Manual for Male Circumcision under Local Anaesthesia

Male circumcision under local anaesthesia
Version 3.1 (Dec09)
Fig. 6.14 Snapping off the Plastibell handle
Step 8. Check that there is no bleeding. If all is well, the child
can be sent home and looked after in the normal way,
including normal washing and use of nappies. The rim of tissue
distal to the ligature will become necrotic and the Plastibell will
drop off after 5–8 days. Alternatively the infant can be checked
after 36–48 hours and the ligature cut.
Information for parents
The parents of infants and children who have had a Plastibell
circumcision should be told that it is not necessary to use a
dressing, and the baby can be looked after in the normal way,
including normal washing and use of nappies. Healing is
usually complete after about one week. Bleeding is rare
because the clamp crushes the edge of the foreskin. The
parents should be told to come back to the clinic if:
• the child appears to be distressed or in pain;
• the child has fever;
• the child does not wake for feeding as per his usual
pattern;
• there is any separation of the skin edges;
• there is any unusual swelling or bleeding;
• the child has any difficulties with urination;
• the plastic ring slips onto the shaft of the penis;
• the tip of the penis becomes swollen or changes colour
• one part of the foreskin remains pink or has not
shrivelled after 48 hours;
• the plastic ring has not fallen off within 8 days;
• the parents have any other worry about healing.
Infant and paediatric circumcision Chapter 6 - 16