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.
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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