Mustafa Kul, Orhan Gürsel, Mustafa Gülgün, Vural Kesik, Serdar Ümit Sarıcı, Faruk Alpay

Sağlıklı term yenidoğanlarda farklı göbek bakımı uygulamalarının göbek düşme zamanı ve diğer klinik sonuçlar üzerine etkilerinin değerlendirilmesi Orijinal Araştırma

Amaç: Göbek bağı nekrotik doku içermesi nedeniyle yenidoğanda bakteriyel kolonizasyon riski taşıyan bölgelerinden birisidir Özellikle az gelişmiş ve gelişmekte olan ülkelerde bakteriyel kolonizasyon sonucu ortaya çıkan göbek bağı enfeksiyonu yenidoğan ölüm ve morbiditesinin en önemli nedenlerinden biridir Bu çalışmada amacımız dört farklı göbek bakım uygulamasının steril gazlı bez alkol povidon iyot eozin term sağlıklı yenidoğanlarda göbek düşme zamanı ve diğer sonuçlar omfalit sepsis ölüm göbek bağından kanama üzerine olan etkilerinin ortaya konulması ve en uygun uygulamanın belirlenmesidir Gereç ve Yöntem: Gülhane Askeri Tıp Akademisi GATA Kadın Hastalıkları ve Doğum Anabilim Dalı Kliniği’nde Ekim 2004 Ocak 2005 tarihleri arasında zamanında doğan 80 sağlıklı yenidoğan bebek çalışmaya alındı Bu sağlıklı yenidoğanlar rastgele seçilerek dört gruba ayrıldı Birinci grubun göbek bakımını göbek düşene kadar sadece steril gazlı bezle ikinci grubun steril gazlı bez ile birlikte alkolle günde iki kez üçüncü grubun eozinle dördüncü grubun povidon iyotla yapması sağlandı Doğumda üçüncü günde yedinci günde bebekler aynı hekim tarafından değerlendirilerek akıntı pis koku kızarıklık kanama yönünden göbek güdüğünden kültür alındı Yedinci güne kadar göbeği düşmeyen bebeklerin aileleri telefonla aranarak göbek düşme zamanları öğrenilerek kaydedildi Bulgular: Birinci grubun göbek düşme zamanı 9 1±2 84 gün ikinci grubun 8 1±1 99 gün üçüncü grubun 8±2 13 gün dördüncü grubun 7 4±1 83 gün olup aralarında istatistiksel olarak anlamlı bir fark saptanmadı p gt;0 05 Yine dört grup arasında omfalit göbek kanaması sepsis ve ölüm gibi diğer sonuçlar açısından istatistiksel olarak anlamlı farklılıklar saptanmadı Sadece steril gazlı bezle göbek bakımı yapılan bir olguda omfalit gözlendi Doğumda üçüncü ve yedinci günde alınan göbek sürüntü kültürleri sonuçları karşılaştırıldığında kolonizasyon oranı gram pozitif ve gram negatif mikroorganizmalarla kolonizasyon sıklığı açısından dört grup arasında istatistiksel olarak anlamlı farklılık bulunmadı Çıkarım: Bu çalışmada zamanında doğmuş sağlıklı yenidoğanlarda sadece steril gazlı bezle yapılan göbek bakım uygulaması yeterli görünmektedir Ancak sosyoekonomik etmenlerin etkilerini araştıracak daha geniş çalışmalara gereksinim vardır Anahtar Kelimeler: bakteriyel kolonizasyon göbek bağı göbek düşme zamanı yenidoğan

Anahtar Kelimeler:

bakteriyel kolonizasyon, göbek bağı, göbek düşme zamanı, yenidoğan

Evaluation of the effects of different cord care regimens in full term newborns on cord seperation time and other clinical results Original Article

Introduction and Aim: Having necrotic tissue the umbilical cord is under the risk of bacterial colonization in newborns In particular the umbilical cord infection developing subsequent to bacterial colonization is one of the outstanding reasons of newborn mortality and morbidity in underdeveloped and developing countries In this study we aimed to evaluate the effects of four different aseptic umbilical care practices sterilized pad alcohol eozin and povidon iodine on cord separation time and consequences such as omphalitis sepsis death and cord bleeding in full term newborns Material and Methods: Eighty full term newborn infants born in between October 2004 and January 2005 in Gülhane Askeri Tıp Akademisi GATA Department of Gynecology and Obstetrics were included in the study These newborns were divided into four groups Umbilical care until cord detachment was ensured by using only the sterilized pad the sterilized pad plus alcohol two times per day eosin and povidon iodine for the first second third and fourth groups respectively The cords were evaluated in respect of discharge bad odor hyperemia and bleeding by the same physician at birth on the third and seventh days of birth and the cultures were taken from the cord stump The families of babies whose umbilical cords had not fallen off until the seventh day were telephone called and their separation times were recorded Results: The cord separation times were 9 1±2 84 8 1±1 99 8 0±2 13 and 7 4±1 83 days for the first second third and fourth groups respectively and no significant difference was determined p gt;0 05 Also no significant difference was ascertained among the four groups in respect of consequences such as omphalitis sepsis death and cord bleeding Omphalitis was observed in one infant whose aseptic umbilical cord care was performed by using the sterilized pad only No significant difference was determined among the four groups with respect to colonization rate and colonization of gram positive and gram negative microorganisms Conclusion: In this study the umbilical care by application of only the sterilized pad is considered appropriate in full term newborns However more studies are needed to investigate the effects of socio economical factors Key words: nbsp;bacterial colonization newborn separation time umbilical cord

