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Review: topical agents for cord care have not been shown to be effective in newborn infants in developed countries

https://doi.org/10.1136/ebn.1.4.113

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    Zupan J, Garner P. Routine topical umbilical cord care at birth. (Cochrane Review, latest version 29 Jan 1998). In: the Cochrane Library.Oxford: Update Software.

    Question Are topical agents for umbilical cord care effective for preventing cord infection, illness, and death in newborn infants in developed countries?

    Data sources

    Studies were identified using the Cochrane Pregnancy and Childbirth Group Controlled Trials Register, the Cochrane Library, Medline, and contact with the World Health Organisation and experts in the field.

    Study selection

    Randomised controlled trials were included if they studied newborn infants of any gestation using any of the following cord care interventions: topical antiseptic applications (alcohol, triple dye, silver sulphadiazine, acraflavine, iodine, chlorhexidine, or gentian violet), antibiotic applications (bacitracin, nitrofurazone, or tetracycline), powders with or without antiseptics, single or multiple applications to the cord area, washing the whole baby or dry care, and care of the cord compared with no care.

    Data extraction

    Data were extracted on study quality; country of study; infant characteristics and numbers; interventions; primary outcomes of cord infection (redness, swelling, or smell), disseminated bacterial infection (fever, meningitis, or septic foci), or death; and secondary outcomes of time to separation, bacterial colonisation, and maternal satisfaction with intervention.

    Main results

    10 studies met the selection criteria. All included healthy term infants and were done in developed countries (USA, Norway, Canada, Israel, and UK). Cord infection was not affected by use of antiseptics (alcohol, benzine, or 2 strengths of chlorhexidine) (4 studies) or closed dressing compared with open care (1 study compared hydrophobic gauze bandage …

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    Footnotes

    • Sources of funding: Department for International Development UK; European Commission (Directorate General XII) Belgium; Shell International Petroleum Company UK; World Health Organisation.

    • For correspondence: Dr J Zupan, Medical Officer, Division of Reproductive Health, World Health Organisation, 20 Avenue Appia, 1211 Geneva 27, Switzerland.