Aftercare

Aftercare

FOR THE PLASTIBELL METHOD

 

General Advice

  • Check the operated area regularly for the first 48 hours for bleeding. A slight ooze is to be expected, and is of no concern. If heavier, then apply the supplied bandage and tape as directed and demonstrated. Then contact the emergency number provided.
  • Slight swelling with or without a small amount of bruising to the local area is to be expected from the local anaesthetic injection which should settle in a few days.
  • If still in nappies, apply them loosely & change them as soon as they are soiled.
  • For older children loose underwear with pyjamas or loose trousers are recommended.
  • Protect the affected area from local trauma.
  • Complete healing is expected in two to four weeks depending upon age.

 

Plastibell Ring Device 

  • The Plastibell ring should fall off between the 7th to the 20th post operative day depending upon age and size. Your surgeon will tell you an approximate time frame for this.
  • Every day when bathing your child gently pull at the ring as demonstrated. This will encourage the ring to come off in due course. Do not apply excessive force.

If the plastibell device has failed to come off by the expected time as given to you by the surgeon, then contact us.

 

ONCE THE PLASTIBELL DEVICE HAS FALLEN OFF A SMALL AMOUNT OF RESIDUAL SWELLING WITH A POSSIBLE WHITE/YELLOW STAINING IS TO BE EXPECTED. THIS SHOULD SETTLE OVER THE NEXT TWO TO THREE WEEKS.

 

Pain Control

  • Apply the topical painkilling gel (supplied) locally as directed every time you change nappies or every 1- 2 hours as a minimum for the first 24 hours.
  • The local anaesthetic used in the procedure renders the procedure painless and will continue to act for up to 4 – 8 hours. After this, minimal pain may be felt which can be either ignored, or simple oral painkillers such as paracetamol can be given. (Do not use any oral painkillers if the child is under two months old). See the manufacturer’s guidance for dosage and frequency.

 

Bath & Urination

  • Bathing should take place in normal fashion from the following day using warm water and a mild antiseptic such as SAVLON. Use the antiseptic sachets provided as directed.
  • Urination is expected to be normal and do report to us if there is any concerns.

 

FOR THE FREEHAND/CONVENTIONAL METHOD

 

General Advice

  • Check the operated area regularly for the first 48 hours for bleeding. Slight ooze is to be expected, and is of no concern. If heavier then apply the supplied bandage and tape as directed & demonstrated and contact the emergency number provided.
  • Slight swelling, with or without a small amount of bruising to the local area is to be expected from the local anaesthetic injection which should settle in a few days.
  • If still in nappies, apply them loosely & change them as soon as they are soiled.
  • For older children loose underwear with pyjamas or loose trousers are recommended.
  • Protect the affected area from local trauma.
  • Complete healing is expected in two to four weeks depending upon age.

 

Conventional Cut and Stitch Method

  • The dressing, (if applied) to the wound should fall off spontaneously after 1-2 days.
  • If it does not, on the third day soak in a bath for 20 – 30 minutes, after which the wet dressing can be gently prised off. Peel the bandage off. DO NOT PULL it off. There is no need to replace it.
  • Apply the topical antibiotic ointment to the wound area twice a day and take antibiotics as directed.
  • The stitches used will dissolve themselves; there is no need to have them removed.
  • If stitches have not come off by the end of the third week, soak in a bath for 20-30 minutes & gently rub the stitched area with a clean cloth, which should encourage them to fall off.
  • Complete healing is expected in three to six weeks time depending upon patients age and size.
  • On day one maintain strict bed rest for the first 24 hours.
  • From day 2 to day 3 walk around indoors and no running.
  • From day 4 to day 7 resume light activities with no running.
  • For the first week rest and minimal activity should be the norm.
  • For the first two weeks no heavy lifting at all and no sports.
  • For the first four weeks no sexual activity at all.

 

Pain Control

  • Apply the topical painkilling gel (supplied) as directed every time you change the nappies or every 1- 2 hours as a minimum for the first 24 hours.
  • The local anaesthetic used in the procedure renders the procedure painless and will continue to act for up to 4 – 8 hours. After this, minimal pain may be felt which can be either ignored, or simple oral painkillers such as paracetamol can be given. (Do not use any oral painkillers if the child is under two months old). See the manufacturer’s guidance for dosage and frequency.