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Darmstadt GL, Di nulos JG. N ewborn skin care. Pediatr
Oishi T, Iwata S, Nonoyama M, Tsuji A, Sunakawa K. Double- blind comparative study on the care of the newborn umbilical cord using 80% eth anol with o r witho ut chlorhexidine. J Hosp Infect 2004; 58: 34- 7.
Pezzati M, Biagioli EC, Martelli E, Gambi B, Biagiotti R, Rubaltelli FF. Umbilical cord care: the effect of eight different cord-care regimens on cord separation time and other outcomes. Biol Neonate 2002; 81: 38- 44.
Rais-Bahrami K, Schulte EB, Naqvi M. Postnatal timing of spontaneous umbilical cord separation. Am J Perinatol 1993;10: 453- 4.
Ronchera-Oms C, Hernandez C, Jimemez NV. Antiseptic cord care reduces ba cterial co loniza tion bu t delays cord detachment. Arch Dis Child Fetal Newborn Ed 1994; 71: F70.
Zupan J, Garner P, Omari AA.Topical umbilical cord care at birt h. Coch rane Database Syst Rev 2004; CD001057 .
Introduction and Aim: Having necrotic tissue, the umbilical cord is under the risk of bacterial colonization in newborns. In particular, the
umbilical cord infection developing subsequent to bacterial colonization is one of the outstanding reasons of newborn mortality and morbidity
in underdeveloped and developing countries. In this study we aimed to evaluate the effects of four different aseptic umbilical care practices
(sterilized pad, alcohol, eozin, and povidon iodine) on cord separation time and consequences such as omphalitis, sepsis, death and cord bleeding
in full term newborns.
Material and Methods: Eighty full term newborn infants born in between October 2004 and January 2005 in Gülhane Askeri Tıp Akademisi
(GATA) Department of Gynecology and Obstetrics were included in the study. These newborns were divided into four groups. Umbilical care
until cord detachment was ensured by using only the sterilized pad, the sterilized pad plus alcohol (two times per day), eosin, and povidon
iodine for the first, second, third, and fourth groups, respectively. The cords were evaluated in respect of discharge, bad odor, hyperemia, and
bleeding by the same physician at birth, on the third and seventh days of birth, and the cultures were taken from the cord stump. The families
of babies whose umbilical cords had not fallen off until the seventh day were telephone called and their separation times were recorded.
Results: The cord separation times were 9.1±2.84, 8.1±1.99, 8.0±2.13, and 7.4±1.83 days for the first, second, third, and fourth groups,
respectively, and no significant difference was determined (p>0.05). Also no significant difference was ascertained among the four groups in
respect of consequences such as omphalitis, sepsis, death, and cord bleeding. Omphalitis was observed in one infant whose aseptic umbilical
cord care was performed by using the sterilized pad only. No significant difference was determined among the four groups with respect to
colonization rate and colonization of gram positive and gram negative microorganisms.
Conclusion: In this study, the umbilical care by application of only the sterilized pad is considered appropriate in full term newborns. However,
more studies are needed to investigate the effects of socio-economical factors. 1.
Darmstadt GL, Di nulos JG. N ewborn skin care. Pediatr
Oishi T, Iwata S, Nonoyama M, Tsuji A, Sunakawa K. Double- blind comparative study on the care of the newborn umbilical cord using 80% eth anol with o r witho ut chlorhexidine. J Hosp Infect 2004; 58: 34- 7.
Pezzati M, Biagioli EC, Martelli E, Gambi B, Biagiotti R, Rubaltelli FF. Umbilical cord care: the effect of eight different cord-care regimens on cord separation time and other outcomes. Biol Neonate 2002; 81: 38- 44.
Rais-Bahrami K, Schulte EB, Naqvi M. Postnatal timing of spontaneous umbilical cord separation. Am J Perinatol 1993;10: 453- 4.
Ronchera-Oms C, Hernandez C, Jimemez NV. Antiseptic cord care reduces ba cterial co loniza tion bu t delays cord detachment. Arch Dis Child Fetal Newborn Ed 1994; 71: F70.
Zupan J, Garner P, Omari AA.Topical umbilical cord care at birt h. Coch rane Database Syst Rev 2004; CD001057 .
Introduction and Aim: Having necrotic tissue, the umbilical cord is under the risk of bacterial colonization in newborns. In particular, the
umbilical cord infection developing subsequent to bacterial colonization is one of the outstanding reasons of newborn mortality and morbidity
in underdeveloped and developing countries. In this study we aimed to evaluate the effects of four different aseptic umbilical care practices
(sterilized pad, alcohol, eozin, and povidon iodine) on cord separation time and consequences such as omphalitis, sepsis, death and cord bleeding
in full term newborns.
Material and Methods: Eighty full term newborn infants born in between October 2004 and January 2005 in Gülhane Askeri Tıp Akademisi
