BABY CIRCUMCISION CARE AND FOLLOWUP 

Follow-up After Traditional Circumcision Without Stitches

After a traditional circumcision without stitches, part or all of the wound is intentionally left open to heal naturally. This is called healing by secondary intention: the raw surface develops a normal protective healing layer, while new skin gradually forms underneath. The wound can look very different from a stitched circumcision and may remain red, swollen and raw-looking for several weeks.

 

Please continue regular breast or bottle feeds and allow your baby plenty of rest. Babies can be more unsettled during the first few days, particularly during nappy changes or when the area is cleaned.

 

Dr Martin Harris will remain in contact during the healing period and will review progress over the first 10 to 14 days. Please contact him at any stage if you are concerned about your baby’s comfort, feeding, urine output, wound appearance or healing.

Dressing, nappy care and hygiene

Follow the individual instructions provided by Dr Harris regarding removal of the initial dressing and the timing of the first bath. Once the original dressing has been removed, a loose gauze cover may sometimes be placed around the penis. If this falls off naturally, this is usually not a problem; do not try to replace it unless Dr Harris has advised you to do so.

 

Always wash your hands thoroughly with soap and warm water before and after nappy changes or touching the area around the wound.

 

Use disposable nappies and fasten them loosely to minimise friction and pressure. Change nappies promptly when wet or soiled.

 

From the first dressing change, apply a generous amount of plain petroleum jelly, such as Vaseline, to the outside of the tip of the penis and/or the front of the nappy at each nappy change, as advised by Dr Harris. This helps prevent the healing area from sticking to the nappy and reduces rubbing. Do not push petroleum jelly into the urinary opening.

 

Continue using petroleum jelly for the length of time advised by Dr Harris. Some babies benefit from its use during the first few months while the skin margin continues to soften and settle.

Bathing and cleaning

Bathe your baby only from the day advised by Dr Harris. Use warm water and clean the area gently. Do not scrub, rub, pick at, or attempt to remove material attached to the healing surface.

 

Do not apply antiseptic liquids, talcum powder, perfumed products, creams or antibiotic ointment unless these have been specifically recommended by Dr Harris. The healing surface is delicate, and unnecessary products may cause irritation.

 

After bathing, gently pat the surrounding skin dry. Do not rub the wound.

What normal secondary-intention healing looks like

A circumcision performed without stitches often looks more open than a circumcision closed with stitches. This is expected. The skin edges may not meet immediately, leaving a raw area around the circumcision line while healing takes place.

During the first three to six weeks, it is common to see:

• a red or raw-looking circumcision line;
• swelling around the wound;
• bruising or temporary colour change;
• a raised rim, ridge or “band” of healing tissue around the shaft;
• a yellow, cream, beige or whitish layer over the raw surface;
• a small amount of clear or yellow-tinged wound fluid; and
• gradual closing and smoothing of the raw area over time.

The yellow, beige or whitish material is usually normal healing exudate or fibrin. It forms a protective layer over the raw surface and should not be confused with pus. New skin develops beneath this layer.

Initial surface healing commonly takes around three to six weeks. The swelling, thickened skin margin and final cosmetic appearance may continue to settle for longer. Healing varies between babies and depends on the size of the raw area and the individual healing response.

Pain relief

Give pain relief only as advised by Dr Harris, using the medication, dose and timing appropriate for your baby’s age and weight. If you are unsure whether to give medication, or uncertain about the correct dose, contact Dr Harris or a pharmacist before giving it.

When to contact Dr Harris promptly

Please contact Dr Harris if you notice:

• fresh bleeding that is persistent, dripping, or soaking a dressing or nappy;
• redness spreading away from the wound or rapidly increasing swelling;
• worsening discomfort or persistent distress that does not settle with feeding, comforting or the agreed pain-relief plan;
• thick, cloudy or foul-smelling discharge;
• a fever or your baby appearing generally unwell;
• poor feeding, repeated vomiting, unusual sleepiness, or significantly fewer wet nappies;
• difficulty passing urine, a weak urinary stream, or no urine in the nappy;
• a wound that appears to be worsening rather than gradually improving; or
• any uncertainty about whether the appearance is normal.

If your baby is under 3 months old and has a temperature of 38°C or above, urgent medical assessment is required. Seek emergency medical help immediately for heavy bleeding, marked lethargy, pallor, floppiness, breathing difficulty, or any baby who appears seriously unwell.

 

If family members, carers or healthcare professionals are unfamiliar with traditional circumcision healing, the red raw appearance and yellow healing layer can be alarming. Please contact Dr Harris. 

 

Thank you for trusting Dr Martin Harris Circumcision London with your baby’s care.

No question is too small when it comes to your baby's health and comfort.