Sutureless Adult Voluntary Male Circumcision with Topical Anesthetic: A Randomized Field Trial of Unicirc, a Single-Use Surgical Instrument

IntroductionThe World Health Organization has solicited rapid and minimally invasive techniques to facilitate scale-up of voluntary medical male circumcision (VMMC).Study designNon-blinded randomized controlled field trial with 2:1 allocation ratio.Participants75 adult male volunteers.SettingOutpatient primary care clinic.InterventionOpen surgical circumcision under local anesthetic with suturing vs. Unicirc disposable instrument under topical anesthetic and wound sealing with cyanoacrylate tissue adhesive.Primary OutcomeIntraoperative duration.Secondary OutcomesIntraoperative and postoperative pain; adverse events; time to healing; patient satisfaction; cosmetic result.ResultsThe intraoperative time was less with the Unicirc technique (median 12 vs. 25 min, p ConclusionsVMMC with Unicirc under topical anesthetic and wound sealing with cyanoacrylate tissue adhesive is rapid, heals by primary intention with superior cosmetic results, and is potentially safer and more cost-effective than open surgical VMMC.Trial RegistrationClinicaltrials.gov NCT02443792