SCROTAL, GLANS, or CIRCUMCISION POST-TREATMENT PROTOCOL

SCROTAL, GLANS, OR CIRCUMCISION

POST-TREATMENT

PROTOCOL     REV 12/22/2016

IF A GLANS TREATMENT WAS PERFORMED

• PLACE WHITE GAUZE ON GLANS WITH PAPER TAPE TO HOLD IN PLACE DURING THE FIRST 24-48 HOURS AFTER TREATMENT, THE GLANS WILL DRAIN, AND THIS GAUZE WILL COLLECT THE BLOOD AND DRAINAGE.
• PLACE A LIBERAL AMOUNT OF TISSUE OR PAPER TOWELS OVER THE GLANS.
• SECURE WITH A SHORT STRIP OF BROWN GAUZE. 
• THE PURPOSE OF THIS TISSUE COVERING IS TO PREVENT URINARY AND BLOOD/BLISTER FLUID LEAKAGE ON YOUR CLOTHING.

• YOU ARE TO TAKE ALL OF YOUR MEDICATIONS, AND APPLY ALL TOPICAL MEDICATIONS AS INSTRUCTED.
• THERE IS NO WRAPPING NECESSARY.
• YOU MUST TAKE DAILY PHOTOS FOR EVALUATION.
• IF YOU HAD THE GLANS TREATED, BE READY FOR SOME BURNING PAIN. MOST PATIENTS WILL GET SOME LEVEL OF PAIN, FROM MILD TO HIGH, SO BE PREPARED. THE BEST WAY TO TREAT THIS TYPE OF DISCOMFORT IS TO PLACE ICE ON IT. USE YOUR BAGGIE, SUPPLIED IN YOUR BLUE TO-GO BAG, FILL WITH WATER AND ICE, AND THEN PLACE ON AREA. THE PAIN WILL SUBSIDE IN 2-3 HOURS.

IF A CIRCUMCISION WAS PERFORMED

• KEEP THE PRESSURE WRAP ON FOR 72 HOURS, THE ONE PLACED IMMEDIATELY AFTER YOUR
• TAKE THE MEDICATIONS AS INSTRUCTED.
• PROCEDURE, AND DO NOT REMOVE FOR 72 HOURS (3 FULL DAYS).
• ON DAY 3, YOU WILL REMOVE THE WRAP, TAKE A HOT SHOWER, WASH ALL WITH SOAP AND WATER, PAT DRY, TAKE PHOTOS, PLACE BACITRACIN OINTMENT OVER THE STITCH LINE, COVER WITH WHITE GAUZE, AND THEN PLACE BROWN STRETCH GAUZE OVER THE WHITE GAUZE WITH MILD TENSION. DO THIS DAILY.
• TAKE PHOTOS DAILY OF THE WRAP. AFTER 3-DAYS, TAKE PHOTOS FOLLOWING YOUR HOT SHOWER AS WELL AS OF THE SUTURES, SO DR. LORIA CAN EVALUATE THE SKIN.

• SUTURE REMOVAL ON DAY 14:

