The dressing applied after a newborn circumcision protects the incision site immediately after the procedure. This dressing, typically sterile gauze coated with petroleum jelly, acts as a barrier between the raw skin and the diaper. It prevents the wound from sticking to the diaper material, which could cause pain or disrupt healing.
Determining When to Discontinue Dressing
The decision to discontinue the gauze dressing depends on the circumcision method, but generally occurs within the first 24 to 48 hours. For procedures using a clamp (Gomco or Mogen methods), lubricant-coated gauze is applied immediately afterward. This initial dressing should remain in place for about 24 hours, or until it falls off naturally during a diaper change. If the gauze remains stuck after 24 hours, warm water can be used to soak and gently loosen it before removal. Once the gauze is removed, the protective action of petroleum jelly must continue without the gauze.
The Plastibell method does not require a traditional gauze dressing. This method involves placing a plastic ring between the foreskin and the head of the penis, designed to fall off on its own within five to ten days. This event marks the completion of the initial healing phase. Parents should not apply gauze or petroleum jelly with this method.
Caring for the Site After Gauze Removal
Once the initial gauze is removed following a clamp procedure, or once the Plastibell ring has fallen off, the focus shifts to maintaining a lubricated and clean environment. For clamp methods, a thick layer of plain petroleum jelly should be applied directly to the head of the penis and the incision site at every diaper change. This application replaces the protective function of the gauze and should continue for approximately five to seven days, or until the incision appears dry and fully crusted over.
Cleaning the area should be done gently using only warm water during diaper changes if the area is soiled with stool. Avoid using soaps, alcohol-containing baby wipes, lotions, or powders on the wound for about a week, as these can cause irritation and slow healing. After cleaning, gently pat the site dry before applying a fresh layer of petroleum jelly.
Sponge baths are recommended until the incision site is visibly healed, which typically takes seven to ten days. Full tub baths should be avoided until the healing is complete and the umbilical cord has also fallen off, to minimize the risk of infection. Fasten the diaper loosely to reduce friction on the sensitive area.
Identifying Normal Healing and Potential Concerns
A newly circumcised penis will exhibit several expected signs of normal healing that parents should anticipate. The head of the penis, or glans, may appear red, glossy, or slightly purple immediately after the procedure, which is a normal color change as the mucous membrane is exposed and toughens. Some mild swelling is also expected and will typically dissipate within a week or two.
Within a day or two, an off-white or yellowish film or crust may form over the glans. This is a natural part of the healing process and is not pus or a sign of infection. This film acts as a protective scab and should not be wiped or scrubbed off, as removing it can prolong the healing time. Complete superficial healing is generally achieved within ten days.
Parents need to be aware of certain signs that warrant immediate contact with a healthcare provider. Persistent bleeding that is more than a few drops or a spot larger than a quarter on the diaper requires urgent attention. Signs of a potential infection include increasing redness that spreads onto the shaft of the penis, severe swelling that worsens, a foul odor, or a thick, pus-filled discharge. Difficulty with urination is also a serious concern if the baby has not had a wet diaper for eight to twelve hours following the procedure.