Umbilical cord antiseptics for preventing sepsis and death among newborns

Imdad, Aamer; Bautista, Resti Ma M; Senen, Kathlynne Anne A; Uy, Ma Esterlita V; Mantaring, Jacinto Blas V.; Bhutta, Zulfiqar Ahmed

doi:10.1002/14651858.cd008635.pub2

Cited by 100 publications

(109 citation statements)

References 82 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In 5 such trials 30 -33 analyzed by Karumbi et al, 22 no treatment was found to significantly reduce omphalitis and sepsis when compared against one another, although the sample sizes were small and the evidence was deemed of low quality. 22 The Cochrane review by Imdad et al, 23 which compared a variety of pairs of topical agents, reached similar conclusions. The most recent meta-analysis, by Sinha et al, 24 considered 2 studies 28, 34 comparing chlorhexidine with dry cord care.…”

Section: Evidence-based Practicementioning

confidence: 77%

“…20 Methods of umbilical cord care have been the subject of 4 recent meta-analyses, 21 -24 including 2 Cochrane reviews. 23,24 Although the scope and methodologies of these reviews differed, all 4 stratified results according to the study setting, distinguishing results reported from communities with high proportions of births at home and high neonatal mortality rates from those obtained in hospitals and settings with low neonatal mortality rates. These analyses concluded that 3 studies (including >44 000 subjects) in community settings in South Asia with a high neonatal mortality rate 3,25,26 24 No other cord-management strategies have been evaluated systematically in such settings, but the application of traditional materials (eg, ash, herbal or other vegetal poultices, and human milk) may provide a source of contamination with pathogenic bacteria, including C tetani.…”

Section: Evidence-based Practicementioning

confidence: 99%

See 1 more Smart Citation

Umbilical Cord Care in the Newborn Infant

Stewart¹,

Benitz²,

Newborn³

2016

Pediatrics

View full text Add to dashboard Cite

Postpartum infections remain a leading cause of neonatal morbidity and mortality worldwide. A high percentage of these infections may stem from bacterial colonization of the umbilicus, because cord care practices vary in refl ection of cultural traditions within communities and disparities in health care practices globally. After birth, the devitalized umbilical cord often proves to be an ideal substrate for bacterial growth and also provides direct access to the bloodstream of the neonate. Bacterial colonization of the cord not infrequently leads to omphalitis and associated thrombophlebitis, cellulitis, or necrotizing fasciitis. Various topical substances continue to be used for cord care around the world to mitigate the risk of serious infection. More recently, particularly in high-resource countries, the treatment paradigm has shifted toward dry umbilical cord care. This clinical report reviews the evidence underlying recommendations for care of the umbilical cord in different clinical settings.

show abstract

Section: Evidence-based Practicementioning

confidence: 77%

Section: Evidence-based Practicementioning

confidence: 99%

Umbilical Cord Care in the Newborn Infant

Stewart¹,

Benitz²,

Newborn³

2016

Pediatrics

View full text Add to dashboard Cite

show abstract

“…26 A meta-analysis of clinical trials that assessed umbilical cord care protocols showed a 23% reduction in neonatal mortality and a 27%-56% reduction in omphalitis in the group using chlorhexidine. 27 Another meta-analysis demonstrated a reduction in mortality and in the incidence of omphalitis among patients who received umbilical cord care with chlorhexidine versus routine community care. But such reduction was not sustained versus routine hospital care or in patients whose skin was cleansed with chlorhexidine compared to control patients.…”

Section: It Also Inactivates Lipid-enveloped Viruses Such As Herpes mentioning

confidence: 99%

Colonization and infection in the newborn infant: Does chlorhexidine play a role in infection prevention?

Rosario¹,

Puentes-Herrera

Corrales

et al. 2017

Arch Argent Pediat

View full text Add to dashboard Cite

Healthcare-associated infections are a major problem in newborn infants, considering their high morbidity, mortality, and long-term sequelae. In preterm infants, it has been shown that skin and gastrointestinal tract colonization undergoes variations compared to healthy term infants, and that preterm infants are more exposed to nosocomial microorganisms given their higher probability of being admitted to the neonatal intensive care unit where they are cared for. This document reviews normal colonization, the changes observed during hospitalization, prematurity, and the potential role of chlorhexidine in the prevention of resistant microorganism transmission, as well as its side effects in newborn infants admitted to the neonatal intensive care unit.

show abstract

“…En el neonato, el gluconato de clorhexidina al 0,5%-1% es el antiséptico de elección para la desinfección en la piel. 25 Existen estudios que evalúan el efecto de la limpieza del canal del parto asociado a la limpieza corporal total de los neonatos y muestran una reducción en la mortalidad, no así los que solo realizaron limpieza de los neonatos sin intervenir el canal del parto 26 Un metaanálisis con ensayos clínicos que evaluaron protocolos de cuidado de cordón umbilical demostró una reducción del 23% en la mortalidad neonatal y del 27%-56% en la onfalitis en el grupo que usó clorhexidina 27 Otro metaanálisis evidenció una reducción en la mortalidad y en la incidencia de onfalitis en pacientes que recibieron limpieza del cordón umbilical con clorhexidina vs. cuidados de rutina de la comunidad. No así frente a pacientes con cuidados de rutina en el hospital ni en aquellos en que se practicó la limpieza de la piel con clorhexidina comparados con los grupos control.…”

Section: Papel De La Clorhexidinaunclassified