Both techniques are performed following the administration of paracetamol by our nurses and ultrasound guided injection of local anaesthetic. Both techniques use and element of skin crushing to prevent bleeding. The surgical cut technique involves using a clamp to crush the skin edges of the skin to be removed and cutting off the excess skin. A bandage is then applied. This bandage is removed the following day. This technique takes 2-3 minutes after the injection of anaesthetic.
The Plastibell technique involves placing a plastic ring between the head of the penis and the foreskin. A string is tied tightly around the foreskin crushing the skin against the ring. The excess skin is removed. The ring stays comfortably in place for 7-10 days before spontaneously falling off. There is no bandage to remove. This technique takes 8-9 minutes after the injection of anaesthetic.
From the parents point of view, the main downside of the surgical cut technique is that the bandage needs to be removed the following day and this can be uncomfortable for the babies. The main downside of the plastibell is that the procedure takes longer and the babies may not like being held still for the additional time.
Both techniques require liberal application of Vaseline. Babies often need two further doses of Panadol in the first 24 hours, but rarely anything after that.