Higher Rate of Cord-Related Adverse Events in Neonates with Dry Umbilical Cord Care Compared to Chlorhexidine Powder

Kapellen, Thomas; Gebauer, Corinna; Brosteanu, Oana; Labitzke, Birgit; Vogtmann, C; Kieß, Wieland

doi:10.1159/000200165

Cited by 31 publications

(33 citation statements)

References 45 publications

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“…For instance between chlorhexidine powder and dry cord care, chlorexidine seems to be the favourite one, therefore the carers would administer this treatment to their next child. 11 In the present study the researcher asked pluripare, experimented both the treatments in different pregnancies, which they preferred and why. About 40% of them would administer dry cord care to their next child appearing to more gentle and comfortable for the newborn.…”

Section: Resultsmentioning

confidence: 99%

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Umbilical Cord Care After the First Day From Birth: A Case Control Study in a Northeastern Italian Hospital

Gallina¹,

Tina²,

Basso³

et al. 2016

Pediatr Neonatal Nurs Open J

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Background: Recently the use of antibacterial agents to clean and dry the stump of the newborns' umbilical cord (UC) after birth has been abandoned by many neonatal units. Aim of this study was to compare the occurrence of adverse events (AEs), time to UC separation and caregivers' satisfaction among newborns treated with dry cord care versus 70% alcohol after one day from birth in an Italian Hospital. Methods: From June 2014 to September 2014, 100 infants were enrolled for the study. Soon after birth, all the newborns were treated in the same way: their UC was cleansed with 70% alcohol, using a sterile gauze. One day after the birth, in the control group the UC was regularly cleansed with 70% alcohol twice a day, while in the case group, from the first nappy change, dry cord care was performed cleansing the UC with sterile saline solution (NaCl 90%), using a sterile gauze twice a day. In all cases UC was left without any dressing upon it as well. The time to UC separation and any AEs (local and systemic infections, haemorrhage, granuloma formation) were reported by mothers. Carers' perception regarding the two procedures were collected by a questionnaire between 6 and 24 hours after birth, and 1 month later. Results: We found a significant difference in the mean cord separation time between the two groups [dry cord care: 9.1 days (standard deviation (SD)=3.1] versus 70% alcohol: 11.3 days (SD=4.6); p<0.01], while no significant AEs and carers' satisfaction on the procedures resulted. Instead, change of treatment at home was more frequent in dry cord care group (23.9% versus 6.1%; p<0.01). Conclusions: This study confirms that dry cord care is an easy, accepted and safe method of handling the UC in healthy newborn infants born in a high-income hospital setting.

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Section: Resultsmentioning

confidence: 99%

“…11,14 After obtaining written consent by parents, during the considered period the first 50 subjects were assigned to control group and the last 50 infants to case group (dry cord care).…”

Section: Methodsmentioning

confidence: 99%

Umbilical Cord Care After the First Day From Birth: A Case Control Study in a Northeastern Italian Hospital

Gallina¹,

Tina²,

Basso³

et al. 2016

Pediatr Neonatal Nurs Open J

View full text Add to dashboard Cite

show abstract

“…11,14 After obtaining written consent by parents, subjects were assigned to control group if born in December 2014 and January 2015, and to case group if born in February 2015 and March 2015. Standard cord care consisted in 1 application of 70% alcohol at birth followed by other 2 times a day, while experimental dry cord care procedure was executed by the only application of a sterile gauze around the base of the UC on the 1st day of life to absorb bloody secretions and after the cord has been exposed to air off the diaper edge.…”

Section: Methodsmentioning

confidence: 99%

“…The study also detected the umbilical granuloma that is the most common umbilical abnormality in the neonate. 11 …”

Section: Methodsmentioning

confidence: 99%

70% Alcohol Versus Dry Cord Care in the Umbilical Cord Care

et al. 2016

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Recently the use of antibacterial agents to clean and dry the stump of the newborns’ umbilical cord (UC) after birth has been abandoned by many neonatal units in favor of dry cord care. Aim of this study was to compare the occurrence of adverse events (AEs) and time to cord separation among newborns treated with dry cord care versus 70% alcohol in an Italian Academic Hospital (AH).From December 2014 to March 2015, 239 infants were born at the AH. The number of eligible infants was 200 and they were equally assigned to either case group (dry cord care) or control group (70% alcohol, standard procedure). Standard cord care consisted in 1 application of 70% alcohol at birth followed by other 2 times a day, while experimental dry cord care procedure was executed by the only application of a sterile gauze around the base of the UC at the 1st day of life and after the cord has been exposed to air off the diaper edge. The time to UC separation and any AEs such as local and systemic infections, hemorrhage, and granuloma formation were reported by mothers.We found a significant difference in the mean cord separation time between the 2 groups (dry cord care: 10.1 days [standard deviation, SD = 4.0] vs 70% alcohol: 12.0 days [SD = 4.2]; P < 0.001), while no significant AEs resulted. Incidence rate of granuloma was 0.67 × 1000 days of life in dry cord care group.Dry cord care is an easy, straight-forward, and safe method of handling the UC in healthy newborn infants born in a high-income hospital setting.

