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What cord care--if any?

I G Verber¹, F S Pagan

¹Department of Paediatrics, Memorial Hospital, Darlington.

Archives of Disease in Childhood

|May 1, 1993

Summary

Antiseptic cord care reduces Staphylococcus aureus colonization in newborns. Chlorhexidine was most effective, though hexachlorophane was preferred by staff, with both agents reducing cross-infection.

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Journal of perinatal medicine·1989

Area of Science:

Neonatal care
Infectious disease control
Dermatology

Background:

Antiseptic use in umbilical cord care lacks standardization.
Potential benefits include reduced bacterial colonization, but risks include delayed cord separation.

Purpose of the Study:

To compare the efficacy of hexachlorophane powder and chlorhexidine detergent against dry cord care for reducing bacterial colonization in newborns.
To assess the impact of these agents on cord separation time.

Main Methods:

An open study conducted over six months on a two-ward maternity unit.
Infants were assigned to receive either hexachlorophane powder (0.3%), 4% chlorhexidine detergent, or dry cord care (control).
Bacterial colonization, specifically Staphylococcus aureus, and cord separation were monitored.

Main Results:

Hexachlorophane reduced Staphylococcus aureus colonization by one-third (33% vs. 47% in controls).
Chlorhexidine reduced colonization by over half (16% vs. 42% in controls).
Chlorhexidine was associated with delayed cord attachment at 10 days (28% vs. 6% in controls). Hexachlorophane was more acceptable to nursing staff.

Conclusions:

Both hexachlorophane and chlorhexidine effectively reduce bacterial colonization in newborns.
Chlorhexidine demonstrates superior efficacy in reducing Staphylococcus aureus colonization but may delay cord separation.
The reduction in colonization is primarily attributed to the suppression of cross-infection.

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