Table Salt is An Alternative to Silver Nitrate Cautery for the Treatment of Umbilical Granuloma: A Prospective Randomized Controlled Trial

Abstract

The aim of this prospective study explore a cheap and readily available alternative to silver nitrate cautery, with far-reaching implications for many populations with limited access to medical care. Seventy four patients were enrolled in this prospective randomized controlled study. Patients were divided in two groups of 37 patients each. A stick applicator of 75% silver nitrate was applied in first group by the pediatric surgeon in the outpatient clinic. The patients in the second group was applied a small amount of table salt granules twice a day for 3 days by the family members at home. In the first week after treatment, the same treatment was applied for the second time to the patients who presence of umbilical exudate in both groups. Response to treatment was evaluated in the second week. There were no statistically significant differences between the two groups in the first week and second week after treatment in regard to presence of umbilical exudate and complication (P>0,05). Table salt is a safe alternative to silver nitrate cautery in the treatment of umbilical granuloma.

Comparison between silver nitrate and table salt in the treatment of umbilical granuloma.

“…9 In resource-poor areas, a reliable, cheap, easily accessible treatment option should be available for the treatment of umbilical granuloma to avoid complications such as omphalitis and sepsis. 10 Topical silver nitrate is recommended as the firstline treatment of umbilical granuloma. 9 It acts as an antibacterial with caustic features, leading to the shrinkage of granulomatous tissue.…”

“…9 It acts as an antibacterial with caustic features, leading to the shrinkage of granulomatous tissue. 10 Another reported method is the excision of the granulation tissue but it has a greater chance of recurrence and bleeding. 1 Treatment of umbilical granuloma with salt was proposed initially in 1972.…”

“…11 Salt creates an osmolality difference leading to desiccation and eventually separation of the granuloma. 10,12,13 Burns are a common complication of silver nitrate application due to spillage to surrounding skin. 6,14 Other challenges in the application of silver nitrate are that a medical professional is needed for proper application 10 , whereas, no side-effects have been reported by application of salt.…”

“…10,12,13 Burns are a common complication of silver nitrate application due to spillage to surrounding skin. 6,14 Other challenges in the application of silver nitrate are that a medical professional is needed for proper application 10 , whereas, no side-effects have been reported by application of salt. 7,10,15 In our study, the cure rate was 88% after applying common salt to the umbilical granuloma twice daily for 7 days.…”

“…6,14 Other challenges in the application of silver nitrate are that a medical professional is needed for proper application 10 , whereas, no side-effects have been reported by application of salt. 7,10,15 In our study, the cure rate was 88% after applying common salt to the umbilical granuloma twice daily for 7 days. Some studies reported a recovery rate of 55%-88% when common salt was applied twice daily for 3 days 5,16 whereas some reported it to be 96%-100% with a period of 5 days.…”