Neonatal umbilical cord treatment: a prospective study on detachment time and complications with different topical approaches

Abstract Background Umbilical granuloma (UG) is a common neonatal condition resulting from excessive granulation tissue at the umbilical stump, often leading to prolonged secretion and minor bleeding. While silver nitrate cauterization remains the standard treatment, there is growing interest in preventive approaches. This study compares different umbilical cord care regimens— Dry Care, Connettivina Silver Plus Spray®, Cliaxin Spray®, or Cicaben Powder®—focusing on umbilical detachment time and associated complications. Methods A prospective study was conducted from November 2020 to February 2022 at the Neonatology Department of the Regional General Hospital "F. Miulli," enrolling 1.699 neonates. Participants were assigned to one of four umbilical care regimens: Dry Care, Connettivina Silver Plus Spray, Cliaxin Spray, or Cicaben Powder. Treatment was administered in the hospital, and post-discharge follow-up on detachment time, bleeding, secretion, and UG formation were conducted on postnatal day 30. Statistical analyses included ANOVA and chi-square tests, with significance set at p < 0.05. Results The shortest detachment time was observed in the Cliaxin Spray group (6.5 ± 2.2 days, p < 0.05), while Dry Care had the longest (8.0 ± 2.8 days). UG incidence ranged from 4.7% to 7.8%, with no statistically significant differences between groups. Bleeding and umbilical discharge rates were significantly lower in the Cicaben Powder group (9.1% and 5.5%, respectively) compared to other regimens ( p < 0.05). No cases of omphalitis or sepsis occurred in any group. Conclusion This study compared Dry Care with dermatological formulations in a large prospective cohort. Cliaxin Spray was linked to faster cord detachment, while Cicaben Powder reduced bleeding and secretion. Although Dry Care remains common, it was associated with more minor complications. No regimen fully prevented all issues, but findings suggest current guidelines should be revisited, considering more individualized approaches. Further controlled studies are needed to confirm these results.