Immediate Period (over the first few hours):
Immediately after the circumcision has taken place, I will place a small piece of gauze around the incision site that is called Surgicel. This gauze helps prevent any bleeding. Please let the gauze fall off on its own. It may fall off within hours to 4-5 days. As long as there is no bleeding, do not be concerned about when it falls off.
I will look at the circumcision 5-10 minutes after completion. If it is not bleeding at that time, it is unlikely that it will. However, it is very important that you look at the circumcision site once an hour for 3 hours to check for bleeding, and at every diaper change after that. If your baby is greater than one month old at the time of his circumcision, the parents will need to check for bleeding every ½ hour for 8 hours, and at every diaper change after that. One or two drops of old blood on the diaper is fine, but any more than that should prompt you to call both your pediatrician and me. If the bleeding is excessive, or you can not get a hold of either your pediatrician or me, go to the Emergency Room. While you are waiting for a call back, put firm pressure on the penis with a dry, clean washcloth to help stop the bleeding.
Long-term care (over the next 5-7 days)
Over the first 2 days, the penis will look mildly swollen, beefy red and will develop a yellowish, wet looking scab (this is healing tissue). The swelling and redness should then start to decrease. Since the scab can stick to the diaper, it is important to place Vaseline on 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). In addition to the Vaseline, I will have you 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). I will show you how to do this step during the circumcision.
Remember:
1. Look for signs of infection. Call immediately if there are concerns regarding infection
- Liquidy pus rather than the healing yellowish scab.
- Increasing redness and swelling rather than decreasing redness or swelling.
- Increasing tenderness
- Possible fever.
2. No regular bath until the circumcision heals and the cord falls off.
3. Use a wet wash cloth rather than a baby wipe to clean the circumcision area until it is healed. You may still use a baby wipe over other areas.