Manual for Male Circumcision under Local Anaesthesia

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Male circumcision under local anaesthesia Version 3.1 (Dec09) Fig. 5.40 Dissecting the sleeve of skin away from the shaft of the penis. Tie off any bleeding vessels with under-running sutures. Step 8. Stop any bleeding and suture, as described in steps 7 – 10 of the forceps-guided method. Step 9. Once the wound has been sutured, check for bleeding. If there is none, apply a dressing as described below. Surgical procedures for adults and adolescents Chapter 5-30
Male circumcision under local anaesthesia Version 3.1 (Dec09) DRESSING Irrespective of the method of circumcision, a standard penile dressing technique is used. Check that there is no bleeding. Minor bleeding from a skin edge will often stop after five minutes of pressure with a gauze. Once all bleeding has stopped, place a piece of petroleum-jelly-impregnated gauze (tulle gras) around the wound. Place a sterile dry gauze over this, and secure in position with adhesive tape (Fig 5.41). Take care not to apply the dressing too tightly, as it could restrict the blood supply and cause necrosis of the glans. Fig. 5.41 Standard dressing. The dressing should be left in position no longer than 48 hours. Either the patient can return to the clinic where the circumcision was performed, or go to another clinic for postoperative follow-up and removal of the dressing. If the dressing has dried out, it should be gently dabbed with antiseptic solution (aqueous cetrimide) until it softens. It can then be removed gently (Fig 5.42). It is important not to disrupt the wound by pulling at a dressing that has dried to the wound. A B C Fig. 5.42. A: after removal of the gauze swab.,B: using cetrimide to soak off a paraffin gauze that has dried to the wound. C: appearance of a wound healing normally 48 hours after the operation Surgical procedures for adults and adolescents Chapter 5-31
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Manual for Male Circumcision under Local Anaesthesia

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