UP TO DATE MANAGEMENT OF UMBILICAL CORD GRANUOLMAS
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Keywords:Umbilical Granuloma, Salt Therapy, Silver Nitrate, Cryocautery
Umbilical granulomas are of common occurrence in the neonatal period. The diagnosis is triggered by the observation of umbilical discharge and the identification of a red granulation tissue mass at the base of the umbilical stump. The clinicians should practice extra vigilance to differentiate the benign Umbilical Granuloma from other serious diagnoses involving the remnants of the umbilical cord including Patent Urachus and Persistent Vitello Intestinal Duct. Identification of urine or stool within the discharge material should alert the Paediatrician or Paediatric Surgeon to such diagnoses. Other differential diagnoses include Umbilical Polyp, Urachal Duct Cyst, Haemangiomas and Pyogenic Granuloma. The association of an infected Umbilical Granuloma with Omphalitis and Necrotizing Fasciitis has persuaded many Neonatologist and Paediatric Surgeons to abandon the expectant management approach. However, there is as yet, no universally agreed management strategy for Umbilical Granulomas. Active management options include topical application of Common Salt, Silver Nitrate, Copper Sulphate, Alcohol Wipes, topical Corticosteroids, topical Doxycycline Powder, Silk ligation, surgical excision, Cryocautery, and Electrocautery. The conclusion of our extensive research is that the majority of the interventions are effective in treating Umbilical Granulomas. However, Common Salt application appears to be the most practical, simple and effective option, with no reported complications.
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