Manual for Male Circumcision under Local Anaesthesia

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Male circumcision under local anaesthesia Version 3.1 (Dec09) Appendix 6.2 SAMPLE CONSENT DOCUMENT FOR A MINOR The name of my son/ward is _______________________ (BLOCK CAPITALS) My name is __________________________ (BLOCK CAPITALS) I am the boy’s parent/legal guardian. I am asking you to do a circumcision operation (removal of the foreskin) on my son/ward and I give you permission to do this operation. Signed ………………………………………… (parent or legal guardian) My name is __________________________________ (BLOCK CAPITALS) I am the counsellor/surgeon who has given information to the parent or guardian of the above-mentioned boy. I have given information about: • what circumcision is; • the benefits of circumcision; • how circumcision is done; • the risks of circumcision; • what to do before circumcision; • what to do after circumcision; • what to do if there are any complications or problems after circumcision; • an emergency contact number and information about where to go in an emergency. I have given the client an opportunity to ask me questions about all the above. I have asked the parent or guardian some questions to make sure that he or she understands the information I have given. To the best of my belief the client is capable of giving consent and has enough information to make a proper decision about whether to proceed with the operation of circumcision. Signed ……………………………………………………… (Circumcision clinic counsellor or surgeon) Infant and paediatric circumcision Chapter 6 - 26
Male circumcision under local anaesthesia Version 3.1 (Dec09) Chapter 7 Postoperative care and management of complications Summary • Possible complications of male circumcision include excessive bleeding, formation of haematoma, infection, an unsatisfactory cosmetic effect, lacerations of the penile or scrotal skin, and injury to the glans. • Certain complications can be managed in the clinic. For others, the patient may need to be referred to a higher level of care. • Complications of circumcision can be avoided by ensuring asepsis during the procedure, performing careful and accurate excision of the inner and outer preputial layers, ensuring adequate haemostasis, and paying attention to the cosmetic result. POSTOPERATIVE CARE Postoperative monitoring It is very important to monitor the client for at least 30 minutes after surgery, because it is during this period that the effects of surgical trauma and other complications become apparent. Nurses or other staff members can carry out the tasks related to postoperative recovery and discharge, but the surgeon is ultimately responsible for the quality of post-circumcision care. The summary below assumes that the circumcision has been performed in a clinic under local anaesthetic. If circumcision was performed in a hospital under general anaesthetic, the normal hospital recovery room protocols should be followed. a • Receive the client from the theatre; review the client record. • Monitor the client’s vital signs: check blood pressure, breathing, and pulse twice, at 15-minute intervals. • Check the surgical dressing for oozing or bleeding. • Ask the patient if he has any pain. • Observe the general condition of the client. • Administer any drugs or treatment prescribed. • Provide bland carbohydrates (such as a biscuit) and liquids to raise blood sugar levels unless medically contraindicated. • Handle the client gently when moving him. • Make the client comfortable, according to the climate. • Complete the client record form. Postoperative care and management of complications Chapter 7-1
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Manual for Male Circumcision under Local Anaesthesia

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