Wound Care after the Procedure
There are two layers of dressings applied to your son’s penis after the procedure. The outer dressing is a square of “Combine” containing soft cotton wool, acting as a cushion to protect the penis from being rubbed on the nappy. It may come away with the next nappy change. If not, then remove it gently and discard at the next nappy change after the procedure, about 2 hours or so after the procedure.
The other dressing applied directly to the penis is a cotton wool ball unravelled to form a strip and soaked in a brown, sticky, antiseptic liquid, and then wrapped around the penis. This dressing adheres to the wound, sealing it, reducing blood loss and providing antiseptic cover. This dressing is to be left alone and the child not bathed until approximately 36 to 48 hours after the procedure. It will change to a grey/ yellow colour. Urine will soak through it and sometimes moist stools will cover it. Simply pick off the stools as best as you can, but you cannot keep it clean.
Bath your child at approximately 36 to 48 hours after the procedure. Soak him in a long warm bath for 3 -5 minutes, and then gently tease free the cotton wool dressing. It is best to have one person hold him in the bath, while another teases off the dressing, one hand holding the end of the dressing closest to the body and the other hand pulling the tip of the dressing against this first hand. If it all does not come away, then the remainder should be teased off in the next bath the following day. Occasionally, this dressing will fall off by itself before the 36 to 48 hour bath. If so, start applying the Vaseline as described below, but still do not bath him until the 36 to 48 hour time.
The appearance of the head of the penis after removal of the dressing will vary depending upon how adherent the foreskin had been to the head of the penis prior to the procedure. It may look red and raw in patches with a thick yellow slough covering over parts or all of the head of the penis and at some edges of the cut area. This is part of the healing process and does not reflect infection. Vaseline or Dermeze in thick amounts should be applied to the head of the penis from the first bath onward at every nappy change and after every bath, until the entire area is pink and clean. This will usually take another 7-10 days after the bath.