Social Aspects in Management of Umbilical Stump

Abstract

ABSTRACT: Background Omphalitis defined as either pus discharge with erythema of the abdominal skin or severe redness (>2 cm extension from the cord stump) with or without pus The aim To idenfy the different lines of treatment of umbilical infections and and to evaluate the response of umbilical infection to these different lines .Subjects and Methods: : A prospective study done on neonate attained to pediatric department at Salahaldeen general hospital and neonate care unit department during the period from the first June to last of septemper 2017 . The diagnosis of umbilical infection are considered if the patient has one of the followings : 1. Severe redness of umbilicus (>2 cm extension from the cord stump) . 2.Incrased vein tributeries around the umbilicus. 3.With or without umbilical pus discharge. Each patient diagnosed as umbilical infection " omphalitis" where assessed by a prepared questionnaire which include name,sex,maturity, residence, signs of umbilical infection and discharge.The patient was examined for signs of umbilical infection and systemic infection which include fever, lethargy, poor feeding,crying, moro reflex.Each patient include in study would be send for umbilical swab for Culture to prove the umbilical infection and know the type of microorganism .The neonate also send for blood culture to prove that the same microorganism that cause the umbilical infectionis the same that present in blood (to exclude the contaminated cases) The result Two hundred neonates randomly selected and examined. The age of neonates ranged between- ) 03 1(days.The males were (59%) and females (41%) . presence of wide varieties in the methods of the umbilical cord. High prevalence of omphalitis recorded in neonatal care unit in hospital and majority of them presented with redness and the gentian violet is best response topical substance in treatment of omphalitis.. The common pathological organism isolated in umbilical swab and blood culture is E.coli. High prevalence of omphalitis (22.5%) recorded among studied group, the majority of them accompanied by redness concomitant with discharge . No significant association between neonatal sepsis and omphalitis. Only pus discharge was significantly associated with positive blood culture .In conclusion The study concludes that omphalitis is still common , and E.coli was the commonest microorganism isolated . Gentian violet has the best response as a topical substance in treatment of omphalitis.