Silver nitrate umbilical: Umbilical Granulomas: Causes, Treatments, and Prevention

07.07.202121.07.2023 by alexxlab

Umbilical Granulomas: Causes, Treatments, and Prevention

Written by WebMD Editorial Contributors

‌An umbilical granuloma is a small red bump of tissue that can form in a newborn’s belly button during the first several weeks after they’re born. Many babies will develop a granuloma and have no problems. However, some umbilical granulomas can become infected. In rare cases, adults can also form painful umbilical granulomas. Here’s what you need to know about how they can affect your health.

Umbilical granulomas are a type of scar tissue that forms in the belly button. Most umbilical granulomas form when the belly button is healing after the umbilical cord falls off. They look like small red lumps in your child’s navel. Unlike the rest of their skin, the granuloma will be a little shiny and covered in a clear discharge.

After the umbilical cord is cut, a small stump remains on your baby’s stomach. Typically, the stump will fall off on its own and heal without a problem. However, in rare cases, an umbilical granuloma will form where the stump fell off. Only about 1 in 500 babies will develop an umbilical granuloma.

Rarely, an adult may develop an umbilical granuloma. These lumps are caused by trauma to the bully button. One of the most common causes of an adult umbilical granuloma is navel piercing. While granulomas in babies are not painful, they may be painful for adults.

Granulomas are relatively minor complications. However, they do require treatment because they won’t resolve on their own. Most granulomas will continue to slowly grow until they’re treated. These lumps can easily become infected.‌

An infected granuloma is a critical health problem. Since granulomas are connected to the umbilical opening, infection can spread quickly. If you believe your child has an infected granuloma, reach out for medical care right away to keep the infection from getting worse.

In most cases, treating granulomas is simple. Your child’s pediatrician will probably be able to treat and remove the lump in their office. Granuloma treatments include:

Silver nitrate: Umbilical granulomas in babies don’t have nerve endings, so they can be treated with a small amount of silver nitrate. The doctor will place the silver nitrate on the granuloma, and it will burn off the tissue. Your baby will not feel any pain during the process. Adults may need a topical anesthetic to numb the area before the same treatment.

Liquid nitrogen: If silver nitrate isn’t an option, then liquid nitrogen can also be used. The liquid is very cold and freezes the lump immediately. After it’s frozen, the granuloma tissue dissolves away.‌

Suture thread ties: In some cases, your doctor may tie off the granuloma with suture thread. This cuts off blood flow to the lump. Over time, it will dry up and shrivel until it disappears.

Salt: Another way to dry out the granuloma is by using salt. Since granulomas are covered in clear mucus, the salt dries them out and causes them to shrivel away. Your doctor will give you instructions on how to apply salt to the granuloma safely.‌

Surgery: In rare cases, an umbilical granuloma may need to be surgically removed. This is most common for infected granulomas, because surgical removal is the quickest treatment. If your baby’s granuloma is infected, surgery will help stop the spread of infection and help them recover more quickly.

Since granulomas are a type of scar tissue, they’re difficult to prevent. However, if your baby develops a granuloma, you can often prevent infections.

The best way to prevent infections is to protect your baby’s belly button and keep the area clean. Gently wiping the area down with warm soap and water can prevent drainage and bacteria from building up. Your child’s doctor may have other recommendations, as well. Always follow their instructions for taking care of your baby’s navel.

All granulomas should be treated by a doctor. However, if a granuloma gets infected, it needs to be treated immediately. Your baby may need antibiotics to prevent the infection from getting worse. Signs your baby needs to go to the doctor right away include:

‌A fever of more than 100.4 degrees Fahrenheit
‌A rash around the belly button
‌The granuloma is bleeding
‌The belly button is draining a bad-smelling liquid
‌The area around the granuloma is swollen or red
‌Your baby seems to be in pain when you touch their belly button

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Umbilical Granulomas: Causes, Treatments, and Prevention

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How to treat the navel of a newborn | clinic blog Nashe Vremya

Pediatrician Rogova Olga Alexandrovna will tell you how to care for the navel of a newborn.

In most cases, a newborn’s belly button heals within two weeks and does not require special care. But parents are concerned about the questions: is it normal that ichor oozes from the wound and whether it is necessary to use antiseptics. We talk about what should be the treatment of the navel for a newborn with a clothespin.

