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→Washing: Revise text and add citation.
The presence of the healthy [[microbiome]], the [[Langerhans cells]], and the lytics in the sub-preputial moisture give the preputial sac strong immunological functions. [[Circumcision]] destroys the preputial sac and its protective immunological functions and makes the patient more vulnerable to [[infection]] throughout life.<ref name="fleiss1998" />
One frequently hears the advice to wash the preputial sac at least daily to prevent [[infection]]. This advice does not reflect the [[Immunological and protective function of the foreskin| immunological functions]] of the [[foreskin]] and is outmodedand inaccurate.<ref name="birley1993" /> <ref name="fleiss1998" /> Washing may introduce pathogens into the preputial cavity.<ref name="fleiss1998" /> It also removes the skin oil and protective lytic substances described above. It is better to rinse only as necessary, using only clear warm water.<ref>{{REFbook
|last=Bigelow
|first=Jim
|publisher=Hourglass Book Pub
|isbn=978-0934061223
}}</ref> One or twice a week is sufficient.<ref name="damon2010">{{REFweb |title=Intact Care of Elderly Men in Nursing Homes |url=http://www.drmomma.org/2010/05/intact-care-of-elderly-men-in-nursing.html |archived= |trans-title= |language= |last=Damon |first= |init=KL |author-link= |publisher=Peaceful Parenting |website=www.drmomma.org |date=2010 |accessdate=2023-12-12 |format= |quote=It is true that nursing programs (and medical school programs) in the [[United States]] have a long way to go in teaching proper [[intact]] care and development.}}</ref> It also is customary to wash before and after sex.
If the [[foreskin]] is non-retractable, then a rubber-bulb ear syringe may be used to squirt warm water into the [[foreskin]] to flush it out for an occasional washing. Washing is recommended before and after sex and as desired to remove accumulated [[smegma]].