Post circumcision wound PH variation and its predictors among males at International Hospital Kampala, Uganda: A cohort study post circumcision wound PH variation and its predictors among males at international hospital Kampala, Uganda: a cohort study

Abstract

Background: Myriads of studies have suggested that a survey of wound pH environment could indicate wound healing activities whereby acidic pH promotes wound healing and alkaline pH delays wound healing. However, studies have not been conducted to determine post circumcision wound pH, how it varies and what predicts this variation. Objective: To determine Post Circumcision wound pH variation and test its predictors among circumcised men at IHK. Methods: A prospective pilot cohort study was performed among 244 males undergoing SMC at International Hospital Kampala using consecutive sampling. Both circumcision procedures and pH measurement were performed by certified health workers. pH status of the epidermal prepuce was recorded pre-operatively and post-operatively on day 0 at 2 minutes, then day 2 and 7 respectively. The average post-operative wound pH was calculated by adding the three post-operative pH for each male divided by three and a multiple linear regression was used to assess the predictors of average post-operative pH. Results: 244 males with a median age of 23 years participated in the study. The median pre-operative pH was 5.2, post operatively at 2 minutes 5.9, on day two 6.2, day seven 6.4 and the average post-operative pH was 6.2. The predictors of average post-operative pH were, pre-operative epidermal preputial pH 0.424(95%CI: 0.354- 0.494, p-value <0.001), duration of surgery 0.0511(95%CI: 0.0125 to 0.0897, p-valve = 0.010), and alcohol use 0.280(95% CI 0.064 to 0.09, p-value= 0.011). Conclusion: The baseline pre-operative epidermal preputial pH was acidic. Post operatively within the first seven days‟ pH was noted raising towards neutral levels. The predictors of post circumcision wound pH were the level of pre-operative pH, the duration of surgery and pre-operativehistoryofalcoholintake.