Clinical meaning
Circumcision involves surgical removal of the foreskin (prepuce) from the glans penis, creating a circumferential wound that heals by secondary intention over 7–10 days. The exposed glans initially appears red and may develop a yellowish fibrinous exudate (granulation tissue), which is a normal part of healing and should NOT be removed. Hemostasis is achieved through cautery or compression devices (Plastibell, Gomco clamp, Mogen clamp). Complications include bleeding, infection, adhesions, and meatal stenosis. The RPN monitors for complications and provides family education on wound care.
Exam relevance
Risk factors: - Bleeding disorders (hemophilia—must be ruled out before procedure) - Prematurity (procedure deferred until medically stable) - Hypospadias or other penile anomalies (foreskin needed for surgical repair) - Family history of bleeding disorders - Active infection at the site
Diagnostics: - Visual assessment of circumcision site for healing, bleeding, or infection - Monitor for adequate urination within 6–8 hours post-procedure - Assess diaper for excessive bleeding (more than quarter-sized spot) - Monitor vital signs for signs of pain or distress - Assess for signs of infection: erythema, purulent drainage, swelling, foul odor