The pain associated with circumcision is very common and most children are fine within 24 hours of the procedure. The doctor will tell parents to avoid rubbing the circumcision areas as it can only worsen the condition. The drainage that may occur will disappear on its own as the incision heals. To keep the incision from sticking, gently pull the skin back while taking a bath. To stop bleeding, a compress can be applied or pressure applied for 5 minutes.
A routine newborn circumcision was performed on a male neonate. He experienced continuous bleeding. The bleeding was intermittent and may have occurred along the skin edges or from a discrete vessel. Sometimes, the bleeding was so severe that the neonate had to be transferred to the neonatal intensive medical unit. The neonate was otherwise healthy and had no family history of bleeding disorders. Postcircumcision bleeding can be controlled with direct pressure, silver nitrate, or anticoagulation medications. A wound examination is rarely necessary. Hematologic tests are only required for persistent bleeding.
Most infants who had been circumcised showed a normal international normized ratio (INR), but some babies are more susceptible to bleeding after the procedure. Researchers recently found that neonates who were placed in neonatal intensive car units had a greater chance of bleeding after circumcisions than those who were placed in the newborn nursery. The authors of this study believe that this could be related to the low vitamin K levels in these infants.
Despite the potential complications of circumcision, most boys underwent it without complications. 95% of circumcised children had an international normalized ratio. 2.5% of cases showed an INR that was high or low for a prolonged period. The INR deranged ranged from 1.3 up to 3.8. Five neonates with this condition bled minimally, while the other neonate had moderate bleeding.
In a recent study of 394 newborns, the majority of boys did not require any intervention. The interventions required were minor and non-surgical. Only 14% of boys (n=15), had to be observed, while 58% (21/36), required pressure. Some children also developed meatal stenosis, and 26 boys had infections at the site of circumcision. The most common treatment is to apply silver nitrate or direct pressure.
The most common problem after a circumcision is bleeding. It can occur between the sutures and in discrete blood vessels. The majority of cases can be controlled by applying silver nitrate or pressure to the affected area. Occasionally, a post-circumcision hematologic workup is necessary.
While the majority of circumcision complications are treatable with the use of a hemostasis solution, the amputation of the penis can be severe and require a hospital stay. However, the bleeding from the plastibell method is largely preventable with a careful technique. During the surgery, you will need to apply direct pressure on the incision site and apply silver nitrate. If it is not painful, the clot can be pulled.
The majority of the male newborns with post-circumcision bleeding did not require any interventions, and in those that required surgical intervention, it was mostly minor. Only 14% of newborns needed sutures while 58% (21/36) needed observation. Among the neonates who had significant bleeding after the circumcision, this was due to severe hemophilia A. In this case, the surgeon used an eight-point suture to puncture the incision.
While most newborns will not experience complications following circumcision, they will experience significant bleeding. In addition to bleeding, infants with circumcision should undergo a careful preoperative assessment and receive adequate prenatal care. The success of the procedure will depend on the newborn’s birth weight, gender, family history, and other factors. It is important to remember that the incision site is a location with high blood vessels. Little bleeding can be fatal.