• YOU WILL BE INSTRUCTED TO REMOVE THE SUTURES THAT HAVE BEEN PLACED DURING THE CIRCUMCISION PROCEDURE. 14 DAYS AFTER YOUR PROCEDURE, YOU WILL NEED TO REMOVE THE SUTURES AS INSTRUCTED BELOW, EITHER AT HOME, LORIA MEDICAL OFFICE, OR AT ANY LOCAL FACILITY CAPABLE OF REMOVING THE SUTURES FOR YOU (PRIMARY PHYSICIAN, FAMILY DOCTOR, OR EMERGENCY ROOM).
• HOW TO REMOVE YOUR SUTURES AT HOME:
  • THE SUTURES THAT DR. LORIA PLACES WILL NEED TO BE REMOVED ON DAY 14, UNLESS INSTRUCTED OTHERWISE. THE MOST COMMONLY USED TYPE OF SUTURE TECHNIQUE IS CALLED A RUNNING HORIZONTAL MATTRESS SUTURE.
    • STEP 1- ASSESS THE WOUND FOR COMPLETE HEALING SIGNS PRIOR TO REMOVAL OF SUTURES. SEND PHOTOS PRIOR FOR EVALUATION, THEN PROCEED TO REMOVE SUTURES.
    • STEP 2- OBTAIN A SUTURE REMOVAL KIT. A TYPICAL SUTURE REMOVAL KIT WILL CONTAIN A PAIR OF STERILIZED TWEEZERS AND A PAIR OF SMALL SCISSORS. THIS CAN BE PURCHASED AT YOUR LOCAL PHARMACY IF NEEDED.
    • STEP 3- CLEANSE THE SUTURED AREA COMPLETELY WITH ANTIBACTERIAL SOAP AND WATER. THIS WILL ALSO MOISTEN THE SUTURES AND ALLOW FOR EASIER REMOVAL FROM THE SKIN.
    • STEP 4- TAKE THE TWEEZERS INTO YOUR NON-DOMINANT HAND AND THE SCISSORS INTO YOUR DOMINANT HAND.
    • STEP 5- GRASP ONE OF THE SURGICAL KNOTS WITH THE TWEEZERS. YOU WILL WANT TO GENTLY LIFT UP ON ONE OF THE KNOTS IN ORDER TO CUT INTO THE SUTURE MATERIAL PAST THE KNOT.
    • STEP 6- THREAD OR PULL THE SUTURE BACK THROUGH THE SKIN DOWN THE LENGTH OF THE WOUND, USING THE TWEEZERS. YOU WILL GRASP THE LENGTH OF THREAD RUNNING OVER THE SKIN SURFACE AND GENTLY PULL UPWARD ALLOWING THE SUTURE TO SLIDE OUT OF THE SKIN. CONTINUE THIS PROCESS UNTIL ALL SUTURE MATERIAL HAS BEEN REMOVED FROM THE WOUND. AS THIS IS A RUNNING SUTURE, THERE SHOULD NOT BE ADDITIONAL KNOTS TO CUT DOWN THE LENGTH OF THE WOUND.
    • STEP 7- RE-CLEANSE THE WOUND WITH THE ANTISEPTIC SOLUTION AFTER THE ENTIRE SUTURE HAS BEEN REMOVED. TAKE PHOTOS TO SEND AFTER FOR EVALUATION TO THE GROUP MESSAGE.
    • STEP 8- PLACE A BANDAGE OVER THE AREA IF ANY BLEEDING IS NOTED AFTER THE REMOVAL OF THE SUTURE. IT IS BEST TO CONTINUE PLACING BACITRACIN OINTMENT, THEN A WHITE GAUZE OVER THE WOUND AND SECURE IT TO THE SKIN WITH THE USE OF SURGICAL TAPE. FOR 7 ADDITIONAL DAYS.

IF A SCROTAL TREATMENT WAS PERFORMED

• MAKE SURE THE SPOT BAND-AID PLACED ON THE NEEDLE POKE USED TO INSERT FILLER MATERIAL IS INTACT ON A DAILY BASIS.
• MASSAGE THE SCROTAL AREA.
  • MASSAGING IS A TWO MINUTE LIGHT RANDOM FINGER TIP MASSAGE OF THE SCROTAL SKIN. THE PURPOSE OF MASSAGING IS TO HELP MIX THE FILLER MATERIAL UNDER THE SKIN WHICH WILL PROMOTE VERY SMOOTH COLLAGEN PRODUCTION.
• PERFORM YOUR BARRIER BREAKS (STRETCHY RINGS) EVERY 4-6 HOURS FOR 10-15 MINUTES.
• CONTINUE WEARING A STRETCHY RING UNTIL DAY 21.
  • FIGURE 8 SCROTAL RING
    • WITH THIS SCROTAL RING THE BIG LOOP WILL BE PLACED AROUND TH SHAFT AND SCROTUM, AND THEN THE SMALL LOOP WILL FLIP UPWARDS TO ISOLATE THE SCROTUM ALONE.
  • TWO SCROTAL RINGS TECHNIQUE
    • TWO SCROTAL RINGS WILL BE PLACED IN TOTAL.
    • THE SILICONE SCROTAL RING (OR THE SMALLEST SCROTAL RING IN DIAMETER POSSIBLE), WILL BE PLACED AROUND THE SCROTAL SACK, ISOLATING THE SCROTUM.
    • THE NEXT SCROTAL RING (BIG RUBBER BANDS) IN SIZE WILL BE PLACED AROUND THE SHAFT AND SCROTUM.