1. Apply firm direct pressure using a sterile gauze to
any area of continued oozing of blood for a period of 10-15
minutes. Do NOT examine the wound while applying the
pressure. If the bleeding is persistent, or if one square
gauze is completely soaked, or if the diaper begins filling
with blood call me, or your physician, or take the baby to
the hospital! (This instruction is precautionary only, NOT
to be routinely used.)
2.Wash the genitals gently after each large bowel
movement (large = stool on the penis), using either a soft
cotton cloth, cotton balls, or a sponge with a few drops of
nondetergent soap (such as Ivory, Dove or Johnson's Baby
Bath) in warm water, rinse, then gently dry. Continue to
wash for a period of 10 days. (it is absolutely OK to wet
& touch the penis) Do NOT use abrasive cleaning wipes on
the circumcision wound!
3. When the baby urinates, simply change the dressing if
soaked, washing is not necessary. The baby will NOT
experience pain with urination... he cries because he is
wet.
4. Apply a copious amount of neosporin-plus ointment to
the center of a sterile gauze, and then gently place it onto
the penis for the first day, The second day, use a 50%
ointment mix (1/2 Neo/Myci-Plus + 1/2 vaseline). The third
day, use just the vaseline. Continue with pure vaseline for
the remaining 8 days of ointment treatment for a total of ten days of care. The penis may remain in any position and the
baby may sleep on his back or side. Do NOT tie anything
around the wound... ever!
5. To reiterate, apply some type of ointment
for the first 10 days after the circumcision.
I recommend: Day
1 (24hrs) of pure neosporin-plus ointment, then Day 2
(24hrs) of a 50% ointment mix, then Days 3-10 of pure
vaseline, again for a grand total of 10 days of
care.
6. If the gauze sticks
to the wound, simply soak the baby's bottom in a basin of
warm water. The baby may be fully bathed 10 days after the
circumcision, if the cord is off. ( i.e. when you have finished with the 10 days of dressing changes you may bath the baby.)
7. Be alert to the signs of infection, such as increases
in redness, pain or swelling. The baby may be irritable for
3-4 days and will heal in 12-14 days with residual swelling
up to three weeks (3 wks) after the circumcision.
8. If the wound appears to be attaching or sticking to
the head (glans) of the penis, firmly retract shaft skin 2
times per day, by grasping immediately beneath the healing
wound and firmly pulling down toward the penile base on Days
2-10. Q-Tips may be used instead of fingers to grasp the
adhering site. The head should always remain completely
visible, i.e., exposed. If in doubt, bring the baby to a
pediatrician for a quick examination.
9.If the baby is irritable you may dispense one single
dose (0.4 ml or 1/3 of the eyedropper) of Infant
Tylenol or Tempra drops 4 hours after the
circumcision. Again, this is a one time dose of
Tylenol or Tempra.
10. NOTE: The glans or head of the penis will be beefy
red in color; the area immediately behind the glans will be
quite swollen for several days. Small yellowish-white firm
plaques, moist crusts or a whitish filmy material may occur
near the wound or head of the penis, Days 3-10. This
plaque formation is normal and
will eventually disappear. The plaque is not foreskin...
foreskin does not grow back!
11. Please feel free to call me at any time with further
questions or problems and relax, the baby will heal just
fine!
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