Omphalitis - Umbilical residue infection and umbilical wound, leading to inflammation of the skin and subcutaneous tissue, epithelialization process violation. Omphalitis accompanied by a serous or purulent exudation, hyperemia and infiltration of the umbilical ring, fever and symptoms of intoxication; in severe cases omphalitis complicated cellulitis, peritonitis and umbilical sepsis. Diagnosis is omphalitis inspection child childhood specialist, holding ultrasound of soft tissues and abdominal cavity, sowing separated from the umbilical wound. omphalitis Treatment includes local processing navel antiseptics, bandages, antibiotics, physiotherapy (UFO, UHF), according to testimony - surgical treatment.
streptococcal and stafilodermiii (vezikulopustulez, epidemic pemphigus newborns, neonatal exfoliative dermatitis). In the structure of neonatal pathology omphalitis occupies a leading position on the prevalence and practical significance. omphalitis danger in children is possible extension and generalization of infection with the development of phlebitis or arteritis umbilical vessels, cellulitis, peritonitis, sepsis.
wounds, the presence of diaper dermatitis or other skin infections in the newborn (pyoderma, folliculitis). In rare cases, infection is possible during the ligation of the umbilical cord, but infection occurs most often between 2-mi-mi and 12 days of life.
The risk of developing omphalitis increased in preterm infants, born to premature birth, or pathologically flowing, non-hospital (in Vol. H. Home) births of children with intrauterine infections, hypoxia, congenital anomalies (incomplete umbilical, yolk or urinary fistula).
Pathogens omphalitis often are staphylococci, streptococci, about 30% of cases - Gram-negative bacteria (Escherichia coli, Klebsiella and others.). The source of infection may make baby skin, contaminated urine, faeces, pyogenic flora; care items, hand nursing staff (health care workers, parents) and others.
pediatrics, pediatric surgery, pediatric dermatology, pediatric urology.
Also soak the umbilical wound, there is pyorrhea - the expiration of purulent discharge and pus when pressing on the umbilical region. Perhaps the formation at the bottom of the umbilical fossa sores covered with a purulent coating. When phlegmonous omphalitis baby condition worsens: the body temperature rises to 38 ° C, expressed signs of intoxication (lethargy, poor appetite, vomiting, dyspepsia), slows the growth of body weight. Premature babies at omphalitis local changes can be expressed in a minimum, but at the forefront is usually overlook common manifestation, lightning develop complications.
Necrotizing omphalitis rare, usually in debilitated children (with immunodeficiency, malnutrition, and so on. D.). When this melt fiber is distributed in depth. In the area of the navel skin becomes dark purple, bluish tinge. When omphalitis necrotizing inflammation is almost always goes to the umbilical vessels. In some cases, may be necrotic all layers of the anterior abdominal wall with the development of the contact peritonitis. Gangrenous omphalitis has the most severe course: body temperature can drop to 36 ° C, the child is malnourished, lethargic, does not respond to surrounding stimuli.
Omphalitis may be complicated by phlegmon of the anterior abdominal wall, arteritis and phlebitis umbilical vessels, liver abscesses, enterocolitis, pneumonia, abscess, osteomyelitis, umbilical sepsis.
neonatologist, pediatrician or pediatric surgeon. To determine the causative agent of bacterial infection and selection of antibiotic therapy is conducted bakposev separated umbilical wound flora with sensitivity.
To eliminate omphalitis complications (phlegmon of the abdominal wall, abdominal abscesses, peritonitis), the child is shown holding ultrasound of soft tissues, abdominal ultrasound, abdominal X-ray Review. It is mandatory to omphalitis child should be examined by a pediatric surgeon.
When assigning treatment omphalitis considered its shape and general condition of the newborn. In an outpatient setting under the supervision of a pediatrician can be cured only catarrhal omphalitis; in other cases, hospitalization of the newborn.
In a simple omphalitis performed local treatment weeping umbilical wound 3-4 times a day at first with hydrogen peroxide, then water or alcohol-based antiseptic solutions - furatsilina, dioksidina, hlorofillipta, brilliant green. All manipulations (processing, drying of the umbilical wound) held separate cotton buds or swabs. Used physiotherapy - UFO, UHF, UHF-therapy, a helium-neon laser. When sprouting Fungus carried his silver nitrate cauterization. During treatment omphalitis bathing the baby is carried in a weak solution of potassium permanganate.
When abscess omphalitis form other than the above mentioned activities to the area of inflammation bandage with antiseptic and antibacterial ointments (bacitracin /polymyxin B, Vishnevsky), made obkalyvanie antibiotics hearth appointed systemic antibiotics and fluid therapy, anti-staphylococcal administered immunoglobulin. In the formation of an abscess resorted to his surgical dissection.
With the development of necrotic omphalitis performed excision of necrotic tissue, are performed ligation, performed an active general treatment (antibiotics, vitamin therapy, plasma transfusion, physiotherapy and so on.).
Prediction and prevention omphalitis
Catarrhal omphalitis easily treatable and usually ends in recovery. Forecast abscess and necrotic omphalitis depends on the adequacy and timing of the treatment, addition of secondary complications and the child's condition. In generalized septic complications, possibly fatal.
Prevention involves omphalitis aseptically in processing the umbilical cord, daily care of the umbilical wound, hygiene caring staff. Categorically unacceptable to forcibly disrupt the crust with the umbilical wound, closing her diaper or bandage, adhesive plaster to seal because it provokes oozing and infection. In the case of umbilical wound redness, swelling and discharge appearance should immediately consult a pediatrician.