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“…Se analizaron 362 RN, 181 en cada grupo. La higiene con baño se asoció con una mayor frecuencia de colonización intrahospitalaria del CU (OR 1,92 [1,12], p <0,01) y caída del cordón más temprana (mediana [rango intercuartílico]= 6,00 [3] vs. 7,00 [4] días en el grupo control; p <0,001). No se observó un mayor riesgo de infecciones.…”

Section: Introductionunclassified

Higiene del cordón umbilical con alcohol comparado con secado natural y baño antes de su caída, en recién nacidos de término: ensayo clínico controlado aleatorizado

et al. 2011

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Arch Argent Pediatr 2011;109(4):305-313 / 305 ResumenEl cuidado e higiene del cordón umbilical (CU) es motivo de preocupación para los padres. Objetivos. Principal: comparar la efectividad del secado natural del CU, con la práctica habitual (alcohol), en la reducción del tiempo de caída del CU y la incidencia de infecciones en el recién nacido (RN). Secundarios: comparar la colonización bacteriana intrahospitalaria del CU, y el grado de satisfacción de los padres en ambos grupos. Población. RN de término asistidos en el Servicio de Neonatología del Hospital Privado del Sur, cuyos padres consintieron participar. Material y métodos. Estudio clínico prospectivo, controlado, abierto, aleatorizado, en dos grupos: Grupo Estudio (secado natural y baño diario con jabón neutro) y Grupo Control (alcohol 70%). Variables principales: tiempo de caída del CU; presencia de infecciones en piel o conjuntivas en el primer mes de vida; colonización del cordón y satisfacción parental. Análisis por intención de tratamiento. Resultados. Se analizaron 362 RN, 181 en cada grupo. La higiene con baño se asoció con una mayor frecuencia de colonización intrahospitalaria del CU (OR 1,92 [1,12], p <0,01) y caída del cordón más temprana (mediana [rango intercuartílico]= 6,00 [3] vs. 7,00 [4] días en el grupo control; p <0,001). No se observó un mayor riesgo de infecciones. El grado de satisfacción parental fue similar y elevado en ambos grupos. Conclusiones. El secado natural y baño redujo el tiempo de caída del CU; aun cuando la frecuencia de colonización fue mayor en el grupo estudio, no se encontró un riesgo mayor de infecciones en el primer mes. Palabras claves: recién nacido, cordón umbilical, cuidado postnatal, ensayo clínico controlado. AbstRActBackground. Umbilical cord (UC) care is a cause of concern for parents right from birth until its separation. Standard practice in Argentina includes frequent cleansing of the UC with alcohol and body bath only two days after its separation. The effect of different methods of UC care on its separation time and on colonization with microorganisms has been insufficiently explored. Objectives. Main: To compare the effect on time of UC separation when using body bath with neutral soap followed by natural drying of the UC vs. standard care. Secondary: a) colonization rates during hospitalization; b) incidence of skin infection and conjunctivitis and c) parental comfort with both types of care. Population. Normal term newborns (≥37 weeks), born at the HPS, and whose parents provided informed consent. Methods. Open prospective controlled clinical trial, with random allocation to two groups: study group -natural drying of the UC and body bath with neutral soap-and control group -UC hygiene with alcohol 70% at each diaper change until its separation and bath two days later-. UC separation time; UC colonization during hospital stay and skin and conjunctive infections in the first 30 days of life were monitored. Analysis was by intention-to-treat. Results. 362 newborns were included, 181 in each group. The...

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Higher Rate of Cord-Related Adverse Events in Neonates with Dry Umbilical Cord Care Compared to Chlorhexidine Powder

Cited by 31 publications

References 45 publications

Umbilical Cord Care After the First Day From Birth: A Case Control Study in a Northeastern Italian Hospital

Umbilical Cord Care After the First Day From Birth: A Case Control Study in a Northeastern Italian Hospital

70% Alcohol Versus Dry Cord Care in the Umbilical Cord Care

Higiene del cordón umbilical con alcohol comparado con secado natural y baño antes de su caída, en recién nacidos de término: ensayo clínico controlado aleatorizado

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