Care&Procedure

Circumcision Care & Procedure Circumcision Care & Procedure

Circumcision Care & procedure is explained by Dr Martin Harris Circumcision in Golders Green, North West London. At your initial consultation or contact you will be encouraged to discuss all aspects of the procedure with Dr Harris. This will enable you to make your decision knowing exactly what is involved. The procedure is carried out by Dr Harris.

Preoperative care

Circumcision Care & procedure includes preoperative care, signed consent, operative care and aftercare. Before the operation, Dr Harris will discuss the nature and purpose of the procedure, and obtain signed consent before performing the procedure.

INFORMATION NOTES ON DR HARRIS CIRCUMCISION FOR PARENTS FROM DR HARRIS

What is a circumcision? The word circumcision means removal of the foreskin and the edges heal together. On rare occasions dissolvable stitches are used.

 Signed Consent  You will be asked to sign your consent for the circumcision operation on your son. If you are not clear about any part of the operation or explanation, ask for more details from Dr Harris who is never too busy to advise. Your son child will be seen by Dr Harris who will be doing the operation. Dr Harris will check that all the necessary preparations have been made.

Timing of the operation. The operation time is arranged. Your child should have been fed up to one hour before the operation.

Anaesthetic The circumcision procedure is performed as a day case in the clinic or at home. Dr Harris gives a local anaesthetic cream (not injection) also oral paracetamol by mouth.

How long does the operation take? The sterile surgical operation is very quick usually taking a few moments.

 Wound Dressing

• a dressing is placed around the penis after the operation. This is to absorb the small amount of blood that may leak out from the wound.

• the wound will appear raw and swollen and this appearance will start to settle down within a few days.

 What happens after the operation?

The next instruction leaflet after the circumcision gives full aftercare instructions.

• Baby is fed after the operation.

• Pain relief medication is available and advised; Baby is unsettled for the first 24 hours.

• The instruction leaflet after the procedure aftercare details keeping in contact with Dr Harris every four hours or earlier if you are concerned in any way.

Follow-up appointment

• The next follow-up appointment is the following day after the procedure regarding the wound and the dressing.

• The final instruction leaflet next day details wound care and bathing.

Are there any complications following a Circumcision?

Complications are rare. Occasionally there is bleeding or swelling. Other complications may include infection, meatal ulcer or stenosis, & reop.

• Sometimes the wound continues to leak fluid or blood. If this happens try to apply pressure. If it does not stop please contact Dr Harris.

• If you notice your wound looks very red and swollen or you have a yellow (pus)

discharge around the wound area you may have an infection, please contact Dr Harris.

Comments Dr Harris welcomes your comments and suggestions covering your child’s procedure, treatment and recovery. If you have any problems, concerns or comments please contact him direct.

Pain relief and Anaesthesia.

The procedure is undertaken with appropriate pain relief and aftercare. Dr Harris has the necessary skills and experience both to perform the operation and use appropriate measures, including anaesthesia, to minimise pain and discomfort. Dr Harris gives a local anaesthetic cream (not injection) also oral paracetamol by mouth. Dr Harris will discuss and advise with written instructions.

Signed consent

Dr Harris will ask you to sign your consent for the circumcision operation on your son. If you are not clear about any part of the operation or explanation, ask for more details from Dr Harris who is never too busy to do this. Your son child will be seen by Dr Harris who will be doing the operation and he will check that all the necessary preparations have been made.

Postoperative care- First 24 hours

Dr Harris will explain the care needed and 24 hour contact following the procedure. He will provide written instructions, which should be read carefully and this includes details on change of dressing and a bath. Dr Harris will advise on followup.

AFTERCARE FOR THE FIRST 24HOURS: includes

Baby will be unsettled the first 24 hrs and requires regular feeding.
POSITION of the baby.
WINDING of the baby over the shoulder.
NAPPY CHECK but do not dislodge dressing.
NAPPY CHANGE directions.
NAPPY CHANGE  and sequence with feeding.
DRESSINGS explained.
TOP GAUZE SWAB additional cover, applied but not tied.
SOILING and what to do.
URINE COLOUR expected.
FRESH BLEEDING what to observe.
ANALGESIA PAIN RELIEF treatment guidelines & dosage.
PLEASE DO NOT BATH BABY OR APPLY DOUBLE NAPPIES.
ARRANGE NEXT & FURTHER CONTACT.
IF YOU HAVE ANY CONCERNS AT ALL, PLEASE CONTACT DR HARRIS.

Postoperative care- next day, 24 hours after operation

Dr Harris will change the dressings and provide written instructions, including change of dressing and bath. it is important that these instructions are read carefully and Dr Harris will advise on followup.

AFTERCARE FOR THE NEXT DAY 24HOURS AFTER THE OPERATION:
FOLLOWUP NOTES FOR PARENTS FROM DR HARRIS

AFTER CHANGING THE DRESSINGS THE DAY AFTER THE OPERATION: PLEASE READ CAREFULLLY

1. APPEARANCE

THE DRESSINGS HAVE NOW BEEN REMOVED AND THE NORMAL APPEARANCE IS RED AND RAW
WHICH GRADUALLY SETTLES INITIALLY OVER 14-21 DAYS. A LOOSE GAUZE SWAB COVER HAS BEEN PLACED AROUND,WHICH MAY COME OFF SPONTANEOUSLY(WHICH IS QUITE NORMAL, DON’T WORRY!)
OTHERWISE THIS SHOULD BE REMOVED WHILE IN HIS NEXT BATH.

 2. NEXT BATH IS ON ______DAY.

Dr Harris will explain and discuss maintaining wound care.

3. REPEAT ALTERNATE DAY BATH & CLEANING AFTER HIS BATH FOR ABOUT 1 WEEK.

4. HEALING APPEARANCE

THE COLOUR, APPEARANCE & BLEEDING GRADUALLY SETTLE INITIALLY OVER 14-21 DAYS. THE RED RAW HEALING AREA EXUDES HEALING TISSUE (NOT PUS). THE SWELLING AROUND GRADUALLY RESOLVES.
The wound of a baby after traditional circumcision looks different to that of a baby after surgical circumcision with stitches.

This healing process is explained by Dr Harris.

This exudate will be beige in colour, thin or thick in consistency, not to be confused with pus or infection. Exudate is normal healing of this type of circumcision wound since there are no stitches. The time taken for the wound to heal completely depends on the age of the child and the size of the raw area, but initially is 14-21 days. The joining skin (“rim, ridge, tyre, band”) takes much longer.

5. The unusual appearance amazes/concerns those doctors and nurses who have not previously seen this traditional method (no stitch) of normal wound healing (exposed raw flesh on the penile shaft, NOT pus/wound infection) around the skin margins. Please reassure anyone who has not witnessed this normal healing process.

6. Dr Harris would like to review the healing at the clinic at 10-14 days.

IF YOU HAVE ANY CONCERNS WHATSOEVER AT ANY TIME  =>CONTACT DR HARRIS

Professional Service
Dr Harris has the necessary skills and experience both to perform the operation and use appropriate measures, including anaesthesia, to minimise pain and discomfort.
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