EMILIO AGUINALDO COLLEGE

School of Dental Medicine

GENERAL ANATOMY I (REGIONAL ANATOMY)

CASE CONFERENCE FOR FINAL PERIOD

Circumcision

Submitted by:

Medina, Katrina Mae E.

Doctor of Dental Medicine Class 2022

Submitted to:

Dr. Beda Jay Igasan

Professor, General Anatomy I

Date Submitted:

December 11,2018
 CHAPTER ONE

BACKGROUND OF THE CASE

I. Short introduction of the case

Circumcision is a surgical procedure of removal of the foreskin (prepuce), which covers the tip of

the penis. The procedure is usually performed for religious and traditional reasons, often 2 days

or first two weeks on newborn boy or at the beginning of stage of adolescence as a rite passage

on the adulthood. The procedure is also performed for medical reasons to treat problems in

which it involves the foreskin. During the procedure, a general anesthesia will be injected on the

base of penis then the foreskin is surgical clamp will be attached to the penis, then the foreskin

will be removed by a cut.

II. Patient’s profile and Chief Complaint

Patient K.A., an 11-year-old male, Roman catholic, Filipino, grade 6 student at St. Francis

school in general trias, residing at Dasmariñas city, Cavite went to wellcare clinic and laboratory

general trias for a surgical procedure known as prepucectomy.

III. History of present illness

1 hr prior to the procedure, patient K.A. consulted for circumcision.

IV. Past medical history

Patient had no any past surgery or any procedures before the circumcision.

V. Family history

Patient’s mother and father are both healthy.

VI. Personal and social history

Patient K.A. is a non-smoker, and a non-alcoholic person. His hobbies include playing volleyball,

and playing online games. He is also a varsity in a volleyball team at the school.
VII. Physical Examination

General: Patient is awake, conscious, and oriented.

Vital Signs: BP = 110/80 mmHg, CR = 75 bpm, RR = 15 bpm, Temperature = 36.9°C

Pain Scale: Patient K.A noted a 1/10 pain in the scale, 10 being severely painful and 1 being

a pain that is bearable.

HEENT: Head is normocephalic. Tympanic membranes and auditory canals are all clear.

No nasal discharge. No infections were seen on the Oral cavity and pharynx.

Lung: normal breath sound was heard during auscultation.

Heart: regular rhythm, no murmurs heard upon auscultation

Abdomen: Soft abdomen, non-tender, normal bowel sounds, absence of any masses or

hernias.

Pelvic: No presence of normalities in the pelvic region

Rectal: absence of hemorrhoids, soft stool

Extremities: no clubbing, no signs of edema, no cyanosis

 CHAPTER TWO

DIAGNOSIS

I. Short discussion about Circumcision

II. Treatment

III. Procedure

 Equipments

(standard equipments for surgical procedure):

1. Instrument tray

2. Dissecting forceps

3. Artery forceps

4. Curved Metzenbaum’s scissors

5. Stitch scissors

6. Mayo’s needle holder

7. Sponge-holding forceps

8. Scalpel knife handle and blades

9. “O” drape (80 x 80 cm, with -5 cm hole)

10. Gallipot for antiseptic solution (e.g. povidone iodine)

11. Povidone iodine (50 ml of 10% aqueous solution)

12. Plain gauze swabs (10 x 10 cm; 10 for procedure and 5 for dressing)

13. Petroleum-jelly-impregnated gauze (5 x 5 cm or 5 x 10 cm) and sticking plaster or

paper tape.
 14. 15 ml of 1% lidocaine anaesthetic solution.

15. 10 ml or 20 ml syringe

16. Injection needles (-18 or -21 gauge)

17. Suture material (chromic gut or vicryl 3-0 and 4-0) with 3/8 circle reverse-cutting

needle

18. Gentian violet (no more than 5ml) or sterile marker pen

19. Gloves, masks, caps, and aprons

 Procedure:

Before procedure the patient undergoes in these steps:

1. The patient would be given a counselling to give him an idea about the procedure. (the

risks and the benefits of circumcision).

2. An HIV testing would be done on the patient. This is recommended on any medical

institutions to take precautions of avoiding infections (passing infection from one

patient to another).

3. A medical staff would take medical history on the patient to know if he would be

suitable for the procedure or not. (e.g.- his current health, medications he is taking,

history of any disorders, etc.)

4. A physical examination and genital examination will be done to check if there’s any

anatomical problems on the penis and this helps to know if the procedure would be

suitable for the patient.

5. The patient would be given an informed written consent to be fill up before the

circumcision is performed. If the patient is a child or adolescent or a newborn (a legal

guardian would be the one who would put the information of the patient).

6. The schedule of procedure would be given to the patient

 Preparation of the patient:

1. Preoperative washing by the patient. On the day of the surgery the patient should

wash his genital area and penis using water and mild soap, retracting the foreskin

and washing under it. This ensures the genital area is clean before the procedure.

2. If the pubic hair is long, it should be clipped before the patient enters the operating

room. Shaving is not necessary.

3. The patient should empty his bladder before entering the operating room.

Preparation of the surgical team:

Before they enter the operating room, all members of the surgical team should:

1. Remove all jewelry and ensure nails are trimmed or filed.

2. Remove any artificial nails or nail, polish.

3. Wash hands and arms up to the elbow with a non-medicated soap.

4. Pat and dry the hands and arms using clean towel.

5. Put on the surgical gloves, wear your surgical crown, facemasks, and protective eyewear.
 CHAPTER THREE

GENERAL ANATOMY

I. Anatomic Discussion

II. Anatomic Correlation

 CHAPTER FOUR

APPENDICES

I. References

II. List Of Tables and Figures