml (p< 0.001). The Unicirc method had a greater proportion of participants with a healed wound at four weeks when compared to the open surgical method 90.7% versus 69.6% (p value 0.04) and cosmetic results were superior in the Unicirc group, while the incidence of adverse events and patient satisfaction were similar in both groups.
Conclusions: VMMC with Unicirc under topical anaesthetic and wound sealing with cyanoacrylate tissue adhesive is rapid, had less blood loss, more rapid healing, superior cosmetic results, and was potentially safer than the open surgical VMMC.

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