Umbilical Cord Separation in the Normal Newborn

Novack, Alvin H.; Mueller, Beth A.; Ochs, Hans D.

doi:10.1001/archpedi.1988.02150020122046

Cited by 33 publications

(33 citation statements)

References 11 publications

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“…12 Our study showed that the use of an antiseptic product in powder form is related to a shorter cord separation time than an antiseptic product in liquid form (Table 3). These data confirm what was already shown in other studies 6,10,13,14,[17][18][19] and emphasize the important role of the dehydrating action in the cord detachment process. 2,17,20 The importance of dehydration is confirmed by the relatively rapid cord sloughing in newborns who were treated with natural drying.…”

supporting

confidence: 92%

“…2 Cord treatment may alter cord separation http://www.pediatrics.org/cgi/content/full/112/4/e275 e277 time. 6,7,10,11 Because the umbilical stump is a common means of entry for systemic infection, delay in cord detachment may risk bacterial entry 2 ; furthermore, it may increase the cost of postnatal care. 12 Our study showed that the use of an antiseptic product in powder form is related to a shorter cord separation time than an antiseptic product in liquid form (Table 3).…”

Section: Discussionmentioning

confidence: 99%

“…9 Finally, the WHO established that in hospital nurseries, it is probably best to apply a topical antimicrobial to the cord stump after cutting the cord and once a day for the first 3 days. 2 It is important to remember, however, that antiseptic treatment delays cord detachment 6,7,10,11 ; subsequently, the cost of postnatal care may increase unnecessarily. 12 Preterm infants are at higher risk of infection, partly because of their prematurity and partly be- by guest on May 7, 2018 http://pediatrics.aappublications.org/ Downloaded from cause they are exposed to a higher risk of nosocomial infections.…”

mentioning

confidence: 99%

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Umbilical Cord Care in Premature Infants: The Effect of Two Different Cord-Care Regimens (Salicylic Sugar Powder vs Chlorhexidine) on Cord Separation Time and Other Outcomes

et al. 2003

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ABSTRACT. Objectives. To evaluate the effect of 2 cord-care regimens (salicylic sugar powder vs chlorhexidine as a 4% detergent water solution) on cord separation time and other outcomes in preterm infants.Methods. A prospective, randomized, controlled trial was conducted on 244 preterm newborns with a gestational age of <34 weeks and a birth weight of <2500 g. All preterm newborns were enrolled, regardless of their health condition. We excluded from the study infants whose conditions during the first hours of life required the catheterization of umbilical vessels. We also excluded from the general statistical analysis all newborns who had their programmed cord-care regimen changed because of the presence or the suspicion of omphalitis. On arrival at our neonatal intensive care unit or neonatal special care unit, infants were bathed thoroughly with a soap solution (Saugella, Guieu, Italy), and the umbilical cord (UC) was treated with 1 of the 2 antiseptic products chosen for the study. The stump was then folded and covered with common sterile, dry gauze and kept in place by an elastic net. Until cord detachment and at every diaper change, the cord stump was cleaned with sterile water and treated with the same product initially used for first-time cord care. On the third day of life, we obtained an umbilical swab either from the base of the cord or from the umbilicus if the cord was already sloughed. Six weeks after birth, during hospitalization or during a follow-up visit if already discharged, all infants had a medical examination to check the umbilicus area. Cord separation time, changing of the programmed cordcare regimen, death, omphalitis, sepsis, cord bleeding, nurses' opinion on treatments efficacy, and UC colonization were measured.Results. The cord separation time was significantly lower in infants who were treated with salicylic sugar powder (6 ؎ 2 days) than in infants who were treated with chlorhexidine (9 ؎ 2 days). The programmed cordcare regimen was changed in a significantly higher number of newborns in the chlorhexidine group (17) than in the salicylic sugar group (3). None of the newborns died, and we found only sporadic cases of sepsis (1 patient in each group) and omphalitis (1 patient in the chlorhexidine group). A significantly higher percentage of nurses were satisfied with the salicylic sugar powder treatment (98%) than with the chlorhexidine treatment (67%), notwithstanding a more frequent occurrence of slight cord scar bleeding in the salicylic sugar group (7.8%) than in the chlorhexidine group (4%). The rate of negative umbilical swabs was significantly higher in infants treated with salicylic sugar powder (73.1%) than with chlorhexidine (53%).Conclusions. T he umbilical cord (UC) is an important bacterial colonization site. 1 A possible consequence of bacterial colonization is cord stump infection, a factor that can greatly increase morbidity and mortality in developing countries. 2 In the 1940s, the introduction of nurseries in hospitals increased the risk of colonization and infecti...

