Manual for Male Circumcision under Local Anaesthesia

Male circumcision under local anaesthesia
Version 3.1 (Dec09)
Fig. 6.25 Excising the foreskin.
Fig. 6.26 Completed Gomco clamp procedure.
Step 7. Once the clamp has been removed (Fig 6.26), the
crushed skin edge will typically have resulted in haemostasis
with good tissue alignment. Normally in early infancy, no
sutures are required. In older infants (>60 days) it may be
necessary to place some 5-0 simple sutures to approximate
the edges.
To obtain a good result with the Gomco clamp, the surgeon
must ensure:
(a) the dorsal slit is not made too long, the apex must be
above the crushed skin edge.
(b) the crossbar of the bell is placed evenly in the yoke of the
rocker arm, so that there is an even distribution of the
crushing force; and
(c) the foreskin is symmetrically aligned over the bell.
Information for parents
The parents of an infant or child who has had a Gomco clamp
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 the use of nappies. Healing is
usually complete after about one week. Bleeding is rare
Infant and paediatric circumcision Chapter 6 - 23