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改变了传统的男性包皮环切手术概念


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The Shang Ring for adult male circumcision: Evaluation of healing at three time intervals
中国商环成年男性包皮环切:术后3个不同时间间隔愈合情况评估
Kenya National AIDS Control Council
First National Biennial HIV and AIDS Research Conference
17–20 May 2011

 

The Shang Ring for adult male circumcision: Evaluation of healing at three time intervals


Quentin Awori, Mark A. Barone, Philip S. Li, Raymond Otieno Simba, Mark Weaver, Peter Cherutich, Nicholas Muraguri, John Masasabi Wekesa, Jared Nyanchoka, Paul Perchal, Puneet Masson, Richard Lee, Marc Goldstein, and David C. Sokal

 

Abstract


Background

Our objective was to assess time to complete healing following the Shang Ring adult male circumcision with ring removal at 7, 14, or 21 days postcircumcision.


Methods

Fifty HIV-negative men underwent a Shang Ring circumcision at the Homa Bay District Hospital. Men were randomly assigned for ring removal at 7, 14, or 21 days after circumcision. Follow-up visits were at 7, 14, 21, 28, and 42 days after circumcision, with an additional visit two days after removal. Healing and adverse events were assessed at follow-ups.


Results

Complete healing was observed in 46/50 (92.0%) men; two were lost to follow-up before complete healing and two were not completely healed by 42 days. No complete healing was observed at 7 or 14 days. Differences in the cumulative probability of complete healing among randomization groups were not significant (p=0.86) (Table 1).


Table 1. Kaplan-Meier estimates of cumulative probability of complete healing (95% CI)

Randomization group
Visit day
Day 7 removal
Day 14 removal
Day 21 removal
21
13.3% (3.5%, 43.6%)
13.3% (3.5%, 43.6%)
20.0% (8.0%, 44.9%)
28
60.0% (37.2%, 83.5%)
71.1% (47.2%, 91.0%)
70.0% (49.9%, 87.7%)
42
100.0% (100.0%, 100.0%)
90.4% (66.2%, 99.4%)
94.0% (76.4%, 99.6%)


Complete healing tended to be sooner when rings were removed after 7 days, although differences were not significant (p=0.18). For example, cumulative probability (95% CI) of complete healing at 28 days was 52.9% (32.0%, 77.0%) versus 74.8% (59.1%, 88.1%) for ring removal at 7 days versus later, respectively. Seven men, all in the 14- and 21-day groups, requested early removal due to pain/discomfort associated with partial ring detachment.


Conclusions

Results suggest that ring removal at later times following adult male circumcision does not lengthen the time to complete healing, and that there are no serious consequences if men do not return on time for removal.

 

SOURCE: http://www.popcouncil.org/mediacenter/events/2011KenyaAIDSConference/Awori.asp



肯尼亚国家AIDS理事会
首届全国双年度HIV/AIDS研究会议
2011年5月17–20日

中国商环成年男性包皮环切:术后3个不同时间间隔愈合情况评估


Quentin Awori, Mark A. Barone, Philip S. Li, Raymond Otieno Simba, Mark Weaver, Peter Cherutich, Nicholas Muraguri, John Masasabi Wekesa, Jared Nyanchoka, Paul Perchal, Puneet Masson, Richard Lee, Marc Goldstein, and David C. Sokal

 

背景


我们的目标是评估商环成年男性包皮环切手术后第7,14,或21天时间的愈合情况。


方法


50名HIV阴性男子在Homa Bay区医院接受中国商环包皮环切手术。男子被随机分组为在包皮环切手术后第7,14,或21天去环。在环切后第7,14,21,28和42天随访,增加的一次随访是在去环两天后。随访时评估愈合与不良事件。


结果


在46/50(92.0%)的男性中观察到完全愈合;2人在完全愈合前从随访中丢失,2人在第42天时未完全愈合。第7或14天时未观察到完全愈合。在随机化分组之间完全愈合的累积概率差异不显著(P = 0.86)(见表1)。



Table 1. 采用Kaplan - Meier估计的完全愈合的累积概率

 

 
随机分组
随访日
第7天去环
第14天去环
第21天去环
21
13.3% (3.5%, 43.6%)
13.3% (3.5%, 43.6%)
20.0% (8.0%, 44.9%)
28
60.0% (37.2%, 83.5%)
71.1% (47.2%, 91.0%)
70.0% (49.9%, 87.7%)
42
100.0% (100.0%, 100.0%)
90.4% (66.2%, 99.4%)
94.0% (76.4%, 99.6%)

完全愈合倾向于在第7天去环后更快,但差异不显着(P = 0.18)。例如,第28天完全愈合累积概率(95%CI)为52.9%(32.0%,77.0%)而第7天去环在第28天的完全愈合累积概念为74.8%(59.1%,88.1%)。在14 - 21天两组的七名男子,因疼痛/与部分环脱离相关的不适而要求提前去环。


结论


结果表明,在成年男性包皮环切后更晚的时候去环,并不延长完全愈合的时间。而且,如果男子不能在约定的时间返回门诊去环也没有严重的后果。


 
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