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→Washing: Wikify.
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" />
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="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