Antiseptics for Preventing Omphalitis

SOPAPAN PANYAVUDHIKRAI,M.D.*, THRATHIP KOLA TAT, M.D.*, SOMWANG DANCHAIVUITR, M.D.**, CHERTSAK DHIRAPUTRA, M.D.***, CHANCHAI V ANTANASIRI, M.D.****, VARAPORN POOMSUWAN, R.N.**, SUWANNA TRAKULSOMBOON, Ph.D.****, NITAYA SRIHAPOL, R.N.**

Affiliation : * Department of Pediatrics, ** Center of Nosocomial Infection Control, ***Department of Microbiology, **** Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

AbstractBackground : Omphalitis may cause serious complications and contribute to neonatal morbidity and mortality. From January 1997 to August 1998, the incidence of omphalitis in the Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital had been increased from 0.9 to 17.4 per 1000 live births. A prospective randomized trial using antiseptic applied directly to the umbilical stump was conducted aiming to reduce an epidemic outbreak of omphalitis in the newborn nursery.
Objective : To determine which antiseptic is appropriate for preventing omphalitis in the newborn infants.
Patients and
Method : Newborn infants delivered in the Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital were randomized into group A (Triple dye) or group B (70% Alcohol). The infant with omphalitis was assessed by a pediatrician or a neonatology fellow. At home, the same antiseptic will be continually applied to the umbilical stump daily until a few days after cord detachment. Relative risk was calculated and statistical significance was tested by Chi-square test.
Results : Four hundred and twenty-seven infants were enrolled. Birth weight, gestational age and gender of the infants in both groups were not different. There were no known maternal risk factors for omphalitis. Omphalitis was observed in 9/213 (4.2%) infants in group A and 23/214 (10.7%) infants in group B. The relative incidence rate between each group was statistically signi ficant (pConclusion : During an epidemic outbreak of omphalitis, Triple dye was the most appro priate and effective antiseptic to prevent omphalitis but could delay cord separation.

Keywords : Omphalitis, Antiseptic Prophylaxis, Umbilical Cord

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