1172 Umblical granulomas: A pinch of salt dries it up

Published Date: 11th October 2021

Publication Authors: Igboekwu T, Ahmad I

Background
An umbilical granuloma is an overgrowth of tissue that usually occurs when the umbilical stump has fallen off. It occurs commonly in the neonatal period usually after Day 15 of life. Parents usually describe a fleshy mass and persistent cumbersome discharge from the umbilical area. The potential risk of omphalitis and necrotizing fasciitis means that it is important umbilical granulomas are identified and treated appropriately. Silver nitrate was previously the first line of treatment of this condition in our local hospital. However,it is associated with various problems which include burns to the surrounding skin and need to be applied by a trained health professional.

Salt treatment was introduced to our local hospital as the first line treatment for umbilical granulomas. Salt is thought to be effective due to it’s desiccant properties. The salt is applied and monitored by our outreach nursing team after the diagnosis is confirmed. Salt is applied to the area for 30 minutes after it has been cleaned. Further application of salt is done by the parents twice daily after they have been trained. On the 4th day of treatment, the granuloma is assessed by the team at home. No further treatment is required if it has resolved completely. In cases of treatment failure, further treatment with polyurethane and silver nitrate is considered as per local policy.

Objectives
A retrospective audit was undertaken to demonstrate the effectiveness of salt therapy as the first line of treatment for umbilical granulomas.

Methods
A review of the case notes of the infants treated for umbilical granuloma between January 2019 and November 2020 in our trust was done. A proforma was created reviewing what treatment the infants received.

Results
A total of 6 infants received salt treatment as the first line of treatment for their umbilical granulomas during the review period. The umbilical granulomas resolved completely with salt treatment after a 3 day course of salt application. No infant during our study period required second line treatment.

Conclusions
Our audit has demonstrated that salt treatment is an effective, environmentally friendly, inexpensive and easily available first line treatment for umbilical granulomas with no reported side effects.

 

Igboekwu, T; Ahmad, I. (2021). 1172 Umblical granulomas: A pinch of salt dries it up. Archives of Disease in Childhood. 106 (Suppl 1), A258-A259

 

 

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