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No real differences
Dr. Hatem Khammash. (1)
Dr. Maher Shahrour. (1)
Dr. Motee Abu Awwad. (2)
Dr. Noor El Huda Sawalha. (2)
Dr. Murad Al Masri. (1)
Dr. Sundus Shalabi. (1)
Dr. Mohammad Salah Al-Din (1).
Dr. Ala’ Lafi. (1)
Dr. Helmi Tamimi. (1)
Dr. Mohammed Ayasa. (1)
Dr. Taha Jo’be. (1)
Dr. Ebtihal Jawabreh. (2)
Dr. Sa’eed Natshe. (2)
(1) Makassed Hospital – Jerusalem.
(2) PRCSH (Palestinian Red Crescent Specialized Hospital – Hebron).
P value 0.010
P value 0.0001
Group means were significantly different
(independent-samples t-test, t(690)=2.39, p<0.001, two tailed).
Why
We recommend the routine use of Dry cord care, if hygienic practice is being applied.
is it Significant To
Answer The Question?
Dry or Alcohol ?
1. U.C stump.
2. Periumbilical area
(44) (Mullany L C, Darmstadt G L,Khatry S K, LeClerq S C, Katz J, Tielsch J M, 2006).
(45). Hess JH, Lundeen EC)
(Janssen PA, Selwood BL, Dobson SR, Peacock D, Thiessen PN,2003)
Dry Cord Care
1. At Normal Nursery:
At age of 48 hours just before discharge.
2. At OPC on the regular follow up:
5-7 days after delivery.
3.By Phone call:
7-10 days, 10-15 days, till separation of the cord.
1. Less time for cord separation
2. Decrease load on mother
3. Decrease Cost
1. Increases Bacterial colonization at U.C stump
2. ++ risk of Omphalitis.
By: Dr. Noor Alhuda Sawalha, Dr. Maher Shahrour
Dr. Hatem Khammash, Dr. Motee Abu Awwad
(2006 Mullany L C,Darmstadt G L, Khatry S K, LeClerq S C, Katz J and Tielsch J M)
Advantages:
Reduce colonization, Omphalitis, infant morbidity and mortality
Disadvantages:
1. Longer time for the cord to separate
2. ++ Load of care on mother
Dependent Variable:
Age of separation of umbilical cord -- Primary Outcome
Independent:
NSVD, Assisted VD,C/S (Urgent/Elective).
-Age
-Parity
- Discharge, Change in the color, Redness
- Hotness
- Tenderness
- Foul odor
- Blisters
- Conjunctivitis
Thank You
The nurseries were introduced in the hospitals.
( AU - Pezzati M; Biagioli EC; Martelli E; Gambi B; Biagiotti R; Rubaltelli FF,2002)
- 692 Newborns;
- Control group: 344
- Experimental group: 348
2. WHO/RHT/MSM/98.4 Care of the Umbilical Cord: A review of evidence. Geneva, Switzerland: World Health Organization; 1998.
Cord Stump is:
-First site of bacterial colonization of the NB.
-Direct rout of the bacteria to inside the body.(5)
-Cord stump infection:
Appropriate Care of U.C Stump
The Controversy Continues
(Cochrane library, 2002, issue 4)
Randomized controlled trial in a tertiary care hospital in Alberta, Canada
1997
Conclusions:
CONCLUSIONS:
- Bathing with neutral soap & drying of UC:
-- the time of cord separation.
Medves JM,O'Brien BA. Cleaning solutions and bacterial colonization in promoting healing and early separation of the umbilical cord in healthy newborns. Can J Public Health 1997 Nov/Dec;88:380–2.
By Robert S. Baltimore, MD. Published in Journal Watch Infectious diseases Feb, 2013
Arch Argent Pediatr. 2011 Aug;109(4):305-13. doi: 10.1590/S0325-00752011000400005.
2. WHO/RHT/MSM/98.4 1998.
5.1985;2 :1075– 1080 medlineWeb of science.
To dye or not to dye
Randomized clinical trial of:
Triple dye/Alcohol V.S Dry Cord Care
In 1998:
1. Hand washing (1,2)
2. Dry cord care under routine conditions
3. Usage of antiseptics is helpful when unhygienic practices are used
Untill now same recommendations
CONCLUSION:
1. WHO/RHT/MSM/98.4 Care of the Umbilical Cord: A review of evidence. Geneva, Switzerland: World Health Organization; 1998.
2. Scanlon JW, Leikkanen M. The use of fluorescin powder for evaluating contamination a newborn nursery. J Pediatr. 1973;82:966–971.
3. World Health Organization. Care of the umbilical cord. WHO/FHE/MSM-cord care. Geneva: WHO, 1998.
4. Garner P, Lai D, Baea M, Edwards K, Heywood P. Avoiding neonatal death: an intervention study of umbilical cord care. J Trop Pediatr. 1994;40:24–8. [PubMed]
5. World Health Organization. Care of the Umbilical Cord. Geneva,Switzerland: World Health Organization; 1998.
(Pediatrics 2003;111.1.15 DOL :10.1542/Peds.111.1.15)