VASELINE!

• The most important aspect of the healing process is to APPLY LOTS OF VASELINE!
• 
  Apply a generous amount of Vaseline to the provided gauze, and apply it over the penis to form a ‘Peepee-Teepee’.  Apply this ‘Peepee-Teepee’ for the first 24-48 hours or until you run out of gauze. Then, apply Vaseline directly onto the area of the diaper that will be in contact with the penis. 

TO PROMOTE PROMPT HEALING:

• Keep the area clean and dry. Use disposable diapers for the first week; they tend to be less irritating and help keep the area drier and cleaner.
• Gently clean the area around the penis using a warm washcloth. You can use regular wipes for all other areas but the penis. DO NOT use alcohol, powders or lotion as these may cause irritation.
• Apply generous amounts of Vaseline in order to prevent the exposed foreskin from adhering to the diaper or forming adhesions with the penis glans.
• Apply gentle traction at the base of the penis to minimize the risk of adhesions.
• AVOID unnecessary car travel as car seats can be irritating to a newly circumcised penis.

FIRST FEW DAYS:

• It is normal for your baby to be a little irritable for the first 12-24 hours. We encourage you to keep him snugly swaddled since the less he kicks his legs, the more comfortable he will be.
• The best sleeping position for your baby is on his back or his side, supported by a blanket roll. Most babies sleep well following the circumcision.
• For the first week, give your baby sponge baths only.
• Avoid changing your son’s diaper too frequently as it may be uncomfortable for him. Only change him immediately after a bowel movement or after feeds, as per usual.
• With each diaper change, it is normal for the penis to be discoloured and for the gauze/diaper to be lightly stained with blood. A normal part of the healing process is to see a green-and-yellow-coloured membrane around the penis, especially on the underside, at the 6 o’clock position.
• If the skin has moved up slightly over the head of the penis, gently apply pressure on the sides of the penis to ensure it heals properly without any adhesions. DO NOT push on the skin for the first 48 hours because it will be swollen from the procedure.

WHAT TO WATCH FOR?

ACTIVE BLEEDING: How to stop it?

• As previously mentioned, we will re-examine your son’s penis 20 minutes after the circumcision. We will show you how to properly change your son’s diaper and make sure that there is no active bleeding.
• Minimal amounts of blood are normal, but active bleeding is not, and we will make sure that everything looks normal prior to your departure.
• Although rare, the most common reasons for bleeding to occur once at home are overly aggressive cleanings, not enough Vaseline applications, or too much pressure placed at the base of the penis for retraction.
• If bleeding occurs, treat it like a nose bleed and apply mild pressure. Grasp the gauze-covered penis between your thumb and two fingers, and apply pressure at the bleed site for 1-2 minutes. Then, inspect the area for continued bleeding. Repeat pressure if necessary.
• Leave the gauze in place, as removing it may lead to renewed bleeding. Make sure to apply Vaseline on the gauze. If needed, you may call the clinic for telephone advice or to book for a reassessment.
• Dr. Brulotte has never had a patient call or return to clinic because of bleeding.

INFECTION:

Although rare, infection can occur. Common signs of infection include:

• Puss-like discharge, foul smell, local warmth, or fever.
• If your son exhibits any of these signs, or if he has not urinated in over 12 hours, call Dr. Brulotte immediately.
• Dr. Brulotte has never had a case of infection after a circumcision.