Antepartum, Maternal And Newborn – Newborn: Circumcision Care SECTION: 19.12 Strength of Evidence Level: 3 __RN__LPN/LVN__HHA

PURPOSE: AFTER CARE: To promote healing of circumcision site. 1. Document in patient's record: a. Appearance of circumcision site. CONSIDERATIONS: b. Treatment provided. 1. Yellowish, white exudate forms as part of the c. Patient's response to treatment. granulating process on/about the second day d. Instructions given to caregiver. following circumcision. This is NOT a sign of e. Document caregiver’s understanding of infection and should not be forcibly removed. treatment. 2. Instruct the caregiver to observe for bleeding, f. Physician notified of any signs of infection or swelling, redness, drainage or decreased urinary healing issues. output, which should be reported to the physician. 3. Petroleum dressing should be changed with each diaper change, if physician orders continued dressings. 4. After petroleum dressing has been removed, petroleum jelly should be applied with each diaper change until the skin has returned to a normal color (approximately 4 to 5 days). 5. Instruct the caregiver to allow extra room in the front of the diaper so that it does not press circumcised area. 6. Instruct the caregiver that it will take at least 7 to 10 days for the circumcision to heal and the plastibell (if used) to come off. The caregiver needs to wait for the plastibell to come off naturally; it may "hang by a thread" for a day or two prior. 7. Instruct caregiver to notify the care provider if the plastibell is not off within 10 days.

EQUIPMENT: Water Petroleum gauze, 3/4 inch width (optional) Diaper Gloves Impervious trash bag Petroleum jelly

PROCEDURE: 1. Adhere to Standard Precautions. 2. Remove diaper slowly; if diaper is sticking to penis, use warm water soak to remove. 3. Remove old petroleum dressing gently. If unable to remove dressing, moisten with warm water. 4. Cleanse penis by gently dripping clean, warm water over it to remove dry urine and/or feces. 5. Reapply new petroleum dressing or ring of petroleum to the penis and around the foreskin. Loosely apply diaper to prevent friction against the penis. 6. If a plastibell was utilized, no dressing is required. 7. Discard soiled supplies in appropriate containers.