How to treat the navel of a newborn

When the baby is born, the umbilical cord is cut and clamped. Under its influence, the blood flow through the umbilical cord stops and its remaining part dries up and falls off within two weeks.

WHO recommends not interfering with this process if it proceeds normally – without purulent secretions and an unpleasant odor.

This approach is different from the one that was adopted in pediatrics 10-20 years ago. Then it was recommended to treat the umbilical wound daily with antiseptics. This has been justified in developing countries with high neonatal mortality from umbilical sepsis. But if the baby was born in normal sanitary conditions, the navel heals faster without unnecessary intervention.

Step-by-step instructions for umbilical wound care

Keep your belly button dry . If it comes into contact with urine or feces, rinse gently with water and pat dry with a clean towel.
Do not put diapers covering the umbilical cord on your baby. The skin sweats, becomes moist and warm, and these are good conditions for the reproduction of bacteria. You can buy special diapers for newborns with a notch in place of the navel or cut out this part of the diaper.
Do not treat cord remnant with alcohol antiseptics.
Try not to touch the wound . You do not need to treat the umbilical wound yourself.
If the wound becomes inflamed , there is discharge and an unpleasant smell – consult a doctor .

There are several brands of cutout diapers.

What not to do with the navel

First, do not try to speed up the process and separate the umbilical cord yourself.
Secondly, do not treat this place with brilliant green . If the child does not live in unsanitary field conditions, antiseptics are not needed. An alcohol solution applied to an open wound causes microtrauma on the mucosal membrane, which makes healing slower.

According to studies [6], the umbilical cord, which is not treated, falls off faster, and the wound heals. But not all parents are aware of the results of these studies.

The older generation remembers well the recommendations of Soviet doctors about the treatment of the navel with Zelenka and readily shares advice.

If you are under pressure from older relatives or feel uncomfortable due to inactivity, use at least colorless antiseptics. “Zelenka” and “Fukortsin” will mask the redness, and if inflammation begins, it will not be immediately noticed. If you decide to use an antiseptic, treat the skin without touching the wound.

What is umbilical wound omphalitis

Usually the umbilical wound heals well. But sometimes complications occur in the form of omphalitis. This is an infection of the umbilicus or umbilical wound that occurs in 0.7% of newborns in developed countries. In developing countries, it occurs in 8% of children born in the maternity hospital and in 22% of children born at home. Omphalitis of the umbilical wound occurs due to bacteria that enter the unhealed wound.

Symptoms are redness, white-yellow purulent discharge from the navel, bleeding and an unpleasant odor. If treatment is not started on time, the infection can spread to surrounding tissues and cause thrombosis, liver abscess, and sepsis.

At the initial symptoms of the child, an urgent need to show the pediatrician. He may prescribe an antibiotic ointment. It is applied along the edge of the wound, after removing the discharge around the navel with a cotton swab. If the child has redness along the umbilical vein, similar to a beam, then the infection goes through the vessel. Most likely, in this case, local treatment will be sufficient. If the infection spreads further, the pediatrician prescribes systemic antibiotics.

You can read more about what Omphalitis is, how to diagnose and treat it, in the “Diseases” section on our website (link at the end of the article).

I’ll give you an example. The child was born at 33 weeks of gestation. On the second day, his diuresis decreased – the volume of urine per day, and there were signs of the spread of infection throughout the body. In the navel area appeared redness, thickening and soreness. Doctors urgently prescribed antibiotics and took a culture of a smear from the umbilical cord. The diagnosis was omphalitis. Antibacterial therapy was adjusted by adding a second antibiotic systemically and locally. Over the next two days, the redness and induration decreased. After the umbilical residue fell off, the condition improved, but each time the navel was manipulated, pus was released. In order for the baby to finally recover, it was necessary to treat him with antibiotics for 14 days.

What other diseases of the umbilicus occur in newborns

Fungus navel (umbilical granuloma)

Fungus is an overgrowth of scar tissue in the umbilical wound. The skin in this disease looks like a mushroom cap, hence the name: in Latin “fungus” means “mushroom”.

