I. Surgical experience and tips: 1. After putting the bell-shaped glans seat into the foreskin, use your right index finger to press gently at the ligature a few times to push the glans into the bell, make sure the ligature is loose at the ligature, and then tie the foreskin tightly on the puller.
2, the first use of this device, if it is really difficult to determine the circumcision site, you can put into the glans seat before, in the expected to cut the part of the ring-shaped circle (this circle for the circumcision site), and then about 1.5-2mm inside this circle and then a circle (this circle is put into the glans seat, and then put on the device, you can see in the head of the device outside, because the circumcision site after the installation of the device (not visible). Beijing University Shenzhen Hospital Urology Shi Bentao 3, in case the foreskin is too long and too thick or children, cut out the foreskin outside the tie line and then on the instrument, which is conducive to better cut and sew.
4, after cutting, loosen the adjustment knob about 5mm or more back, maintain the position, can not move too much, by the top of the adjustment knob forward to push out the bell-shaped glans seat, not good to push when you can lightly press the handle (try not to repeat the operation) will cut the suture parts (in front of the suture) to loosen, at this time to observe whether the foreskin is completely cut, if completely cut, then lightly rotate the exit instrument, if there is a little not cut, available scissors or If there is still a little uncut, the scissors or blade can be used to trim it slightly and then withdraw the instrument. Sometimes the blade is dragged out a small part of the knife anvil, there is no effect on the completion of surgery.
5.After withdrawing the instrument (do not take the time to observe), immediately wrap the incision with dry gauze and apply appropriate pressure to stop bleeding for about 5 minutes, when there is still active bleeding after release (rare), additional sutures can be added to stop bleeding, otherwise, appropriate pressure bandages can be applied as usual.
6, pressure bandage is recommended to use self-adhesive elastic bandage, otherwise it is better to sew a few stitches to the external dressing to avoid loosening in a short time.
7.There is usually no obvious abnormality after surgery, and when the bandage is too tight, the urine will feel uncomfortable. If the elastic bandage is wrapped, you can ask the patient to loosen a little, and then slightly looser wrapped on the line, if it is sewn, you can cut off one or two stitches that are tight.
8, available large condoms or protective plastic film, near the side with rubber bands not into the water then, after washing remove the condom or plastic film. A week later, you can remove the outer dressing under the shower, after the dry water, with iodine volt treatment of the surgical mouth, and thereafter several times a day with iodine volt treatment, according to personal factors to decide to package or not.
If the foreskin is thin, the surgery can be performed directly after 10 minutes of intramuscular injection of 50mg of dulcolax.
The foreskin can also be removed with consent during other lower abdominal or perineal procedures (when the circumcision site is also under anesthesia).
Since most circumcisions in children are performed under general anesthesia, some children may be circumcised at the same time as other surgeries.
Possible postoperative situations and methods of response: 1. The inner plate is left too much, and the way to overcome it is to pull the inner plate slightly tighter during the operation. 2.
2, the suture nail is not sutured to the surgical opening, if the rod is rotated in place, there are two other reasons, one is too much action, remove the glans seat when the suture nail has been sewn to pull apart, the second is the foreskin is really too thick, the suture nail can not eat. Overcome the method is to take the glans seat to lightly rotate out, if you see a little uncut, you can use scissors or blades to trim a little before taking; foreskin is too thick, in tightening the foreskin on the rod, the foreskin outside the tie first cut, and then set on the instrument for cutting, adjust the knob to turn tighter, cut when the time to press the handle a little longer.
3, post-operative hematoma formation, the method to overcome is to remove the glans seat, immediately wrap the operation mouth with dry gauze, pressure for about 5 minutes to stop bleeding on its own (because the operation has a squeezing process, near the operation mouth about 1 mm of tissue or some extrusion injury, not a few minutes of pressure to stop bleeding, there will be some blood seepage, skilled surgery can be omitted from this step, can be directly pressure bandage), and then use external dressings after the appropriate pressure Afterwards, the dressing will be applied with appropriate pressure.
4, post-operative foreskin and glans edema, mainly due to excessive activity, usually wrapped forehead exposed, and underwear friction, the way to overcome is to reduce activity as much as possible, the glans can be coated with some erythromycin ointment to reduce friction.
5, the suture nail off a long time, this is related to the individual physique, there is no effect, so far, I encountered the longest time is in the 30th day after surgery off the last suture nail, even if the time is longer will not have an impact. After a week, disinfection of the surgical opening with some iodophor every day will not only prevent infection but also shorten the time of staple removal.