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WHAT TO EXPECT AFTER CIRCUMCISION - By Dr. Lackore
Immediately after circumcision I place a small absorbable piece of gauze called "Surgicel" around the tip of the penis that helps prevent the baby from "sticking" to its diaper and also reduces bleeding. Please let the gauze fall off on its own. It may fall off within 5 hours or 5 days. As long as there is no bleeding, do not be concerned about when it falls off. Make sure you use vaseline (see below) after it falls off. I always look at the circumcision 5-10 minutes after the procedure and if it is not bleeding at that time, it is unlikely to have any troublesome bleeding at all. If bleeding is excessive call my office number. While you are waiting for a call back, put firm pressure on the penis with a dry, clean washcloth to help stop the bleeding. If you cannot get a hold of either your pediatrician, me or the Doctor on call for me - then apply direct pressure to minimize blood loss and go to the nearest Emergency Room.
FIRST 1-7 DAYS:
Appearance: Over the first 2-3 days, the penis will look slightly swollen, reddened and will develop a wet, yellowish scab (this is healing tissue). This redness, swelling and yellowish appearance should then start to decrease.
Vaseline: The wet scab can stick to the diaper, therefore please place Vaseline ointment around the tip of the penis (and over the Surgicel while it is present) starting with the first diaper change after the circumcision and every diaper change until the healing is completed (usually within 5-7 days).
Gently retract foreskin: In addition to the Vaseline, GENTLY pull the skin down at the base of the penis to prevent penile adhesions starting the day after the circumcision until there is complete healing (with every diaper change). Please ASK to be shown how to do this.
Stitches: It is very uncommon that stitches are used - if present, they will dissolve and do not need to be removed.
Pop-up the head: If Head of the penis is hidden by the fat pad at the base of the penis. Gently push the fat pad down with diaper changes to make head of penis "pop-up"
•Avoid baby wipes to clean the circumcision area.
•No regular bath until circumcision heals and umbilical cord falls off usually day 2-4 or when allowed by pediatrician.
•Wash genitals gently - after each bowel movement as needed; using warm water and a few drops of soap (Johnson and Johnson's Baby Bath) and gently dry. Continue this technique for 7 days
•Apply Vaseline ointment to the surgical site 3x a day for 5 days (best after bathing)
•Loose-fitting diapers may make baby feel more comfortable.
•Minor bleeding can be controlled by placing a soft cloth over the penis and applying pressure for five minutes.
•Bleeding persists after five minutes or with applied pressure.
•A thick, yellow LIQUID pus or foul smell develops.
•Redness and swelling Increases after the first day rather than decreasing.
•Tenderness increasing rather than decreasing
•Fever greater than 100.5 degrees Fahrenheit.
•Vomiting that lasts more than six hours or if the vomiting is severe.
•Dehydration from prolonged or severe vomiting and is not able to drink enough fluid to keep up with the loss.
•Foreskin narrowing covering tip of penis (preventing the head of the penis from coming out).
•Tylenol (occasionally used) ONLY after discussing with your pediatrician.