Dr. Stefanie Green, M.D.
   Safe and Quick Infant Circumcisions


AFTERCARE

THE FIRST 2 HOURS | THE FIRST 24 HOURS | THE FIRST 72 HOURS | BLEEDING | APPEARANCE | NOT NORMAL IF




    PAIN BLOCKING
    Dr. Green uses the newest local nerve block technique and a longer acting anesthetic. The local anesthetic will wear off several hours after the procedure. Your son may be uncomfortable. Remember this is a 2 day event for him. If you feel he is uncomfortable you may give him some sugar, Dr. Green will teach you how to do this easily in your home. Sugar is well documented as a pain reliever in infants. You may keep doing this throughout the day. If you feel he is still too uncomfortable, you may give him a dose of infant acetaminophen (infant Tylenol drops).

    DO NOT give him ibuprofen (advil or motrin) as it may increase bleeding.


    THE FIRST 2 HOURS:

    There will be WHITE GAUZE with vaseline placed over the head of the penis after the procedure. Please leave it in place for 2 hours, then remove it.

  • If it gets soiled with urine- that's OK. Leave it in place.
  • If it gets soiled with stool, remove it, gently rinse the head of the penis with clean warm water (if absolutely necessary, you may use a cotton ball) and replace the gauze with Vaseline. The purpose of this gauze is to prevent the head of the penis from getting irritated by or sticking to the diaper.
  • If it falls off in the first 2 hours, please replace it with a fresh gauze with Vaseline.

    After the first 2 hours there is no need to replace the gauze. Simply coat the whole head of the penis and cut edge with a decent amount of VASELINE with every diaper change for 7 days.


    THE FIRST 24 HOURS:

    There will be a YELLOW GAUZE wrapped around your son's penis after the procedure. Please leave it in place for 24 hours, then remove it.

  • If it falls off early it's OK, leave it off.
  • If it is dry/stuck when you try to remove it, gently wet it with warm water, allow it to soften for several minutes and remove. If it is still stuck, you must pull slightly harder and understand the penis might bleed a few drops of blood when it comes off. That is NORMAL. If necessary, apply some pressure afterwards to stop the bleeding (see below for instructions).


    THE FIRST 72 HOURS:

  • Do not bathe your son for 3 days after the procedure. Wiping in his groin and under the scrotum with warm water and cloth every day is good enough.
  • Do not use any soap in the bath for 7 days.
  • Sponge baths are OK anytime
  • Do not use (chemical) wipes on his genitals for 3 days, it will just irritate him. Warm water on a cotton ball is best. You may gently wipe off any soiled areas on the penis. Using bum cream to prevent diaper rash is OK.


    BLEEDING

    It is NORMAL to have some blood in the diaper after circumcision for the first 24 hours. Spots the size of a twoonie for the first 3 diaper changes is normal. It should then become less and less.

    It is NOT NORMAL to have a dripping or flow of blood. If you see this, DO NOT REMOVE THE GAUZE, apply pressure to the area that is bleeding with a fresh gauze, firmly, for 3-5 minutes (No peeking! Keep the pressure on for 3-5 minutes by the clock.) The bleeding should have stopped. If not, repeat the process for a full 13 minutes of pressure. Again, do not remove the gauze to look at the site, this may increase bleeding. If after 2 times of applying pressure the penis is still actively bleeding, call Dr. Green.


    APPEARANCE

    It can look terrible for a few days.
    • It is NORMAL to have SWELLING around the head of the penis.
    • Sometimes what looks like a blister or ball of water forms on the underside.
    • Very often a yellow or green DISCOLOURATION forms on the head of the penis. This is NOT an infection but a normal healing process of skin in this area that may take up to a week to fade. NOTE: Some family doctors or walk in clinics are NOT familiar with this initial appearance and may mistakenly think there is an infection because of the discolouration and swelling. Please try to follow up with Dr. Green if you are concerned.
    • It may look as if too much or too little skin has been removed

      The penis will look much better in 1 week, and very good at 2 weeks.

    IT IS NOT NORMAL
    • to have a squirting or flow of blood
    • to develop a foul smell or actual pus
    • for the skin on the shaft of the penis, the scrotum or abdomen to turn red
    • to develop a fever
    • to not urinate in the first 12 hours

    If you suspect these things are happening, call Dr. Green.

    DR. GREEN WILL CALL YOU within 24 hours of the procedure to see how things are.