A randomized controlled trial, comparison of time to umbilical cord separation between 3 regimens of cord care: alcohol, chlorhexidine and alcohol, chlorhexidine
Keywords:
Time to cord separation, chlorhexidine, alcoholAbstract
Background: Newborn umbilical cord cleaning with chlorhexidine may have a longer time to cord separation compared with using other antiseptic agents.
Objective: To compare time to cord separation, bacterial colonization, infection, and adverse outcome among 3 regimens of cord care: (1) alcohol, (2) chlorhexidine and alcohol, and (3) chlorhexidine.
Method: A Randomized controlled trial, 3 groups opened label study was conducted during 1st November 2021 – 1st February 2022 at Lamphun Hospital. Term infants born at Lamphun Hospital were randomly assigned into one of three groups based on umbilical cord cleansing regimens: (1) alcohol, (2) chlorhexidine for 7 days then apply alcohol until the cord falls off, and (3) chlorhexidine. Within 48-72 hours after discharge, all infants were appointed to visit an outpatient pediatrics office to monitor compliance and to perform umbilical swab cultures. Data on time to cord separation, infection, or other complications were obtained by telephone interviews on days 7,14, 21, and 28 after birth.
Results: Seventy-six infants were recruited (25, 25, and 26 in groups 1, 2, and 3, respectively). Time to cord separation was 11.72 ± 2.71, 13.72 ± 5.26, and 14.23 ± 4.22 days, respectively. In the survival analysis, the time to cord separation in group 3 was significantly longer than in group 1 but there was no statistically significant difference when compared between group 2 and group 1. Of 43 culture specimens, 95% showed gram-negative. The bacterial colonization rate was significantly lowest in group 3. There were no omphalitis or other adverse events found in the present study.
Conclusion: The time to cord separation in the chlorhexidine group was significantly longer than in the alcohol group. We conclude that antiseptic agent options for umbilical cord cleansing depend on the context and availability of the antiseptic preparation in each hospital.
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