title: Topical treatment of major omphalocoele: Acacia nilotica versus povidone-iodine: A randomised controlled study.
abstract: BACKGROUND
  Conservative management for major omphalocoele with topical agents as escharotics therapy is well established in practice. Different agents have been used in the past, including mercurochrome and alcohol, proved later to be unsafe. The aim of this study is to evaluate the efficacy and safety of the application of Acacia nilotica paste compared to povidone-iodine solution as a primary non-surgical treatment of major omphalocoele.
  
  
  METHODS
  A double-blind, randomised study was conducted on 24 cases of major omphalocoele where they were randomly divided into two equal groups; Group A treated with topical application of A. nilotica paste and Group B treated with topical application of povidone-iodine solution. Cases with gastroschisis, ruptured major omphalocoele or minor omphalocoele were excluded from the study. The evaluating parameters were size of the fascial defect in cm, period of mechanical ventilation if needed, time required for full oral feeding tolerance, duration of hospital stay and any short- or long-term complications.
  
  
  RESULTS
  There was no statistical significant difference between both groups regarding their gestational or post-natal age, weight and the mean umbilical port defect. Patients from Group A tolerated full oral feeding earlier and had shorter total hospital stay duration than those from Group B, but without a statistical significant difference (P = 0.347 and 0.242, respectively). The overall mortality rate was 33.3% without a statistical significant difference between both groups (P = 0.667).
  
  
  CONCLUSIONS
  Application of A. nilotica is a safe and effective treatment of major omphalocoele as it was associated with rapid full enteral feeding tolerance, short duration of hospital stay and low mortality rate.
authors.affiliation: Assiut University Children Hospital, Pediatric Surgery Unit, Assiut University, Asyut, Egypt.
authors.forename: Almoutaz A
authors.initials: AA
authors.lastname: Eltayeb
authors.forename: Mahmoud M
authors.initials: MM
authors.lastname: Mostafa
mesh_terms: D000045:Acacia; D000287:Administration, Topical; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006170:Gum Arabic / Q000008:administration & dosage*; D006554:Hernia, Umbilical / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011206:Povidone-Iodine / Q000008:administration & dosage*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine; D006170:Gum Arabic