PREPARATION

• Rewrap every 3-4 days until day 21.

• Rewrap sooner if the area is visibly soiled or saturated.

• Review the wrap video made on your phone the day of the procedure.

• The type of rewrap you will perform will be the very same wrap received on the treatment day (unless instructed otherwise).

• Have all the rewrap materials prepared on a counter and sorted in order of placement.

• Take your shower as usual leaving the genital area for last, at the end of your shower remove the current wrap.

• Remove wrap at the end of your shower. The wrap is easier to remove when it has been soaking for 15-20 minutes. Remove each layer/element of the wrap slowly and carefully, especially the gauze tape (the sticky white strips on the bottom and top of the shaft). Do not remove the gauze tape if it is too adhered to the skin, you might cause a skin tear.

• Wash all the genital area with soap and water, rinse, pat dry.

• Take photos while the wrap is off, then place complete wrap back on, take photos again, then send all these photos to the Medical staff via the secure chat for evaluation. 

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WRAP PLACEMENT – REVIEW WRAP VIDEO DURING PLACEMENT 

Step 1 White gauze tape

• Place two small squares (slightly larger than the size of the toe pads) of the white gauze tape on the penile shaft. Place one on the top side of the penis at the base, place the second on the back (underside) of the penis at the base near the scrotum. 

 

Step 2 Toe pad placement

• Place a toe pad (cut in half) on the shaft. One toe pad piece will go on the top side, and one will go on the underside near the scrotum.

• These toe pads will be placed on the white gauze tape (not on the skin directly).

 

Step 3 Betamethasone & Nitro-bid placement and triple antibiotic ointment

• Mix all the creams together, remember to only place a rice-size amount of Nitro-bid 2%

• Place a thin layer of creams on both lateral sides of the shaft in the space between both gauze tape strips and then with a cotton tipped applicator spread evenly along the lateral sides of the shaft.

 

Note: if you experience nausea or dizziness after applying the Nitro-bid 2% it means that you are applying too much of the medication.

 

Step 4 Sterile white gauze placement

• Place a single layer of sterile white gauze around the entire shaft, going as low as possible and continuing up over the glans (glans should be covered).

• Place a white sterile gauze folded in 4 (in the shape of a square) and placed it underneath the glans and stick it with tape to the white gauze previously placed.  Your half fold will go here in the last step.

 

Step 5 Pre-wrap placement (light tan)

• Place pre-wrap on the entire penile shaft, going as low as possible and continuing up over the glans (glans should be covered).

 

Step 6 Stretch gauze placement

• Place stretch gauze on, starting at the penile base, with mild tension, but overlapping considerably (80-90%). Continue placing this gauze until you reach just under the glans. Keep some of the blue pre wrap visible (sticking out) so the brown stretch gauze is not touching the skin of the glans directly (it will irritate otherwise).

Step 7 Pre-wrap placement

• Place 3-4 turns of pre-wrap around the base of the penile shaft. This pre-wrap will go behind/partially on top of the toe pad (this will help cushion the skin because this area is where the half fold and rubber band will be placed).

 

Step 8 Stretch gauze placement

• Place stretch gauze on top of the 3-4 turns of the blue pre-wrap just placed on at the penile base and continue placing the gauze up to the mid shaft level (70% overlap only). 

 

Step 9 Half-fold at penile base placement

• Place the half-fold at the penile base area with mild-moderate tension. The half-fold must sit behind and partially on the toe pad. This placement is very important. The half-fold should not be directly on the penile shaft but on the pubic skin. 

 

Step 10 Half-fold under the glans placement

• Place the half-fold just under the glans with mild tension (unless you have bulging skin, then use mild moderate tension). Go around only two times. (if a swoop is used, then you will need to go around more than two times (2-4 times). 

 

Step 11 Rubber band placement

• Typically, a #1 (smallest) rubber band is placed on the penile base area. Rubber band placement location is very important. Place the rubber band directly on the half-fold, and place on the lower edge of the half fold, as close as possible to the pubic area. So, the rubber band should be placing pressure on the pubic area (top or front side) and penile-scrotal junction area (on the underside). 

• Keep in mind that the rubber band may become loose over a few days. Please make sure it has a very snug fit (mild-moderate tension). If getting loose, you can replace it with a new #1 rubber band. If this #1 rubber band still feels loose, then add a small, looped rubber band on top of the #1 rubber band. The looped rubber band should be placed at the bottom of the #1 rubber band (closest to the pubic area).

 

NOTE: IF needed and to prevent any rubber band displacement, you can apply a small 1x1” square of the gauze tape on top of the rubber band. This will prevent any shifting of the position.