100 Comparision of effect of dry cord care versus chlorhexidine cord care on cord separation time in healthy newborns

Background: Umbilical cord infection (omphalitis) is a major cause of neonatal mortality and morbidity in a developing country like Nepal. Detached umbilical stump is an important colonizing site for different types of bacteria and it also provides direct access to bloodstream. Hence, inadequate cord care may lead to omphalitis as well as neonatal sepsis. Objectives: This study aims to compare two different cord care regimens (dry cord care versus chlorhexidine cord care) on their cord separation time and the incidence of omphalitis. Methodology: This is a comparative observational study conducted at the Neonatal unit of Kathmandu Medical College over a three months period (August 2019 to October 2019). All newborn babies born between 37 to 42 weeks of gestation were enrolled. Randomization for dry cord care and chlorhexidine cord care group was done via computer generated numbers. Statistical package for social sciences 19 version was used for statistical analysis. Results: Among 514 term babies, 256 babies were included in the dry cord care group while 258 babies were enrolled in the chlorhexidine cord care group. The two groups had similar baseline characteristics. The mean cord separation time in the dry cord care group was 7.70±1.2 days (range 3-15 days), whereas in the chlorhexidine group, it was 7.77±1.4 days (range 4-18 days). Conclusion: There was no significant difference between the cord separation times in dry and chlorhexidine cord care regimens. Both dry cord care and chlorhexidine cord care regimens were found to be safe and effective.

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Chlorhexidine Cleansing of the Umbilical Cord and Cord Separation Time: A Hospital Based Study in Bangladesh

Journal of Science Foundation ◽

10.3329/jsf.v13i2.27929 ◽

2016 ◽

Vol 13 (2) ◽

pp. 27-30 ◽

Cited By ~ 2

Author(s):

Md. Khairuzzaman ◽

MA Mannan ◽

Abdul Matin ◽

Mst. Monjuman Ara Sarker ◽

Nihar Ranjan Sarker ◽

...

Keyword(s):

Umbilical Cord ◽

Care Group ◽

Cord Care ◽

Maternal Acceptance ◽

Separation Time ◽

Umbilical Cord Care ◽

The Mean ◽

The Impact ◽

To Receive ◽

Level Hospital

Background: Cord separation time has evolved as an important justification for recommending against the topical use of chlorhexidine on the cord. Objective: This present study was undertaken to determine the impact of cord cleansing with chlorhexidine on cord separation time and maternal acceptance of chlorhexidine in umbilical cord care. Methods: Between April 2013 to July 2014, 340 newborns were randomly assigned within a tertiary level hospital in Bangladesh to receive 1 of 2 cord care regimens: clean and dry cord care (control) and single cord cleansing with 4% chlorhexidine. Results: The mean cord separation time in newborns of chlorhexidine group was significantly longer than dry cord care group (p < 0.001). Mother of newborns in chlorhexidine group more frequently reported longer than usual cord separation time. Overall satisfaction of mother with cord separation time was high (95.9%). Conclusion: Topical chlorhexidine significantly increased cord separation time.Journal of Science Foundation, 2015;13(2):27-30DOI: http://dx.doi.org/10.3329/jsf.v13i2.27929

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Impact of different antiseptics on umbilical cord colonization and cord separation time

The Journal of Infection in Developing Countries ◽

10.3855/jidc.7224 ◽

2017 ◽

Vol 11 (02) ◽

pp. 152-157 ◽

Cited By ~ 5

Author(s):

Hulya Ozdemir ◽

Hulya Bilgen ◽

Ahmet Topuzoglu ◽

Senay Coskun ◽

Guner Soyletir ◽

...

