An 8 lb, 7 oz full-term, breech-delivery baby was born after a 36-hour labor. With a technique first described by Kariher and Smith in 1956, circumcision was performed at about 12 hours of age, utilizing a plastic flange-like ring which fitted over the glans and under the excess skin of the prepuce; a ligature was tied tightly over the excess skin which lay on the plastic ring. At age 24 hours, the baby was observed to have a moderately edematous scrotum, one-plus pitting leg edema, and a black, necrotic-appearing glans (Fig.1).

The ligature and the plastic ring were removed, without bleeding, following which the glans gradually became quite swollen and slightly moist over the following 12 hours.

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