Fungus can begin when the umbilical residue heals for a long time and is not properly cared for. Sometimes the development of fungus provokes omphalitis. Fungus also threatens with infection: the tissue with a granuloma becomes loose, easily injured, and is strongly supplied with blood.

In most cases, neonatal granulomas are easily treatable. Silver nitrate is applied to the fabrics, which cauterizes them. Since neonatal granulomas do not have nerve endings, the baby will not be hurt during this process. In addition to silver nitrate, liquid nitrogen is used, which freezes the granuloma, and after that the tissue is resorbed.‌

Another method is to tie the granuloma with a thread that cuts off blood flow. Over time, the fungus dries up, shrivels and disappears.

Surgical intervention is required in rare cases when the granuloma is infected and the risk of spreading the infection is high.

Umbilical hernia

When a child cries, screams, or coughs, parents may notice a protrusion of the navel the size of a large pea. This is the umbilical hernia.

An umbilical hernia may occur due to a delay in closing the umbilical ring while the wound heals. In general, the navel is weak, prone to hernias. They may occur due to the immaturity of the connective and muscular structures. It occurs more often in premature babies, but it often happens in full-term babies. Also, a hernia can appear due to a strong increase in intra-abdominal pressure during constipation.

Most often, umbilical hernias decrease spontaneously. It is important not to confuse them with hernias of the white line of the abdomen, which do not close on their own. Seeing the child’s belly button pushed forward, contact the surgeon. He will examine the baby, make a diagnosis and prescribe treatment. In the case of an umbilical hernia, most likely, the doctor will choose to wait and see until the child is 4 years old. Until this age, surgery can be performed in cases where self-closure of the hernia is unlikely. In particular, if the child has large proboscis hernias that have not decreased during the first two years of life, or if the hernias are caused by genetic conditions, such as Ehlers-Danlos syndrome or Down syndrome.

An umbilical hernia is extremely rarely infringed. Regardless of age, an urgent (it seems to me better to say an emergency operation) operation requires a strangulated hernia – squeezing the abdominal organ in the hernial ring (omentum or intestinal loops). Infringement leads to impaired blood circulation and tissue necrosis.

Photo source [8]

In other cases, it is worth choosing expectant tactics: the muscles of the anterior abdominal wall can get stronger and the hernia will decrease. To strengthen the muscles of the anterior abdominal wall and close the expanded umbilical ring, try massage, gymnastics, swimming, lay the baby on the stomach before feeding.

Sometimes parents look for an alternative solution, such as stickers and bandages that support the abdominal muscles. Significant effect from them should not be expected. However, a bandage can alleviate the situation during the period of constipation, when the child pushes and pressure on the umbilical ring increases.

An example from the practice of doctors [7]. A boy weighing 2.3 kg was born by caesarean section at 38 weeks. The family had no congenital anomalies, but during pregnancy, my mother never did an ultrasound. The baby was diagnosed with a large hernia size 9× 8 cm. Eight hours after the birth of the child, a surgical operation was performed. Postoperative recovery went without complications, and three days later the little patient was discharged home.

Umbilical cord care at a glance

If the newborn’s umbilical wound heals normally, no treatment is needed. It is enough to keep this place dry and clean. Do not be afraid of small transparent discharge of light yellow color without an unpleasant odor: this is normal.
Algorithm for treating the umbilical wound, if it gets dirty: rinse with water and pat dry with a clean towel. Antiseptics do not need to be used.
Pus, redness and odor can appear at any time, so it is important to check the umbilical wound periodically. At the first symptoms, consult a doctor.
Don’t be afraid to turn your baby on your stomach if the cord is still in the clamp. It’s not easy to tear it off by accident. It will fall off on its own when the umbilical cord tissues dry out.
A child’s umbilical wound usually heals without assistance. In rare situations, diseases of the umbilical wound are possible, for example, omphalitis. Symptoms – red skin around the wound, purulent discharge, an unpleasant odor.
Do not self-medicate. Coloring antiseptics, for example, Zelenka, mask signs of inflammation.

