Gautam Chawla1, K K Diwakar2. 1. Former Senior Resident, Department of Neonatology, Malankara Orthodox Syrian Church Medical College , Kolenchery PO, Kochi, Kerala, India . 2. Professor & Head, Department of Neonatology, Malankara Orthodox Syrian Church Medical College , Kolenchery PO, Kochi, Kerala, India .
Abstract
AIM: To compare the effect of umbilical cord care with Povidine Iodine- Spirit on umbilical infection in early neonatal period. MATERIALS AND METHODS: Prospective double blinded randomized controlled study was undertaken to evaluate the effect of daily cleansing of the umbilical cord of term infants with Spirit (Alcohol) -Povidine Iodine combination). This was also compared to the retrospective data obtained for the prevailing practice of keeping the umbilical cord dry. RESULTS:1518 infants were included in the study. (462 in the "cord care group", 496 in the "water" placebo group, & 560 in "Dry" retrospective group). There was an overall reduction in the clinically screened and evaluated "umbilical infection" in the Povidine -Iodine group. This was attributable to a greater reduction in the mixed bacterial (Colonizer/ commensals) isolates. The Relative Risk for Staph. aureus was lesser when the cord was kept dry (RR 0.6, p<0.01) and sterile water (Placebo) group (RR 0.7, p<0.01). CONCLUSION: Avoiding the antiseptic cleansing increased the RR for commensal / mixed bacterial over growth that would probably facilitate umbilical cord separation.
RCT Entities:
AIM: To compare the effect of umbilical cord care with PovidineIodine- Spirit on umbilical infection in early neonatal period. MATERIALS AND METHODS: Prospective double blinded randomized controlled study was undertaken to evaluate the effect of daily cleansing of the umbilical cord of term infants with Spirit (Alcohol) -PovidineIodine combination). This was also compared to the retrospective data obtained for the prevailing practice of keeping the umbilical cord dry. RESULTS: 1518 infants were included in the study. (462 in the "cord care group", 496 in the "water" placebo group, & 560 in "Dry" retrospective group). There was an overall reduction in the clinically screened and evaluated "umbilical infection" in the Povidine -Iodine group. This was attributable to a greater reduction in the mixed bacterial (Colonizer/ commensals) isolates. The Relative Risk for Staph. aureus was lesser when the cord was kept dry (RR 0.6, p<0.01) and sterile water (Placebo) group (RR 0.7, p<0.01). CONCLUSION: Avoiding the antiseptic cleansing increased the RR for commensal / mixed bacterial over growth that would probably facilitate umbilical cord separation.
Authors: Luke C Mullany; Gary L Darmstadt; Joanne Katz; Subarna K Khatry; Steven C LeClerq; Ramesh K Adhikari; James M Tielsch Journal: Am J Epidemiol Date: 2006-10-25 Impact factor: 4.897