Comparison of time to umbilical cord separation using 3 cord-care regimens : triple dye, alcohol and no antiseptic agent

Abstract

Objectives: To compare time to cord separation, parental satisfaction, bacterial colonization, infection and adverse outcome among 3 regimens of cord care at home: (1) triple dye, (2) alcohol, and (3) no antiseptic agent. Study design: A randomized controlled trial Setting: Phramongkutklao Hospital Research Methodology: Term infants born at Phramongkutklao Hospital were randomly assigned into one of three groups based on cord care regimens at home: (1) triple dye, (2) alcohol, and (3) no antiseptic agent. Triple dye was applied on umbilical stump in every infant during hospital stays, Within 1 week after discharge, all infants were visited to monitor compliance and to perform umbilical swab cultures. At one month of age, infants were evaluated. Parents returned the records of timing of cord separation, satisfaction, infection or other complications. Results: 185 infants were recruited (63, 60 and 62 in group 1, 2 and 3, respectively). The time to cord separation in infants of group 1 was significantly longer than in group 2 (p = 0.036) and group 3 (p = 0.003). The mean time to cord separation in each group was 16.25 ± 6.29, 13.79 ± 4.26 and 13.12 ± 3.82 days, respectively. The parental satisfaction scores of group 1 were significantly lower than those of group 2 (p = 0.019) and group 3 (p < 0.01). 171 (95%) of 180 culture specimens grew gram-negative bacteria whereas staphylococcus was found only in 30%. No omphalitis occurred in study infants. Three infants were suspected to have clinical sepsis and were treated with antibiotics. Conclusion: The umbilical cord care at home using triple dye delayed time to cord separation and was less satisfied by parents when compared to the other regimens using alcohol or no antiseptic agent. We conclude that using alcohol or dry clean could be alternative ways of umbilical cord care at home.