Manual for Male Circumcision under Local Anaesthesia

Male circumcision under local anaesthesia
Version 3.1 (Dec09)
Fig 5.22 Horizontal mattress suture at the frenulum (6 o’clock position)
When placing the frenulum suture, take care to align the midline skin
raphe with the line of the frenulum (Fig. 5.23). A common error is to
misalign the frenulum and the midline skin raphe, which results in
misalignment of the whole circumcision closure.
Fig. 5.23 Alignment of the midline skin raphe on the shaft of the penis
and the line of the frenulum.
Step 9. Place a vertical mattress suture opposite the frenulum, in the
12 o’clock position (Fig. 5.24). The suture should be placed so that
there is an equal amount of skin on each side of the penis between the
12 and 6 o’clock positions. The technique of vertical mattress suture is
shown in Fig. 5.6. Place two further vertical mattress stitches in the 3
o’clock and 9 o’clock positions (see Fig. 5.8).
Surgical procedures for adults and adolescents Chapter 5-20