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}}</ref> Moistness also may be maintained by [[transudation]].<ref name="cold-taylor1999" /> The preputial sac may also receive [[pre-ejaculate]].
A longer prepuce helps to keep out contaminants and pathogens. Lakshmanan & Parkash (1980) described the muscle fibers in the [[prepuce]] (known as the [[dartos]]), which contract to keep the prepuce snugly close to the [[glans penis]]. The muscle fibers form a whorl at the tip to keep the tip of the [[foreskin]] and keep the preputial sac closed against the outside world and contamination.<ref>{{REFjournal
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}}</ref> The muscle fibers form a whorl at the tip to keep the tip of the [[foreskin]] and keep the preputial sac closed against the outside world and contamination.<ref name="fleiss1998">{{FleissP HodgesF VanHoweRS 1998}}</ref>
Cold & Taylor (1999) described a healthy microbiome that lives within the preputial sac.<ref name="cold-taylor1999" /> They also reported that Langerhans cells are found in the mucosa of the preputial sac. [[Langerhans cells]] are part of the immunological defenses of the [[penis]]. De Witte et al. (2007) reported that Langerhans cells produce a substance named ''langerin''. The langerin offers protection against HIV infection:
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Fleiss, Hodges & Van Howe (1998) reported the presence of cathepsin B, lysosyme, chymotrypsin, neutrophil elastase, and cytokine in the sub-preputial moisture. These substances have a destructive lytic effect on pathogens and make the preputial sac a trap for disease-causing organisms.<ref name="fleiss1998">{{FleissP HodgesF VanHoweRS 1998}}</ref>
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 cavity sac at least daily to prevent [[infection]]. This advice is outmoded.<ref name="birley1993fleiss1998" /> <ref name="fleiss1998birley1993" /> Washing may introduce pathogens into the preputial cavity. It also removes the skin oil and protective lytic substances described above. It is better to wash only as necessary.
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]].