Manual for Male Circumcision under Local Anaesthesia

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