[Antiseptic treatment of the umbilical cord in newborns: survey and recommendations].
OBJECTIVE
To determine whether umbilical cord care of the neonate is in accordance with the guidelines of antiseptic treatment at this age of life.


METHODS
A survey was conducted during the 3rd trimester of 1996 in 57 maternity units and departments of neonatalogy in the region of Provence-Alpes-Côte d'Azur (south of France). A questionnaire was sent to the head of each unit asking the modalities of disinfection of the umbilical cord.


RESULTS
Fifty units answered the questionnaire. Six different groups of antiseptic products were used, corresponding to 17 distinct commercial preparations. The simultaneous association of several products (two or three) was done in 70% of cases. Eosin was the most frequently used (60%), in association with 25 units. Alcohol was used in 28 centers (56%). It was associated 22 times. Chlorhexidine was used in 16 units (32%), twice alone, and with another topic 14 times. The commercial association chlorhexidine-benzalkonium chloride (Biseptine) was reported seven times (six times in association with another topical treatment). Ektogan (a powder of Zn and Mg peroxide and Zn oxide) was used in ten centers, always in association. Hexamidine was used in four units, once in association. Silver nitrate, Milian solution, iodinated alcohol, and povidone iodine were respectively used once.


CONCLUSIONS
This survey shows that a great variety of umbilical cord care modalities is used in this region, and that the recommendations for antiseptic treatment in young babies, are not always respected. According to these, eosin, ethanol, Ektogan and iodine should not be used for this purpose. Although chlorhexidine has been proven to be the most suitable disinfectant, it comes only in third place, used in association in 95% of the cases. Several studies in neonates have shown that it is well tolerated and efficient even if it delays cord separation. This study should lead to interdisciplinary consensual guidelines for umbilical cord care.
Service de dermatologie, hôpital Archet-2, Nice, France.
J P
JP
Lacour
J
J
Castanet
P
P
Boutté
J P
JP
Ortonne
D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001548:Benzalkonium Compounds / Q000627:therapeutic use; D001550:Benzamidines / Q000627:therapeutic use; D002710:Chlorhexidine / Q000627:therapeutic use; D004203:Disinfection / Q000379:methods* / Q000706:statistics & numerical data; D000431:Ethanol / Q000627:therapeutic use; D005260:Female; D005602:France; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011795:Surveys and Questionnaires; D014470:Umbilical Cord; D014472:Umbilicus
D000891:Anti-Infective Agents, Local; D001548:Benzalkonium Compounds; D001550:Benzamidines; C018961:hexamidine; D000431:Ethanol; D002710:Chlorhexidine
Antisepsie du cordon ombilical du nouveau-né: enquête et recommandations.