The plastic ring will normally fall off between 7 and 14 days (average 10). It often hangs by a small piece of tissue for a few days. It will come off on its own. Pulling it off can cause bleeding.
The thin layer of white or yellow by the glans is called the epithelium, this is normal and is part of the healing process. What if the ring is hanging on by a small amount of skin? Leave the ring in place and it will eventually fall off. By pulling off the ring you may cause significant bleeding.
Call us if it hasn't fallen off after 8 days. Every time you change the diaper for the next 5-7 days, or until the Plastibell falls off and all the granulation tissue is gone, place petroleum jelly (Vaseline) over the glans (head) of the penis and on the front of the diaper.
Call your doctor if your child has: Severe pain that does not get better with pain medicine. Fever over 101 degrees F. More than a few drops of blood on the penis or diaper.
After the Plastibell has fallen off, apply petroleum jelly to the entire tip of penis. Gently retract the remaining skin and put petroleum jelly into the groove just beneath the tip. You may need to use a Q-tip to do this. Petroleum jelly will help your child's penis heal properly.
Clean the circumcision site with warm water and a cotton ball once or twice a day. Apply Vaseline for several days. This helps keep the area clean and keeps the wound site from adhering to the diaper.
Only give sponge baths to your baby for the first week. The head of the penis (glans) is likely to be red at first and swollen, It will develop a yellow coating (scab). A dark ring around the plastic rim is normal until the plastibell falls off. The plastibell ring will fall off by itself in five to eight days.
Every circumcision comes with a risk of bleeding or infection. However, the Plastibell technique does carry a lower risk of bleeding as compared to other types of circumcision. Other more serious complications include scarring, fistulas, and deformation are very rare, according to the American Academy of Pediatrics.
The complications are, for example, infection, bleeding or hematoma, excess mucosa, bell disposition (entrapping the ring), and delayed falling.
Late complications include wound infection, meatal stenosis, phimosis, inadequate or overdone circumcision leading to buried penis, urethral fistula, and sepsis.
About 36 hours before you find the ring free in the nappy you will notice some swelling and redness around the ring, this is normal and means the ring is about to completely separate.
These however, may be signs of an infection and medical advice should be sought as soon as possible: discharge that includes pus (cloudy, yellowish/white, foul-smelling fluid) hot skin and/or spreading redness around the wound site.
While incidents of injury resulting from the circumcision procedure are rare, surgical errors do occur and the severity can range from excessive bleeding to significant tissue loss, and even partial amputation. A botched circumcision can have life-long effects ranging from deformities to pain and erectile dysfunction.
In this technique, a tight ligature is tied around the foreskin, drawn over a grooved plastic ring commonly known as the 'Plastibell', and the skin distal to the ligature is excised.
Normal Circumcision Healing
The scab at the incision line comes off in 7 to 10 days. If a Plastibell (plastic ring) was used, it should fall off by 14 days. 10 days is the average. While it can't fall off too early, pulling it off can cause bleeding.
Bleeding is the most commonly encountered complication of circumcision. The expected blood loss during neonatal circumcision is just a few drops (easily handled with one 4 x 4 " gauze pad), so bleeding that exceeds this expectation is a complication.
Circumcision at the age of 7 days
However the Plastibell device seems to perform best between one and three months but is also regularly performed on babies younger than one month safely and effectively. Circumcision at the IMC can be performed on boys from the age of 7 days old, provided they are fit and well.
Plastibell circumcision is safe, quick, easily manageable, and acceptable technique for parents. Complications are low in neonates and infants than older age group.
Advanced laser circumcision is safe for all age groups. It is minimally-invasive in nature and there are no major wounds or stitches to take care of. Thus, it is absolutely reliable technique of circumcision for infants.
The Plastibell technique is commonly used to circumcise infants in the community for cultural and religious reasons. Bleeding occurs in 3–10% of cases in reported series,2,3 although this may be reduced by careful technique.
Incision care
Wash the area daily with warm water and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a thin layer of petroleum jelly, such as Vaseline, and gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
Keep it clean
This is the most important rule of newborn circumcision care: At every diaper change, gently clean the area and wipe away any bits of poop you may see. Use warm water and gauze and let it air-dry, which will help prevent irritation.
The adhesions can be located anywhere around the head of the penis and vary in severity. There are 2 types of adhesions; non-vascularized and vascularized. With non-vascularized adhesions the foreskin naturally adheres to the head/glans of the penis and sometimes happens again after circumcision.