Keyword(s):

Umbilical Cord ◽

Delivery Room ◽

Single Application ◽

Cord Care ◽

Separation Time ◽

Care Groups ◽

Significant Difference ◽

Umbilical Cord Care ◽

Care Practices ◽

Group 1

Introduction: There is still some uncertainty on cord care practices all around the world, especially in developing countries. The aim of our study was to investigate the effects of six different umbilical cord care practices on the rate of colonization and cord separation time. Methodology: A total of 516 newborns were randomly allocated to the following six umbilical cord care groups: group 1 received dry care; groups 2–4 received a single application of 70% alcohol, 4% chlorhexidine, or povidon-iodine in the delivery room, respectively, which were discontinued thereafter; groups 5 and 6 received a single application of 70% alcohol or 4% chlorhexidine, respectively, starting in the delivery room and continuing every six hours until discharge. Umbilical cords were examined on the second and third days and between the fifth and seventh day for signs of omphalitis. Swab cultures were taken on the second or third day from all cases. Results: Cord separation time (median [interquartile range]) was the shortest for group 1 (7 [6–7] days) and the longest for group 3 (10 [7–12] days) and group 6 (10 [8–12] days) (p < 0.001). The cord colonization in the swab cultures was significantly lower in groups 3 and 6 (p < 0.001). Omphalitis was detected in eight (1.5%) patients among the study population, and there was no significant difference between the groups. Conclusions: Our study showed that chlorhexidine application was the most effective agent in decreasing colonization, though it increased cord separation time significantly in both groups.

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Effect of Topical Application of Human Breast Milk, Chlorhexidine and Dry Cord Care on Neonatal Umbilical Cord Separation Time and Rate of Cord Infection : Cluster Randomized Trial

10.21203/rs.3.rs-122199/v1 ◽

2020 ◽

Author(s):

Melat Mekonnen ◽

Abiy Estifanos ◽

Mulugeta Gebremariam ◽

Yemisrach Biru

Keyword(s):

Breast Milk ◽

Umbilical Cord ◽

Care Group ◽

Human Breast Milk ◽

Human Breast ◽

Cord Care ◽

Chi Square ◽

Separation Time ◽

Surveillance Site ◽

Cluster Randomized

Abstract Background- Annually 1 million newborns worldwide die of infection caused by bacteria that enter the body via the umbilical cord. Regarding this the Ethiopia national strategy of new born and child survival identified Chlorhexidine as one of the high impact interventions to minimize neonatal mortality. Whereas, studies have shown Human breast milk application to the neonatal umbilical cord has a shorter cord separation time and lower rate of infection than Chlorhexidine or dry cord care. Method- From May to November, 2018, a three arm, non- masked, community based, cluster randomized controlled trial was conducted at Butajira Demographic and Health Surveillance site located in the Gurage Zone of the Southern Nations, Nationalities and Peoples´ Region of Ethiopia. Nine sub districts of the Butajira Demographic and Health Surveillance site were randomized into two intervention groups that are human breast milk and Chlorhexidine and a control group which is the dry cord care using a lottery method. From a sample size of 337, data were entered and analyzed for 302 term singleton newborns. Baseline characteristics across the groups were compared by ANOVA for continuous variables and Chi square for categorical variables. Mean cord separation time was compared among the groups using one way ANOVA whereas the secondary outcome i.e. rate of omphalitis was expressed in terms of frequency and was compared among the groups using Chi square. Level of significance was set at p <0.05 with 95% confidence interval. Result- The mean cord separation time was 5.6 days in the human breast milk group, 5.9days in the Chlorhexidine group, and 5.7days in the dry cord care group but this difference was not statistically significant among the study groups (p value=0.40). The highest signs of cord infection rate were observed in the dry care group and this was significant regarding the redness on the base of the cord stump (P<0.001). Conclusion- Topical application of human breast milk is related with shorter cord separation time compared to chlorhexidine or dry cord care. It also has reduced incidence of infection, as much as topical chlorhexidine application. Generally the readily available human breast milk should be given further emphasis.Trial registration- This trial is registered at the Pan African Clinical Trial Registry on 27th August 2020 with a clinical trial registration number of PACTR202008804462886 . It can be accessed using the URL address:https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=593.

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

Nigerian Journal of Paediatrics ◽

10.4314/njp.v38i4.72280 ◽

2011 ◽

Vol 38 (4) ◽

Cited By ~ 1

Author(s):

M Mukhtar-Yola ◽

Z Iliyasu ◽

BJ Wudil

Keyword(s):

Umbilical Cord ◽

Cord Care ◽

Separation Time ◽

Umbilical Cord Care

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RETRACTED ARTICLE: Application of 4% chlorhexidine to the umbilical cord stump of newborn infants in lower income countries: a systematic review and meta-analysis

Maternal Health Neonatology and Perinatology ◽

10.1186/s40748-019-0111-y ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Aklilu Abrham Roba ◽

Maleda Tefera ◽

Teshager Worku ◽

Tamirat Tesfaye Dasa ◽

Abiy Seifu Estifanos ◽

...