 

Bath & Urination

  • Bathing should take place in normal fashion from the following day using warm water and a mild antiseptic such as SAVLON. Use the antiseptic sachets provided as directed.
  • Urination is expected to be normal and do report to us if there is any concerns.

  

FAQ TEEN/ADULT CIRCUMCISION

 

After-care

After the operation your local area will be swollen and look bruised. This is a normal effect of both the injected anaesthetic and the handling it necessarily receives during the operation. These will gradually reduce over the next week or two.

Underwear

If you normally wear boxers you may find that they give insufficient support immediately post-operative. You may wish to consider some form of briefs which will hold your penis in position and thus reduce the frictional stimulation which it would otherwise receive if allowed to swing freely.

The Bandage

It serves two purposes, to protect the wound and to contain/reduce the swelling.

  • Removal of the initial bandage is a compromise between maintaining the compression for as long as possible to reduce swelling as fast as possible, and changing the dressing on the wound before it sticks too much to the healing skin.
  • 2 to 3 days after the operation is generally regarded as the best compromise time. The bandage may be stained with small amounts of blood (particularly the inner layers) and will need to be soaked off in the bath to avoid tearing the healing wound.
  • Place only enough lukewarm water in a bath as needed to just cover your groin completely.
  • You may wish to put in a few spoonful of salt to promote healing.
  • Add in the antiseptic solution provided.
  • Now peel, not pull away any tape holding the bandage. If needed cut the bandage into manageable lengths as you unwind it. (Having a small plastic bag available to throw the used bandage into is a good idea.)
  • Slowly unwind the bandage, stopping whenever you start to need to use any force to release it ­ let the water soak the clotted blood off and then continue.
  • Be sure to remove the entire bandage, including any odd strands of gauze that might otherwise become embedded in the wound.
  • Once the bandage is off, spill away any bloody water and replace it with more lukewarm water.
  • Allow the exposed area to soak for a few minutes (not too long, but enough to remove caked blood) and then pat dry with a gauze pad followed by applying a fresh bandage to protect the wound as it continues to heal.
  • A thin coating of a bland ointment, e.g. Vaseline, before applying the bandage will reduce the possibility of blood making it stick to the skin.

Pain Killers

Everyone reacts differently with respect to pain. For most people a circumcision will not be truly painful, but a degree of discomfort is to be expected during the first few days.

If you choose to take pain killing tablets, then follow the instructions precisely. Do not take more than the recommended maximum dose.

If you have a favourite brand of pain killer and the doctor has prescribed something else, be sure to ask about the effects of ‘mixing and matching’.

Do not take Aspirin or any Aspirin based product since these thin the blood and have an anti-clotting action which can increase bleeding from a wound.

The Stitches

The stitches need to remain in place long enough for the cut edges to knit together and to allow the skin around them to fully heal. In practice this usually means they should remain for between 2 and 3 weeks. Leaving them longer increases the risk of small holes (or ‘stitch tunnels’) remaining in the skin.

Although the doctor will normally use soluble (or self-dissolving) stitches they should still be removed after 3 weeks if not already dissolved by then.

Erections

To reduce the effect of nocturnal erections pulling on the stitches during the first few days, empty your bladder before going to bed and a few times during the night. Do not lie on your back, but on your side. It may be helpful to draw your knees up a bit into a more foetal position.

Sexual Activity

Do not be over eager to engage in sexual activity until your circumcision has healed, which will normally take up to six weeks.

To avoid excessive friction on the healing scar line you may wish to consider the use of a condom. A condom should always be used for penetrative sex (even with a regular partner) until the scar line is completely healed and settled down, which may take two to three months to achieve.

Time off School or Work

 

There is no absolute need to take time off school or work after circumcision, but you may find it very hard to concentrate on work for the first few days and so may find it useful to take a week off.

A week, or even two off work is very desirable if you do heavy lifting or if your job keeps you seated and unable to move around freely for long periods.

Do not schedule a circumcision immediately before major examinations.

You should naturally avoid fast-moving or contact sports, cycling and swimming until your circumcision has fully healed.