Dr. Kamalesh Pal

GOLD Medalist from AIIMS, New Delhi

Patient Information

The Plastibell is a clear plastic ring with handle and has a deep groove running circumferentially.
  • It is done under local anaesthesia and sucrose drop.
  • The adhesions between glans and foreskin are divided with a hemastat (artery forceps).
  • A thread is tied over the ring and the skin. Extra foreskin is removed
  • A gauze dressing is applied around it.
  • This gauze dressing has to be removed after 24 hours, by soaking the dressing in water. No further dressing is needed.
  • The ring and the thread will be visible; this will come out on its own after around 7-10 days.
  • Fucidine ointment has to be applied over the tip of penis during every nappy change. Adol drops to be given for 2-3 days as advised.
  • Baby should receive bath regularly without soap on the penile area.
  • It is expected to have little swelling of the skin over the ring and some yellow coating.
  • Baby will be reviewed in the clinic after 5 days.
    • Plastibell Circumcision & Dressing
    Plastibell Circumcision & Dressing Post circumcision healing and separation of plastic ring
    Post circumcision healing and separation of plastic ring

    Circumcision - Frequently Asked Questions

    If dressing gets soaked in urine and stool?
    No change required.
    If dressing comes off within 24hrs - keep open, apply Fucidine. Should redress?
    Not to apply gauze again.
    Bleeding happens?
    Mild is expected, persistent bleeding - contact surgeon.
    Can the area be washed?
    Yes, next day onwards.
    Baby is crying after circumcision?
    Give Adol as advised.
    When will the ring fall?
    In 7-9 days.
    There is swelling on the penis?
    Usually it's stretching of skin over the ring and not due to infection.
    The redness is increasing after surgery.
    Could be allergy to ointment or infection – consult surgeon.
    Yellow coating on the glans.
    Not to worry, do not remove it.
    Ring is stuck with a string-like tissue?
    Wait for a few hours, it will fall. If still stuck – consult surgeon.
    Ring has slipped onto glans and stuck?
    Consult the surgeon.
    Surgical Circumcision
  • Circumcision is the removal of the foreskin from the human penis. In the most common procedure, the foreskin is opened, adhesions are removed, and the foreskin is separated from the glans
  • It is done by surgical technique with stitches under General Anaesthesia
  • Baby is required to fast for at least 6 hours (no milk / water / food) and the baby should come to the hospital for admission 3 hours prior to the surgery.
  • The Anaesthetist will visit the baby in the room. They will discuss the options of Pre Anaesthetic sedation and Caudal Analgesia ( Pain Management)
  • After 2 hours of surgery, child will be fed and if stable will be discharged in next few hours.
  • There will be a gauze dressing surrounding the penis. This dressing has to be removed after 24 hours at home by the parents. The dressing should be soaked with water to facilitate its smooth removal.
    • Surgical Circumcision-2
  • The Penile wound will be very sensitive. So generous amount of Fucidine ointment has to be applied over the bare tip of penis 3-4 times a day. It would be covered by only Fucidine intertulle . No gauze dressing should be applied.
  • Pain Medicines ( Adol & Nurofen) has to be given regularly as advised.
  • Baby should be given warm water, bath daily and soap to be avoided.
  • Baby will be reviewed in the clinic after 3-4 days.
    • Surgical circumcision and dressing
    Surgical circumcision and dressing
    Steps to apply fucidine intertulle
    Steps to apply fucidine intertulle

    Post-Circumcision Care - Frequently Asked Questions

    How to remove dressing?
    Ask the child to take a shower, or wet the dressing with water, then remove the whole dressing gently.
    How to apply Intertulle?
    Make a hole and slide it onto the tip of the penis.
    Sensitivity
    Apply only Fucidine ointment and Intertulle. No gauze should be applied.
    Washing & Bathing
    Encourage the child to take a shower daily.
    Yellow coating
    It is expected to appear on the tip. Do not remove it.
    Black scab
    It will separate naturally with washing.
    Redness and Pain
    If redness and discharge increase, consult the surgeon—it could be a sign of infection.
    Sutures
    They will fall off in a few days.

    Dr. Kamalesh Pal has performed more than 7000 neonatal and 15000 pediatric surgical procedures. Has more than 40 indexed publications, 5 chapters in Pediatric Surgical Textbooks, recipient of Young Scientist Award (2004), Mohanlal Wig Gold Medal (2003)

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