Biomedical Engineering – From Theory to Applications

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Biomedical Engineering – From Theory to Applications
methemoglobinaemia (from the EMLA cream) that, after immediate hospital admission,
resolved spontaneously overnight, with no medical intervention required.
Prof Roger Short orchestrated the production of a video that teaches the Russell method. Dr
Russell featured in this "no scalpel circumcision" video. Also featured was one of Prof
Short’s students from Botswana, who took it there for teaching purposes. Another, filmed in
Vanuatu of a traditional circumcision using a sharpened bamboo, was produced for use in
Papua New Guinea (PNG) where, unlike most Pacific Islands, circumcision is uncommon.
These were aimed primarily to reduce HIV/AIDS in Botswana and PNG.
Since the simple plastic Plastibell device is now off patent it can be produced at very low
cost, but parallel production cannot use the name Plastibell, which remains to this day a
Registered Trade Mark. Nevertheless, the device has the potential to help reduce HIV in
poor countries (Short, 2004).
Dr. Sam Kunin points out, however, that "the [Plasti]bell techniques leave too much inner
skin. Besides the inherent problems of this method with later adhesions and buried penis,
allows for possible migration of the bell down the shaft, with ensuing potential damage to
the penile skin" (personal communication). A Nigerian study also noted that incorrect
technique can lead to proximal migration of the Plastibell in neonatal boys (Bode et al., 2009).
Correct training in this method is thus essential. An Iranian study involving 7,510 term
neonates found that Plastibell circumcision incorporating thermal cautery of the frenulum
reduces bleeding (0.4% versus 0.05%), but led to greater urinary retention (0.03% versus
0.9%) (Kazem et al., 2009). Modifications to the standard procedure by authors in the UK
have improved outcomes, particularly the risk of bleeding (Mahomed et al., 2009).
A study in Pakistan found that for babies under 3 months of age, the time taken for the
Plastibell to fall off was 8.7 days (Samad et al., 2009). This increased gradually to 16.8 days
for children over 5 years.
8.2.5 Mogen Clamp
Inventor: Bronstein, H.
Primary patent: US2747576
Patent priority date: 3 Feb 1955
Patient age range: Full-term neonate to adult
Category: Tug-&-Chop shield with inbuilt crushing action
Fig. 8. The Mogen Clamp.