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"Many changes to the wound are a normal part of the healing process." hierfür noch etwas Zeit.
Below are some important changes that the wound may undergo after circumcision, from the first day until healing (duration approximately 7 to 10 days). Next to the images, you will find possible explanations and solutions for any issues. If needed, you can contact me during office hours.
If you notice on the same day after the circumcision that the dressing is no longer sitting correctly, you can proceed as follows:
Do not worry — as long as there is no active bleeding, it is not a serious problem. Apply a small amount of Bepanthen ointment to the wound and wrap it again using a new sterile gauze dressing.
1.2
Image 1.2 serves as a reminder that the dressing must be removed on the day after the circumcision.
If the dressing has already adhered to the wound, we recommend moistening it gently with clean, lukewarm water or a little olive oil before removing it. Please note that the adhesion becomes more persistent the longer the dressing remains in place. When the dressing sticks, the glans skin may appear irritated; however, it usually recovers quickly.
Cases 2.1 and 2.2 show normal wound development.
The first image in 2.2 demonstrates a clean, non-irritated wound surface that is still visible without any fibrin coating in the early phase.
The cases in 2.3 show a bluish discoloration of the glans, which is neither a disease nor a sign of any disorder.
The intensity of the blue color depends on the brightness of the skin, as the blood vessels in the glans are visible through it. It is not possible to predict how long this discoloration will persist; however, it has no pathological significance.
Cases 3.1 and 3.2:
These cases illustrate the development of coatings and the accumulation of wound-secretion-like substances (fibrin coatings, shown in 3.1) in the wound area, especially on the underside.
During the sitz baths, it is recommended to gently attempt to loosen and remove these coatings using cotton swabs.
Although small amounts of coating—such as in image 3.1—are naturally shed by the body, you should not wait until large amounts accumulate, as seen in image 3.2, in order to avoid the risk of inflammation.
Cases 3.3 and 3.4:
3.3
In these cases, a preventable swelling is visible. It is important not to fasten the diaper too tightly, especially after the dressing or gauze has been removed.
Additionally, it is crucial to change the diaper immediately whenever urine or stool is present — particularly during the night.
3.4
This case illustrates the consequences when the diaper remains adhered to the glans for several hours and when the underside of the penile shaft becomes stuck to the diaper’s adhesive surface. This can lead to small tears and the formation of granulomas or improper tissue adhesions.
This is easily preventable by changing the diaper as soon as it becomes wet and by ensuring it is not applied too tightly.
In such situations, mild bleeding may occasionally occur.
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Important notes — please make sure to remember the following:
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1. The following images highlight a very important issue that can lead to serious consequences if the necessary measures are not carefully followed by the parents.
2. Important notes — please make sure to remember the following:
3. React early; do not wait.
4. Regularly and fully retract any remaining skin — day and night — exactly as instructed.
5. Do not fasten the diaper too tightly, and change it immediately whenever it becomes wet or soiled.
6. Remove coatings (fibrin deposits) in a timely manner during the sitz baths.
7. Take every adhesion seriously — the earlier it is noticed, the easier it is to treat.
8. Prevention is crucial:
9. A repeat operation is burdensome for the child, difficult to organize, and associated with additional costs.
In 4.1 and 4.2, it is shown how the remaining skin must be retracted — starting 24 hours after the procedure, at every diaper change or approximately every two hours, day and night, for a duration of 3 to 7 days, depending on the anatomy of the penis and the tendency toward adhesion formation.
In image 4.3, the early stage of an adhesion is visible. At this point, it is important for parents to ensure that the aftercare is being performed correctly and that the glans truly remains uncovered. If they notice that the situation is not improving or if they feel uncertain, they should consult a doctor promptly — before the adhesion progresses and becomes more difficult to treat.
In image 4.4, the adhesion has progressed further. The doctor can likely still manage the situation on an outpatient basis. However, it is important to address it at this stage, before it becomes more complicated. If treatment is delayed too long, problems with urination and a severe bladder infection may develop.
Note: The correction procedure is associated with additional costs.
Cases 4.5 represent situations in which the changes were noticed or addressed too late. The doctor may still attempt to correct the adhesion on an outpatient basis, but success is not guaranteed.
This correction is labor-intensive and associated with additional costs. In most cases, it would have been avoidable.
In some situations, treatment cannot be performed on an outpatient basis and must instead take place in the hospital. These costs may also be charged to the parents.
In this situation, it is unfortunately not helpful to say that one “did their best” or “followed all instructions,” as these changes develop gradually, not suddenly.
For this reason, it is essential — both for the well-being of the child and in terms of effort and cost — to take aftercare and daily observation very seriously from the beginning.
Example regarding the effect of circumcision on a so-called “buried penis”:
Circumcision does not change the actual position of the penis; it only makes the natural position more visible once the foreskin is removed.
This image and the video show that with proper aftercare, everything remains healthy. The penis may retract slightly into the fatty tissue, but it can be easily pushed out again without any problems.