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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 is outmoded.<ref name="fleiss1998" /> <ref name="birley1993" /> 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 wash only as necessary, using only warm water.
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]].