The Acceptability and Safety of the Shang Ring for Adult Male Circumcision in Rakai, Uganda
The Acceptability and Safety of the Shang Ring for Adult Male Circumcision in Rakai, Uganda
复制标题
DOI：
10.1097/qai.0b013e3182968dda
复制
发表时间：
2013-08-15
影响因子：
3.6
通讯作者：
Gray, Ronald H.
中科院分区：
文献类型：
--
作者：
Kigozi, Godfrey;Musoke, Richard;Gray, Ronald H.
目的：医学男性包皮环切术（MMC）被推荐用于男性艾滋病毒预防。我们比较了上环装置与背缝法的可接受性和安全性。方法：在乌干达Rakai农村，对要求免费MMC服务的18岁以上hiv阴性、未割包皮的男性告知尚环和背缝手术，并允许其自由选择手术。术后7天对男性进行随访，以评估与手术相关的不良事件并移除尚环。术后4周评估伤口愈合情况。结果：共纳入621名男性，其中508人（81.8%）选择上环，113人选择背缝。为504例男性提供上环，其中4例环放置失败（0.8%），需要手术止血和伤口关闭。500名接受上环治疗的男性和术后手术相关的中度不良事件为1.0%，而接受背缝治疗的男性为0.8%。4周时，环形切口的伤口完全愈合率为84%，背侧切口的伤口完全愈合率为100% （P, 0001）。4周前性交复复率环组为7.0%，背缝组为15.0% （P = 0.01）。手术的平均时间环为6.1分钟，背缝为17.7分钟。取环平均时间为2.2分钟。结论：尚环在该环境下具有较高的可接受性和安全性，可提高MMC服务效率。然而，在环放置失败的情况下，需要备用手术服务。
Objectives: Medical male circumcision (MMC) is recommended for HIV prevention in men. We assessed the acceptability and safety of the Shang Ring device compared with those of the dorsal slit method.Methods: HIV-negative, uncircumcised men aged 18 years or older who requested free MMC services in rural Rakai, Uganda, were informed about the Shang Ring and dorsal slit procedures and offered a free choice of procedure. Men were followed at 7 days postoperatively to assess adverse events related to surgery and to remove the Shang Ring. Wound healing was assessed at 4 weeks postoperatively.Results: Six hundred twenty-one men were enrolled, of whom 508 (81.8%) chose the Shang Ring and 113 the dorsal slit. The Shang Ring was provided to 504 men, among whom there were 4 failures of Ring placement (0.8%) that required surgical hemostasis and wound closure. Five hundred men received the Shang Ring and postoperative surgery-related moderate adverse events were 1.0%, compared with 0.8% among dorsal slit recipients. Complete wound healing at 4 weeks was 84% with the Ring and 100% with the dorsal slit (P, 0001). Resumption of intercourse before 4 weeks was 7.0% with the Ring and 15.0% with the dorsal slit (P = 0.01.) The mean time for surgery was 6.1 minutes with the Ring and 17.7 minutes with the dorsal slit. The mean time for Ring removal was 2.2 minutes.Conclusions: The Shang Ring is highly acceptable and safe in this setting, and could improve the efficiency of MMC services. However, back-up surgical services are needed in cases of Ring placement failures.