Wounds that do not heal and discharge after the umbilical cord falls off

Introduction The initial symptom of neonatal umbilical inflammation is that the wound is delayed and there is an overflow after the umbilical cord falls off. After the baby is born, under the sterile conditions, the umbilical cord should be broken. The gauze wrapped during the treatment should be kept clean and dry. Do not unravel it. The diaper should not cover the umbilicus and should be replaced frequently to prevent the dirt from contaminating the umbilicus. When taking a bath, avoid contaminating the umbilical cord with dirty water. After changing the underwear, you need to change the underwear after bathing. You only need to clean the umbilical cord with a sterile cotton swab every day, so that the umbilical cord can be dried and detached. The normal dry umbilical cord is not bandaged. In order to facilitate early fall off.

Cause

The main causes of umbilical cord infection in newborns are: contamination after umbilical cord ligation after birth or dressing contaminated by feces and urine before umbilical cord detachment; premature rupture of amniotic membrane, contamination of umbilical cord before birth; umbilical cord contaminated by bacteria in birth canal during delivery; Contamination of urinary fistula or yolk sputum effluent; infection secondary to umbilical cord or umbilical sinus.

an examination

Related inspection

Skin fungus microscopy cord blood puncture

1. Blood examination: white blood cells are normal or elevated. The number of white blood cells and neutrophils increased with symptoms of systemic infection.

2. Bacteriological examination: The wound secretion can be taken for smear staining or bacteriological culture as a guide for clinical medication. Blood culture examination is feasible when suspicious sepsis is suspected.

Differential diagnosis

Acute ointment

(1) Neonatal umbilical inflammation: The initial symptom is that the wound is delayed and there is an overflow after the umbilical cord falls off. Sometimes there is redness and swelling of the umbilical cord, and there is a small amount of mucus or purulent secretion in the small granulation surface or umbilical stump in the umbilicus. In severe cases, there may be symptoms of cellulitis such as redness, swelling, heat, and pain. When the infection is more serious, it can be seen that the umbilical cord is obviously red and swollen and hard, and there are more purulent secretions. The umbilical cord is lightly pressed, and the pus flows out from the umbilicus and has an odor. Generally, the systemic symptoms are mild. If the infection spreads to the peritoneum leading to peritonitis, patients often have different degrees of fever and increased white blood cells. If sepsis is caused by the spread of blood vessels, irritability, paleness, refusal of milk, difficulty in breathing, and large splenomegaly may occur.

(2) Adult umbilical inflammation: The acute phase manifests as pain, congestion, edema in the umbilical fossa or ring umbilicus, and often has a scented serous secretion. In the examination, the umbilical fossa is moist, the umbilical circumference is swollen, and the tenderness is severe. In severe cases, the empyema in the umbilical fossa is accompanied by fever, and the lymph nodes in the inguinal region may be enlarged. Occasionally spread to the periphery of the umbilicus, and with deep infection, cellulitis and systemic symptoms.

2. Chronic umbilical inflammation: The umbilical fossa is moist, swollen, and has odor, which may be purulent or mixed with blood. Eczema-like changes can occur as a result of secretions irritating the surrounding skin, and even erosions can occur. Adults or older children have a itching sensation, often scratching the umbilicus with their hands. Physical examination revealed granulation tissue hyperplasia in the umbilical fossa, dark red color, convex, no mucous membrane covering on the surface, and bleeding. Most of the patients have a long course and they will not heal.

1. The blood picture checks for normal or elevated white blood cells. The number of white blood cells and neutrophils increased with symptoms of systemic infection.

2. Bacteriology examination can be done by smear staining or bacteriological culture of wound secretion as a guide for clinical use. Blood culture examination is feasible when suspicious sepsis is suspected.

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