Sources:

Kozlova L. V., Ibatulin A. G., Gribko T. V., Koroid O. A., Turkova L. I., Vysotskaya L. A. Clinical efficacy of curiosin in the treatment of inflammatory diseases of the navel in newborns // Bulletin of the Smolensk State Medical Academy, 2002
Rekhviashvili M.G., Yakovleva A.A., Kruglyakov A.Yu., Chusov K.P., Kozlov M.Yu., Sytkov V.V. Experience in the treatment of open omphalomesenteric duct in newborns // Pediatric Surgery, 2020
Dzigua M.V., Skrebushevskaya A.A. Obstetrics: hands. to pract. occupations: textbook. allowance // GEOTAR-Media, 2014
Lyutikova O. K., Kacharovskaya E.V. Nursing in pediatrics // GEOTAR-Media, 2013
Shabalov N.P. Neonatology // GEOTAR-Media, 2016
70% Alcohol Versus Dry Cord Care in the Umbilical Cord Care
Newborn with Hernia Umbilical Cord: A Case Report and Review of Literature
https://www.puchkovk.ru/

Fungus of the navel in newborns. What is the fungus of the navel in newborns?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Fungus of the navel in newborns is an excessive growth of granulations in the umbilical wound, which has a mushroom shape. The cause of the disease is the long-term healing of the umbilical residue with improper care, the development of simple or phlegmonous omphalitis. It looks like a pale pink or grayish rounded formation up to 1.0 cm in diameter, dense to the touch. Uncomplicated fungus proceeds without pain and discomfort. A visual inspection is sufficient for diagnosis. There are 2 treatment options: conservative (cauterization of granulations with silver nitrate solution) or surgical removal of excess connective tissue.

ICD-10

L92.8 P38

Causes
Pathogenesis
Symptoms
Complications
Diagnostics
Treatment of navel fungus in newborns
- Conservative therapy
- Surgical treatment
Prognosis and prevention
Prices for treatment

General

Navel fungus is a common neonatal problem that occurs in 1 in 500 babies, equally common in boys and girls. The name comes from the Latin word “fungus” (mushroom), which is due to the characteristic appearance of the formation of granulation tissue. The disease itself does not pose a threat to the health of newborns, but an atypical skin defect, which is sometimes mistaken for a tumor, causes concern for parents.

Fungus of the navel in newborns

Causes

Growth of granulations occurs as a result of a protracted healing process of the umbilical wound, due to improper skin care for newborns or inflammation of the navel. Omphalitis takes the first place among purulent-inflammatory processes in children of the first month of life, but far from always ends with the development of fungus. The risk factor is a large body weight, a wide umbilical ring.

Granulations grow in newborns with a slow wound healing process, which is caused by non-compliance with medical recommendations, late referral to the pediatrician, when omphalitis became common and turned into a phlegmonous form. There are studies confirming that the fungus of the navel is more common in post-term children or in infants with congenital pathologies and reduced body reactivity.

Pathogenesis

The formation of the navel fungus is based on the physiological process that occurs during the healing of wounds and ulcers. After the acute inflammation subsides, the edema subsides, and the umbilical wound is cleared of exudate. During this period, granulations begin to form in newborns – a young connective tissue that has a granular surface and contains a large number of capillaries. Gradually, it thickens, becomes smooth and uniform.

Normally, granulations completely fill the wound and are subsequently replaced by a scar that remains inside the navel for life. With sluggish subacute inflammation or a decrease in the regenerative abilities of the skin in newborns, an excess of granulations containing leukocytes, fibroblasts and an increased number of vessels begins to form. The formation grows outward and is not covered by the epithelium. This is how fungus is formed.

Symptoms

Fungus is distinguished by specific visual features by which parents can easily recognize it. At 2-3 weeks of life, excess granulation tissue of a grayish or pale pink color, dense in consistency, grows inside the umbilical wound in newborns. In shape, it resembles a mushroom: the main part of the tumor-like mass resembles a hemisphere, which rests on a thin stem or has a wide base. Fungus sizes vary from a few millimeters to 1 cm.

Growths do not cause discomfort in newborns. In the normal state, the fungus is painless and does not manifest itself in any way. If the formation reaches a large size, the child shows concern when swaddling or careless processing of the umbilical wound. Uncomplicated forms of the disease occur without general symptoms, do not disturb the state of health and present only an aesthetic problem.

