To dye or not to dye: A randomized, clinical trial of a triple dye/alcohol regime versus dry cord care
To dye or not to dye: A randomized, clinical trial of a triple dye/alcohol regime versus dry cord care
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DOI：
10.1542/peds.111.1.15
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发表时间：
2003-01-01
期刊：
影响因子：
8
通讯作者：
Thiessen, PN
中科院分区：
文献类型：
--
作者：
Janssen, PA;Selwood, BL;Thiessen, PN
Objective.使用抗菌剂清洁和干燥新生儿脐带残端出生后，最近已经放弃了许多新生儿单位赞成干脐带护理。本研究的目的是比较三重染料和酒精与干脐带护理新生儿脐带细菌定植和发病率。我们将766名新生儿随机分为两组，一组在出生当天对脐带残端应用三重染料，每天用酒精擦拭两次，直到脐带脱落（n = 384），另一组进行干燥护理（n = 382）。干性护理包括用肥皂和水局部清洁脐周区域的污染皮肤，用干棉签或布擦拭，并使该区域风干。对所有受试者的脐带残端进行擦拭和培养。社区卫生护士在出院后2或3天访问观察残肢感染的迹象。出院后3周内对母亲进行电话随访。干燥护理组中的一名婴儿被诊断患有子宫内膜炎。脐带残端定植有α-溶血性链球菌和凝固酶阴性链球菌。干燥护理组的婴儿更容易感染大肠杆菌（34.2% vs 22.1%）、凝固酶阴性葡萄球菌（69.5% vs 50.5%）、金黄色葡萄球菌（31.3% vs 2.8%）和B组链球菌（11.7% vs 6.0%）。在家访期间，社区卫生护士在分配到干燥护理组的婴儿中观察到渗出液（7.4%对0.3%）和恶臭（2.9%对0.7%）的可能性更大。Omega仍然是一个临床问题。在停止脐残端的杀菌护理的同时，必须警惕脐周炎的体征和症状。
Objective. The use of antibacterial agents to clean and dry the stump of the newborn's umbilical cord after birth has recently been abandoned by many neonatal units in favor of dry cord care. The objective of this study was to compare cord bacterial colonization and morbidity among newborns whose cords were treated with triple dye and alcohol versus dry cord care.Methodology. We randomly allocated 766 newborns to either 2 applications of triple dye to the umbilical cord stump on the day of birth with alcohol swabbing twice daily until the cord fell off (n = 384) or dry care (n = 382). Dry care consisted of spot cleaning soiled skin in the periumbilical area with soap and water, wiping it with a dry cotton swab or cloth, and allowing the area to air dry. Umbilical stumps on all subjects were swabbed and cultured. Community health nurses visiting at 2 or 3 days after hospital discharge observed the stump for signs of infection. Follow-up phone calls were made to mothers within 3 weeks of discharge.Results. One infant in the dry care group was diagnosed with omphalitis. The umbilical stump was colonized with alpha-hemolytic streptococcus and coagulase-negative staphylococcus. Infants in the dry care group were significantly more likely to be colonized with Escherichia coli (34.2% vs 22.1%), coagulase-negative staphylococci (69.5% vs 50.5%), Staphylococcus aureus (31.3% vs 2.8%), and group B streptococci (11.7% vs 6.0%). Community health nurses were significantly more likely to observe exudate (7.4% vs 0.3%) and foul odor (2.9% vs 0.7%) among infants allocated to the dry care group during the home visit.Conclusions. Omphalitis remains a clinical issue. Cessation of bacteriocidal care of the umbilical stump must be accompanied by vigilant attention to the signs and symptoms of omphalitis.