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supporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Umbilical Cord Care in Premature Infants: The Effect of Two Different Cord-Care Regimens (Salicylic Sugar Powder vs Chlorhexidine) on Cord Separation Time and Other Outcomes

et al. 2003

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“…Adequate care of the umbilical cord stump of the newborn infant may prevent infections. At present, various topical methods are used for cord care, including washing 2,3 newborns in Kano, northern Nigeria. The aim is to establish the mean separation time and the effect of maternal and infant characteristics, perinatal factors and cord care practices on the cord separation time.…”

Section: Introductionmentioning

confidence: 99%

Survey of Umbilical Cord care and Separation time in Healthy Newborns in Kano

Mukhtar-Yola¹,

Iliyasu²,

Wudil³

2011

Nig. J. Paed.

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hundred and forty nine (60.9. p e r c e n t ) m o t h e r s a p p l i e d methylated spirit, 145 (25.3 percent) used hot compress, while 50 (8.7 percent) applied toothpaste on the cord. Twenty (3.5 percent) others applied herbs, while nine (1.6 percent) applied dusting powder to the umbilical stump. C o r d s e p a r a t i o n t i m e w a s significantly shorter among babies whose mothers were of high parity, unbooked, and of low educational status. In addition, the use of razor blade, thread, hot compress or application of herbal preparations o r t o o t h p a s t e s i g n i f i c a n t l y shortened the separation time (P<0.05).Cord separation time and cord care practices varied. Nigerian mothers often use unorthodox interventions to shorten cord separation time; however, the risk of omphalitis that may result from this is real. We recommend that each centre should adopt and teach mothers a standard hygienic c o r d c a r e p r a c t i c e w h i l e discouraging the use of herbs and untested materials. A b s t r a c t B a c k g ro u n d :Objectives: M e t h o d s :Results:

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“…Finally, the WHO established that in hospital nurseries it is probably best to apply a topical antimicrobial to the cord stump after cutting the cord and once a day for the first three days [2]. It is important to remember, however, that antiseptic treatment delays cord detachment [6,7,10,11] and that consequently, the cost of postnatal care may unnecessarily increase [12].…”

Section: Introductionmentioning

confidence: 99%

Umbilical Cord Care: The Effect of Eight Different Cord-Care Regimens on Cord Separation Time and Other Outcomes

Pezzati¹,

Biagioli²,

Martelli³

et al. 2002

Neonatology

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In this study we evaluate the effect of eight cord-care regimens on cord separation time and other secondary outcomes: omphalitis, sepsis, death, cord bleeding, compliance, satisfaction or dissatisfaction with regard to the type of treatment, umbilical cord colonization – in 1,535 healthy term infants. The eight cord-care regimens studied were: 70% alcohol, natural drying, salicylic sugar powder, triple dye, micronized green clay powder, colloid silver-benzyl-peroxide powder, neomycin-bacitracin powder, 1% basic fuchsine. None of the newborns developed sepsis or died and we found only sporadic cases of omphalitis. With regard to cord separation time the best results were obtained with salicylic sugar powder (5.6 ± 2.3 days) and green clay powder (6.7 ± 2.2 days). Both forms of treatment proved to be more effective (p < 0.05) than all the others. We found that salicylic sugar powder allows for early cord detachment resulting in excellent parent treatment compliance and reduction of their concern, notwithstanding higher percentages of cord bleeding. The rate of positive umbilical swabs was low and was significantly higher only than the results obtained with neomycin-bacitracin powder treatment. This study demonstrates that, in hospital nurseries of developed countries, salicylic sugar powder can be effectively and safely used for umbilical cord care of healthy term infants.

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Umbilical Cord Separation in the Normal Newborn

Cited by 33 publications

References 11 publications

Umbilical Cord Care in Premature Infants: The Effect of Two Different Cord-Care Regimens (Salicylic Sugar Powder vs Chlorhexidine) on Cord Separation Time and Other Outcomes

Umbilical Cord Care in Premature Infants: The Effect of Two Different Cord-Care Regimens (Salicylic Sugar Powder vs Chlorhexidine) on Cord Separation Time and Other Outcomes

Survey of Umbilical Cord care and Separation time in Healthy Newborns in Kano

Umbilical Cord Care: The Effect of Eight Different Cord-Care Regimens on Cord Separation Time and Other Outcomes

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