Monday, October 19, 2009

Sterility and Cleanliness - Can't Emphasize Enough

Circumcision as Surgery - An Observation

Today I accompanied a pediatric surgeon friend of mine to the O.R. where he performed a circumcision on a three month old baby.

Those who do circumcisions strictly for non religious reasons have many options for how to do it. They can do it in the doctor's office, in their home, in the hospital with local anesthetic, or in an Operating Room, under general anesthesia.

It is a different kind of experience, watching a procedure I knew so well, and a result I am so familiar with, done in a completely different way. Surgeons have the luxury of all the time in the world. There is no crying baby, no nervous mother who only wants the baby to stop crying and for the mohel to leave him alone. And just about any error in the course of the procedure can be corrected right away without anyone being the wiser.

Emphasis on Sterility

There is no compromising on the sterility of the procedure in the operating room. Sterile drapes are put all around the surgical field. All instruments have the same level of sterility as for open-heart surgery. The surgeon and his assistant do a full scrub before donning their surgical robes and sterile gloves.

And why should they act any differently? They have a responsibility to assure that the risk of infection is minimized under their watch. At all costs.

The beef

I understand that the nature of a bris makes the sterility degree of an operating room nearly impossible to achieve. And thankfully, the bris usually heals without complications and without problems.

But...
  • I see too many mohels operate without gloves.
  • I see too many mohels who wash their hands and then touch everything from the baby's clothes to a briefcase on the floor before starting the bris.
  • I see too many mohels operate after putting their "sterilized" instruments onto a laundered diaper cloth handed to them by the baby's mother five minutes earlier.
  • I see too many mohels who have no regard for sterility, and explain their ways by virtue of their unverifiable track record and their inability to change their ways after having done things this way for decades.

There should be no tolerance for anyone treating your baby and his fresh wound any differently than how a fresh wound would be treated by medical personnel in a doctor's office or under close to O.R. conditions. Mohels are not perfect, but they can be much better.

While infections are uncommon (rare), they should be non-existent. And infections in a baby which come from the bris can be life-altering if not deadly.

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