Circumcision is a common procedure often considered minor, but complications—ranging from minor skin loss to severe injuries like glans amputation or penile necrosis—can occur, especially when performed outside formal healthcare settings. Complication rates range from 0.2% to 5%, depending on provider skill, sterility, and timing. This case series presents three severe circumcision injuries with varied causes, requiring complex, staged management. Key factors included early debridement, infection control, and tailored reconstructive grafting. Our findings highlight the importance of timely, multidisciplinary, and compassionate care to restore function and support emotional recovery.

We present a series of three pediatric patients with severe post-circumcision injuries, managed through a multidisciplinary approach involving urology and plastic surgery. All required hospitalization, multiple surgeries, and individualized planning. Case 1 had dry gangrene of the shaft and glans, treated with debridement, split-thickness skin graft (SSG), and buccal mucosa graft—resulting in good graft uptake and preserved urinary function. Case 2 had extensive shaft denudation with glans involvement; SSG was successful, but the buccal graft failed due to Pseudomonas infection, managed with targeted antibiotics. Case 3, a 7-year-old, sustained a glans burn from monopolar cautery. He required serial debridement, initial SSG, and later conversion to full-thickness skin graft (FTSG) due to poor uptake. These cases underscore the challenges of circumcision injuries and the need for timely debridement, infection control, appropriate grafting, and coordinated multidisciplinary care.

All three patients underwent successful staged reconstruction with preserved urinary function and good healing. Each case required initial debridement followed by grafting—two with split-thickness skin and buccal mucosa, and one converted to full-thickness grafting due to poor uptake. Infection complicated two cases, needing targeted antibiotics. One parent required psychological support due to stress. Key points: Early debridement (3–7 days) improves outcomes. Culture-guided antibiotics are critical before grafting. Suprapubic catheterization helps prevent wound contamination. Detailed assessment of penile structures guides reconstruction. Urology–plastic surgery collaboration ensures best outcomes. Family psychological support is essential for holistic care. These cases highlight the complexity of severe circumcision injuries and the need for precise, multidisciplinary, and compassionate care

Severe circumcision-related complications, while uncommon, demand prompt and coordinated multidisciplinary care. Our series highlights that early intervention, meticulous surgical planning, and effective infection control can yield favorable functional and cosmetic outcomes. Collaboration between urology and plastic surgery is vital, and addressing the emotional impact on families is equally important.