Keyword(s):

Systematic Review ◽

Neonatal Mortality ◽

Umbilical Cord ◽

Topical Application ◽

Meta Analysis ◽

Newborn Infants ◽

Lower Income ◽

Cord Care ◽

Separation Time ◽

Lower Income Countries

Abstract There are conflicting results from large randomized controlled trials in different populations regarding the effectiveness of topical application of 4% chlorhexidine to the umbilical stump of newborn infants at reducing neonatal mortality. Meta-analysis and systematic review of trials performed in South Asia and Europe support 4% chlorhexidine application to reduce neonatal mortality, whereas trials performed in Sub-Saharan Africa do not. The aim of this review is to determine the effectiveness of 4% chlorhexidine application to the umbilical stump of newborn infants born in lower income countries in order to reduce neonatal mortality when compared with usual cord care. Our search strategy included randomized trials published between January1st 2000 and September 4th, 2018, that compared 4% chlorhexidine with usual cord care (“dry cord care”). The outcome variable of interest was neonatal mortality. Pooled relative risks (RR) with 95% confidence intervals (CIs) using a random-effects model were calculated. Nine trials were included, from six countries: Zambia, Tanzania, Bangladesh, Nepal, India and Pakistan, with a total of 257,153 participants. Five studies (N = 119,833) reported neonatal mortality. There was a 21% reduction in neonatal mortality among with 4% chlorhexidine application: pooled RR (95% CI) 0.79 (0.69–0.90), P = 0.0005. The incidence of omphalitis was decreased by 35% with 4% chlorhexidine (6 studies, N = 108,263): pooled RR (95% CI) 0.65 (0.56–0.75), P = 0.00001. Chlorhexidine application delayed the umbilical cord separation time (4 studies, N = 28,917): mean difference (95% CI) 2.71 (2.63–2.78) days. In conclusion, this systematic review found that topical application of 4% chlorhexidine to the umbilical cord stump of newborn infants in lower income countries significantly reduces the incidence of neonatal mortality. Chlorhexidine also reduces the incidence of omphalitis, but prolongs umbilical cord separation time. Trial registration Systematic Review Registration: CRD42018109280.

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Survey of umbilical cord care practices and separation time in healthy new-born in Maiduguri, Nigeria

Clinical Nursing Studies ◽

10.5430/cns.v6n4p94 ◽

2018 ◽

Vol 6 (4) ◽

pp. 94

Author(s):

Dathini Hamina ◽

Robert Teryila Kever ◽

Markus Njida Uba ◽

Lola Nelson ◽

Habu Haruna ◽

...

Keyword(s):

Umbilical Cord ◽

Health Care Facilities ◽

Care Practice ◽

Cow Dung ◽

Cord Care ◽

New Born ◽

Separation Time ◽

Validated Questionnaire ◽

Umbilical Cord Care ◽

Care Practices

This study aimed at assessing the umbilical cord care practices and separation time in healthy new-born in Maiduguri, Borno State, Nigeria. A descriptive survey design was adopted for the study. A total of 365 women attending child welfare clinic were selected through systematic random sampling technique from three health care facilities in Maiduguri Metropolis. A self-developed and validated questionnaire was used to collect information from the women on common cord care practices and knowledge of standard umbilical cord care practices. The questionnaire was pretested in State Specialist Hospital Maiduguri, Borno State and the correlation coefficient of 0.87 determined. The result of the study revealed that common cord care practices among women in Maiduguri include the use of methylated spirit, hot compress, charcoal, Vaseline and table salt. Others were mixture of methylated spirit with traditional concoctions, toothpaste and cow dung were also found to be commonly used by the mothers. The mean umbilical cord separation time of 3.5 days (± 0.397) was observed with the unorthodox treatment of the cord. Although there was a good knowledge among the respondents with regards to standard umbilical cord care practice, there was however no commensurate practice. Therefore, there is an urgent need for cultural re-orientation most especially of women with regard and unhygienic traditional cord care practices on the new born.

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