Needing clear cut advice on circumcision aftercare

[Colbryn]

I am hoping this does not start a debate, I only want factual information. I am an OB nurse and recently started in a hospital that does couplet care. I have always been L&D before, so I am learning to care for infants now. I did not have my own sons circumcised, so the care is new to me. I have read our policies and procedures, searched online and in textbooks, etc and keep coming up with mixed or dated information. After the circumcision, do you use wipes to clean with a diaper change? Or just drip warm water? Always place vasoline on a gauze pad and over the head? If so, how often is this changed? Is it true that the remaining foreskin has to be pulled back, and if so, for how long? I had a patient tell me that her last son had issues because she did not know to pull it back so that it did not reattach. Is any bleeding amount normal? Are there stitches with some methods, and do these dissolve? Are you supposed to apply TAO to prevent infection? Thank you in advance. I want to make sure I am giving the new moms the right information.

[gamecaco4, BSN]

In the birth center where I work, aftercare varies slightly depending on the type of circ done. Gomco gets a large amount of Vaseline in the diaper (no gauze or other dressing), no pulling or cleaning besides water if necessary. Plastibell gets nothing. No Vaseline or other dressing. Those are the main two we do. Blood - scant amount in the first 12 hours at each diaper change is expected.

Another hospital I worked at was pretty close to exactly the same except Vaseline on gauze was used for the gomco.

Edited to add ACOG recommendations: https://m.acog.org/Patients/FAQs/Newborn-Male-Circumcision#decide

[Leader25, ASN, BSN, RN]

After the original surgical gauze has been gently unwound after 24 hours,a 4x4 dressing sponge not that harsh gauze ,with vaseline is applied over the head ,reapplied with every diaper change until healed appx one week.I cringe at how many thoughtless staff use the stringy harsh gauze which adheres to the dry blood and scrapes the surgical site,no need to pull anything back,we are trying to prevent scarring over the urethral opening,teach good hygiene,comfort for pain.

My Recommendation is do not do this to your baby,leave nature alone.I bow out of here do not want to be in a controversy.

[Colbryn]

Thank you so much. I believe my hospital does Gomco and I have seen the surgical gauze with petroleum jelly. I thought the 4x4s would be softer and I thought wipes were probably not a great idea but I wasn't sure.