The “Wolf and” brand disposable circumcision suture device consists of the following components.
Bell-shaped glans seat, knife anvil ring, nail warehouse ring, suture nail, top cutting body, main body shell, handle, adjustment knob, safety button, etc.
Preparation before surgery.
1.Conventional skin preparation, iodine disinfection towel.
2.Conventional local anesthesia or general anesthesia (sacral anesthesia can also be used).
3, first deal with the comorbidities: prepuce need to expand the foreskin mouth first, if necessary, scissors can be used to cut open, in order to facilitate the placement of bell-shaped glans; adhesions have to separate adhesions; ties too short also need to correct first, all the pre-treatment need to be thoroughly stop bleeding first.
Surgical operation standard procedure
1. Clamp the ventral part of the foreskin (at the ligature) with a hemostatic forceps at the internal and external plates, and then clamp the other parts with two to four hemostatic forceps respectively in order to lift the foreskin. Note that the inner plate is appropriately tightened and the ligature is kept loose to ensure that the ligature is not excised too much.
2. Lift the foreskin and place the bell-shaped glans into the foreskin, with the bell covering the glans. Hold the skin against the abdominal wall to prevent lifting and push the glans into the hood at the tether.
3.Tilt the longitudinal axis of the bell-shaped glans into a certain angle with the longitudinal axis of the penis to keep the bell along the same direction as the coronal sulcus to ensure accurate positioning of the pre-cut area.
4.Fix the foreskin on the puller with a tie or silk thread.
5.Check again to make sure that the pre-cutting site is accurate and that the foreskin is adequately fixed on the puller, determine the cutting position and make sure that the tether is loose. If the foreskin is too thick and too much or if the foreskin is relatively too much for a small child, the excess foreskin must be cut outside of the tie or ligature so that the instrument can be placed smoothly and cut perfectly.
6, the instrument set on, screw on and tighten the adjustment knob to pull the rod end face and the back of the knob flat or slightly protrude (do not exceed 0.5mm), adjust the two “ears” of the knob to avoid the direction of the handle so that when the handle is pressed there will be no conflict.
7. Remove the safety clasp, hold the first 2/3 of the handle with the right hand to facilitate forceful pressing, and hold the last 1/3 with the left hand to facilitate stability, the handle is pressed simultaneously or successively, the foreskin is cut and sutured simultaneously.
8.Let go of the handle after a few seconds, when the handle will not be released on its own, hand-assisted release is available.
9.Hold the instrument with your left hand and turn the adjusting knob with your right hand up to 5-10mm, turn the knob forward to make the cutting part loose and observe whether it is completely cut, if there is a little uncut, use a blade or scissors to trim.
10, gently spin out the bell-shaped glans seat and immediately wrap the surgical site with dry gauze, use five fingers evenly separated to stop bleeding (cutting suture squeezing process will cause tissue seepage) for a few minutes (depending on the situation can be pressed for 3-8 minutes), release and then see the suture (this process can be omitted after surgical proficiency, after cutting can be directly after the pressure bandage), if encountered rare In case of rare spotted blood spray, additional sutures must be added to stop the bleeding.
11, immediately wrapped with dry gauze (also can be wrapped in a little Vaseline or iodine gauze strip is inside the gauze), preferably with self-adhesive elastic bandage appropriate pressure and properly wrapped (can not let the dressing in a short time off), no self-adhesive elastic bandage, it is recommended to sew the outer dressing to prevent a short time loose, if the degree of elasticity is not grasped, under the premise of playing the role of pressure, it is best to a few stitches loose a few stitches tight.
Postoperative care.
1, when the pressure is too tight resulting in difficulty in urination, the patient can loosen the elastic bandage for one or two turns by themselves (never loosen all of them, otherwise hematoma will appear), and then make a slightly loose pressure bandage. If the stitches are sewn, the patient can cut off a few stitches that are too tight. After two to three days, the dressing can be slightly loosened.
2, dressing contamination requires timely dressing change treatment. Children can be loosened after two or three days according to the specific situation, local iodine disinfection treatment several times a day, friction discomfort, loose bandage is possible.
3.After one week, you can take a shower and disinfect the surgical opening with iodophor after bathing. To prevent discomfort from friction with underwear, you can wrap it with gauze or handkerchief.
4.After that, disinfect the operation opening with iodophor more than twice a day.
5.Do not over-activate for one month.
6.Usually, the staples will start to fall off one week after the surgery, and the concentrated falling off time is in the third and fourth week, and most of them will be finished within one month.
7. Due to individual reasons, some people will be allergic to iodophor and show local edema, sometimes drops to the scrotum also appear edema. Then you can no longer use iodophor. Erythromycin ointment can be used instead.
8. It is recommended that sexual intercourse be prohibited for 50 days.