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[Umbilical stump care in full-term neonates]
Insights
Umbilical stump care in Czech Perinatological Centres primarily involves sterile surgical removal. However, a trend towards non-surgical methods is emerging to facilitate earlier neonate release and improve after-care.
Area of Science:
- Neonatal care and perinatology
- Infection control in newborns
- Surgical and non-surgical wound management
Context:
- Umbilical stump care practices vary across Perinatological Centres (PCs) in the Czech Republic.
- Current practices involve sterile surgical removal, with specific timings and post-ablation treatments differing.
- Hospitalization periods for full-term neonates are influenced by umbilical stump management protocols.
Purpose:
- To evaluate current umbilical stump care procedures in Czech Perinatological Centres.
- To assess the relationship between umbilical stump management and early discharge of full-term neonates.
- To propose a standardized therapeutic approach for umbilical stump care.
Summary:
- All 12 Czech Perinatological Centres utilize antiseptics in the initial days post-birth.
- Surgical removal of the umbilical stump is standard, occurring between 36-72 hours post-birth, followed by antiseptic or antibiotic application.
- Hospital stays exceed 72 hours in most centers, with a growing preference for non-surgical methods promoting spontaneous detachment for earlier discharge.
Impact:
- Identifies a uniform practice (sterile surgical removal) while highlighting a shift towards non-surgical methods.
- Provides data for developing a unified protocol for umbilical stump care in the Czech Republic.
- Informs strategies for optimizing neonate hospital stay duration through standardized, evidence-based umbilical cord management.
Objective:
The objective of the study was to evaluate the umbilical stump care in the Perinatological Centres in the Czech Republic and to propose a uniform therapeutic procedure in relation to the issue of early release of full-term neonates.
Design:
An epidemiological data analysis.
Setting:
Mother and Child Care Institute, Prague - Podoli.
Methods:
The representatives of all the Perinatological Centres (PCs) in the Czech Republic (12 centres) were contacted over the telephone with the aim of evaluating the umbilical stump care in full-term neonates in relation to the period of hospitalisation. The telephonic questionnaire evaluated the following aspects: the treatment method used in the first days after birth; the time of surgical removal and/or leaving the umbilical stump; the technique of surgical access; the treatment after ablation of umbilical stump and the period of hospitalisation.
Results:
In the first days, antiseptics are used in all the Perinatological Centres of the Czech Republic. All PCs carry out surgical removal of umbilical stump (in 7 centres it is cut off and in 5 centres it is removed through abscission). In 11 centres, the surgical removal takes place 36-48 hours after birth; in 1 centre it takes place 60-72 hours after birth. After removal, antibiotics are applied locally in 2 centres and antiseptics are applied locally in 10 centres. The period after which neonates were released was > or = 72 hours in 8 centres and > or = 96 hours in 4 centres in the case of full-term neonates after spontaneous birth.
Conclusion:
The uniform practice of the Perinatological Centres in the Czech Republic is sterile surgical removal of umbilical stump. However, with regard to early release and after-care, the current trend is to prefer a non-surgical method with spontaneous mummification and detachment of umbilical cord.
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