A comparison of umbilical cord treatment in the control of superficial infection

Abstract

Owing to a high incidence of superficial infection in the newborn period the existing cord care treatment of Iodosan 10% in surgical spirit was compared with 4% chlorhexidine detergent solution. A prospective crossover study was performed between two comparable maternity units. Cord bacteriology was assessed at the time of discharge from hospital and the day of cord separation recorded. The number of infections involving skin, eyes and umbilical cord occurring in hospital and at home were recorded. Chlorhexidine treatment of the cord was associated with an overall reduction in bacterial colonisation of the cord. This was most marked for coagulase positive staphylococci and was not associated with an increase in gram negative organisms. Cord separation occurred at a mean of 10 days with Iodosan and 20 days with chlorhexidine. Chlorhexidine treatment was associated with fewer infections overall; 21% of babies v 38% of babies treated with Iodosan. Conjunctival infection was most commonly recorded; 48 babies being affected in the Iodosan group and 20 in the chlorhexidine group. The use of 4% chlorhexidine detergent solution is supported, but the length of treatment may have to be limited in order to encourage cord separation.