How are blood vessels managed during circumcision?

Circumcision is a surgical procedure performed on patients with redundant prepuce or phimosis to remove the excess foreskin. Blood vessels are generally managed by ligation during the surgery, which must be conducted at a正规 medical facility. The specific procedure is as follows:

1. The patient lies in the supine position. The genital area is cleaned with iodophor-soaked cotton balls, and anesthesia is administered by an anesthesiologist.

2. After the anesthesia takes effect, the surgeon uses a hemostatic clamp to grasp the frenulum of the foreskin to lift it up, then uses a scalpel to make a mark on the outer foreskin plate 0.5 cm distal from the coronal groove.

3. Using scissors, the inner and outer layers of the foreskin are cut along the probe groove, with the inner layer cut to approximately 0.5 cm from the coronal groove.

4. Once the glans penis and coronal groove are exposed, firmly pull the two hemostatic clamps on the right side. Using scissors, excise the redundant foreskin longitudinally starting from the dorsal incision site, maintaining a distance of 0.5–0.8 cm from the coronal groove, continuing until reaching the ventral longitudinal incision.

5. Release the left hand quickly after circumcision, push the remaining foreskin downward toward the base of the penis to expose the wound surface, and ligate bleeding points using 3-0 silk suture.

6. Align the inner and outer edges of the foreskin, then use fine silk sutures to place a mattress stitch at the frenular site. Add one stitch each at the dorsal midline and at the central points on the left and right sides. Tie these four sutures while leaving their ends intact. Then add 1–2 additional stitches between each pair of existing sutures, tie them off, and trim the suture ends short.

7. Fold gauze impregnated with petroleum jelly into strips and wrap it around the circumcision site. Secure it with the long ends of the previously retained sutures, then cover with several layers of dry gauze for dressing.

After surgery, the wound should be kept clean and dry. During urination, care should be taken to avoid wetting the gauze. Additionally, protect the wound from contact with water and contaminants to prevent possible infection.