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Once you are certain that the Gomco Clamp is in the correct position and the proper and symmetrical amount of prepuce is being removed, then tighten the nut snuggly onto the base plate. Once tightened, start the five minute timer on the warmer. Use the #10 scalpel to completely excise the now ischemic prepuce as shown in Figure 1.
In this image: Figure 1. Use the #10 scalpel to completely excise the now ischemic prepuce.
A helpful angle to use to avoid leaving bits of foreskin after excision is to keep the scalpel blade about 20º to the base plate.
Make sure no ischemic tissue is left behind, since this non-viable tissue that can be a nidus for infection. See Figure 2 below. The interface between the bell and bevel hole is clear of any residual tissue.
Use scissors to completely cut the excised prepuce from the bell. Wait the full five minutes before removing loosening the nut to remove the clamp.
Check for any bleeding during this time.
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