When the fungus is complicated by microbial inflammation, redness and swelling of the skin around the navel, maceration of the surface of the granulations is observed. A cloudy liquid with an unpleasant odor is released from the wound. The baby becomes restless and often cries, eats worse, gains weight poorly. When turning over and changing a diaper, the newborn screams loudly, because touching causes pain.

Complications

The granulation tissue is very thin and delicate, therefore, with constant trauma (diaper, overalls), bacteria enter it and the inflammatory process begins. Fungus can be complicated by extensive phlegmonous inflammation, which affects not only the navel, but also the surrounding tissues. In the absence of timely treatment, the disease passes into a necrotic form.

Active bacterial inflammation of the tissues of the navel is fraught with the spread of the pathological process to the umbilical vessels with the occurrence of phlebitis and arteritis. In this case, microorganisms enter the bloodstream and can spread throughout the body. As a result, newborns with reduced immune responses are at risk of manifesting umbilical sepsis.

Diagnostics

The child is examined by a pediatrician. The fungus of the navel has pathognomonic clinical manifestations, therefore, the results of a physical examination of newborns are sufficient to make a diagnosis. Additional methods are indicated for a complicated course of the disease and the addition of a purulent infection. In such cases, the following is done:

culture of discharge from the wound;
general blood and urine analysis;
Ultrasound of the soft tissues of the anterior abdominal wall.

Treatment of navel fungus in newborns

Conservative therapy

Fungus of small size is successfully treated with medicines. To destroy excess granulations, the doctor cauterizes the umbilical wound with silver nitrate. After manipulation, it is necessary to treat the navel daily with antiseptic solutions (chlorhexidine, hydrogen peroxide). It is recommended to lubricate the wound with brilliant green to prevent the ingress of microorganisms and speed up healing.

With the development of phlegmonous inflammation in the fungus area, systemic antibiotic therapy is carried out for newborns, with reduced immune reactivity, immunoglobulins may be administered. For local treatment of a purulent wound, ointments with antimicrobial components (synthomycin emulsion, levomekol) are used, which are applied to fungus 2 to 3 times a day.

Surgical treatment

In modern pediatrics, surgical intervention is resorted to in the presence of large-diameter granulation growths in newborns or in case of severe purulent complications. The fungus is removed with a scalpel, after which the wound is opened, treated with antiseptics and wound healing medicines. Necrotic inflammation requires wide excision within healthy tissues.

Prognosis and prevention

Fungus is a disease that is not dangerous to life and health, the prognosis for newborns is favorable. After removal of the overgrown granulations and healing of the navel, there is no cosmetic defect left. Complicated forms with inflammation of the phlegmonous type are of concern, in which bacterial pathogens can enter the bloodstream. The success of treatment in this case depends on the timeliness of contacting a doctor.

The basis of prevention is the correct care of the umbilical residue in the neonatal period: it is important to prevent contamination of the wound with urine or feces, wash and wipe the navel area daily, do not cover it with a diaper to allow air access, accelerating healing. Preventive measures include early detection and treatment of omphalitis in the catarrhal stage to eliminate the risk of granulation formation.

You can share your medical history, what helped you in the treatment of navel fungus in newborns.

Sources

Purulent-inflammatory diseases of the navel in newborns / V.N. Golovanov, A.S. Pulikov, V.O. Kin, N.I. Tolstonogov // Bulletin of the Khakass State University. N.F. Katanov. – 2015.

Silver nitrate umbilical: Umbilical Granulomas: Causes, Treatments, and Prevention

Umbilical Granulomas: Causes, Treatments, and Prevention

In this Article

Top Picks

Umbilical Granulomas: Causes, Treatments, and Prevention

In this Article

Top Picks

How to treat the navel of a newborn | clinic blog Nashe Vremya

How to treat the navel of a newborn

Step-by-step instructions for umbilical wound care

What not to do with the navel

What is umbilical wound omphalitis

What other diseases of the umbilicus occur in newborns

Fungus navel (umbilical granuloma)

Umbilical hernia

Umbilical cord care at a glance

Fungus of the navel in newborns. What is the fungus of the navel in newborns?

ICD-10

General

Causes

Pathogenesis

Symptoms

Complications

Diagnostics

Treatment of navel fungus in newborns

Conservative therapy

Surgical treatment

Prognosis and prevention

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