(GATA) Department of Gynecology and Obstetrics were included in the study. These newborns were divided into four groups. Umbilical care
until cord detachment was ensured by using only the sterilized pad, the sterilized pad plus alcohol (two times per day), eosin, and povidon
iodine for the first, second, third, and fourth groups, respectively. The cords were evaluated in respect of discharge, bad odor, hyperemia, and
bleeding by the same physician at birth, on the third and seventh days of birth, and the cultures were taken from the cord stump. The families
of babies whose umbilical cords had not fallen off until the seventh day were telephone called and their separation times were recorded.
Results: The cord separation times were 9.1±2.84, 8.1±1.99, 8.0±2.13, and 7.4±1.83 days for the first, second, third, and fourth groups,
respectively, and no significant difference was determined (p>0.05). Also no significant difference was ascertained among the four groups in
respect of consequences such as omphalitis, sepsis, death, and cord bleeding. Omphalitis was observed in one infant whose aseptic umbilical
cord care was performed by using the sterilized pad only. No significant difference was determined among the four groups with respect to
colonization rate and colonization of gram positive and gram negative microorganisms.
Conclusion: In this study, the umbilical care by application of only the sterilized pad is considered appropriate in full term newborns. However,
more studies are needed to investigate the effects of socio-economical factors. 1.
Darmstadt GL, Dinulos JG. Newborn skin care. Pediatr
Oishi T, Iwata S, Nonoyama M, Tsuji A, Sunakawa K. Double- blind comparative study on the care of the newborn umbilical cord using 80% ethanol with or without chlorhexidine. J Hosp Infect 2004; 58: 34- 7.
Pezzati M, Biagioli EC, Martelli E, Gambi B, Biagiotti R, Rubaltelli FF. Umbilical cord care: the effect of eight different cord-care regimens on cord separation time and other outcomes. Biol Neonate 2002; 81: 38- 44.
Rais-Bahrami K, Schulte EB, Naqvi M. Postnatal timing of spontaneous umbilical cord separation. Am J Perinatol 1993;10: 453- 4.
Ronchera-Oms C, Hernandez C, Jimemez NV. Antiseptic cord care reduces bacterial colonization but delays cord detachment. Arch Dis Child Fetal Newborn Ed 1994; 71: F70.
Zupan J, Garner P, Omari AA.Topical umbilical cord care at birth. Cochrane Database Syst Rev 2004; CD001057.
Introduction and Aim: Having necrotic tissue, the umbilical cord is under the risk of bacterial colonization in newborns. In particular, the
umbilical cord infection developing subsequent to bacterial colonization is one of the outstanding reasons of newborn mortality and morbidity
in underdeveloped and developing countries. In this study we aimed to evaluate the effects of four different aseptic umbilical care practices
(sterilized pad, alcohol, eozin, and povidon iodine) on cord separation time and consequences such as omphalitis, sepsis, death and cord bleeding
in full term newborns.
Material and Methods: Eighty full term newborn infants born in between October 2004 and January 2005 in Gülhane Askeri Tıp Akademisi
(GATA) Department of Gynecology and Obstetrics were included in the study. These newborns were divided into four groups. Umbilical care
until cord detachment was ensured by using only the sterilized pad, the sterilized pad plus alcohol (two times per day), eosin, and povidon
iodine for the first, second, third, and fourth groups, respectively. The cords were evaluated in respect of discharge, bad odor, hyperemia, and
bleeding by the same physician at birth, on the third and seventh days of birth, and the cultures were taken from the cord stump. The families
of babies whose umbilical cords had not fallen off until the seventh day were telephone called and their separation times were recorded.
Results: The cord separation times were 9.1±2.84, 8.1±1.99, 8.0±2.13, and 7.4±1.83 days for the first, second, third, and fourth groups,
respectively, and no significant difference was determined (p>0.05). Also no significant difference was ascertained among the four groups in
respect of consequences such as omphalitis, sepsis, death, and cord bleeding. Omphalitis was observed in one infant whose aseptic umbilical
cord care was performed by using the sterilized pad only. No significant difference was determined among the four groups with respect to
colonization rate and colonization of gram positive and gram negative microorganisms.
Conclusion: In this study, the umbilical care by application of only the sterilized pad is considered appropriate in full term newborns. However,
more studies are needed to investigate the effects of socio-economical factors.