Purulent omphalitis. Omphalitis Inflammation of the umbilical wound of a newborn is called

- infection of the umbilical cord and umbilical wound, leading to inflammation of the skin and subcutaneous tissue, disruption of epithelization processes. Omphalitis is accompanied by serous or purulent exudation, hyperemia and infiltration of the umbilical ring, fever and signs of intoxication; in severe cases, omphalitis is complicated by phlegmon, peritonitis and umbilical sepsis. Diagnosis of omphalitis consists in examining the child by a pediatric specialist, conducting an ultrasound scan of the soft tissues and abdominal organs, sowing discharge from the umbilical wound. Treatment of omphalitis includes local treatment of the navel with antiseptics, dressings, antibiotic therapy, physiotherapy (UVI, UHF), and, if indicated, surgical treatment.

General information

Omphalitis is a disease of newborns characterized by inflammation of the skin and subcutaneous tissue in the area of ​​the umbilical wound. Purulent-septic skin diseases are predominant in the neonatal period. Among them are streptoderma and staphyloderma (vesiculopustulosis, epidemic pemphigus of the newborn, exfoliative dermatitis of the newborn). In the structure of neonatal pathology, omphalitis occupies one of the leading places in terms of prevalence and practical significance. The danger of omphalitis in children lies in the possible spread and generalization of infection with the development of arteritis or phlebitis of the umbilical vessels, phlegmon, peritonitis, sepsis.

Causes of omphalitis

The development of omphalitis is associated with infection through the stump of the umbilical cord or an unhealed umbilical wound. This can happen in case of neglect of hygiene standards and rules for caring for a newborn and treating an umbilical wound, the presence of diaper dermatitis or other infectious skin diseases in a newborn ( pyoderma, folliculitis). In rare cases, infection is possible during ligation of the umbilical cord, but more often infection occurs between the 2nd and 12th day of life.

The risk of developing omphalitis is increased in premature babies born from premature or pathological births, out-of-hospital (including home) births, children with intrauterine infections, hypoxia, congenital anomalies (incomplete umbilical, vitelline or urinary fistula).

The causative agents of omphalitis are most often staphylococci, streptococci, in about 30% of cases - gram-negative microorganisms (E. coli, Klebsiella, etc.). The source of infection can be the skin of an infant contaminated with urine, feces, pyogenic flora; care items, hands of caregivers (medical workers, parents), etc.

Omphalitis classification

For reasons of occurrence, omphalitis can be primary (with infection of the umbilical wound) or secondary (in case of infection against the background of existing congenital anomalies - fistulas). Secondary omphalitis in a child develops at a later date and lasts longer.

According to the nature and degree of inflammatory changes in the navel, catarrhal or simple omphalitis (“weeping navel”), phlegmonous and gangrenous (necrotic) omphalitis are distinguished.

In the spectrum of consideration of the clinical course of omphalitis, the disease may be of practical interest for pediatrics, pediatric surgery, pediatric dermatology, and pediatric urology.

Symptoms of omphalitis

The most common and prognostically favorable form of the disease is catarrhal omphalitis. Usually, an independent fall of the umbilical cord in a newborn occurs in the first or second week of life. In its place, a loose bloody crust forms; the final epithelialization of the umbilical wound with proper care is observed by the 10-15th day of life. In the case of the development of local inflammation, the umbilical wound does not heal, a meager secret of a serous, serous-hemorrhagic or serous-purulent nature begins to stand out from it. The wound is periodically covered with crusts, however, after their rejection, the defect does not epithelialize. The umbilical ring is hyperemic and edematous. With prolonged weeping (for 2 or more weeks), excessive growth of granulations may occur with the formation of a mushroom-shaped protrusion at the bottom of the umbilical wound - the fungus of the navel, which makes healing even more difficult. The general condition of the newborn (appetite, physiological functions, sleep, weight gain) with a simple form of omphalitis is usually not disturbed; subfebrile condition is sometimes noted.

Phlegmonous omphalitis is characterized by the spread of inflammation to the surrounding tissues and is usually a continuation of the "weeping navel". The skin around the navel is hyperemic, the subcutaneous tissue is edematous and rises above the surface of the abdomen. The pattern of the venous network on the anterior abdominal wall is enhanced, the presence of red stripes indicates the addition of lymphangitis.

In addition to weeping of the umbilical wound, pyorrhea is noted - the expiration of purulent discharge and the release of pus when pressed on the umbilical region. Perhaps the formation of an ulcer at the bottom of the umbilical fossa, covered with a purulent coating. With phlegmonous omphalitis, the infant's condition worsens: the body temperature rises to 38 ° C, signs of intoxication are expressed (lethargy, poor appetite, regurgitation, dyspepsia), weight gain slows down. In premature babies, local changes in omphalitis can be minimally expressed, but general manifestations usually come to the fore, complications develop at lightning speed.

Necrotizing omphalitis is rare, usually in debilitated children (with immunodeficiency, malnutrition, etc.). In this case, the fusion of cellulose spreads in depth. In the navel area, the skin acquires a dark purple, bluish tint. With necrotic omphalitis, inflammation almost always passes to the umbilical vessels. In some cases, all layers of the anterior abdominal wall may become necrotic with the development of contact peritonitis. Gangrenous omphalitis has the most severe course: body temperature can drop to 36 ° C, the child is exhausted, lethargic, does not respond to environmental stimuli.

Omphalitis can be complicated by phlegmon of the anterior abdominal wall, arteritis or phlebitis of the umbilical vessels, liver abscesses, enterocolitis, abscess pneumonia, osteomyelitis, umbilical sepsis.

Diagnosis and treatment of omphalitis

Usually, an examination of the child by a neonatologist, pediatrician, or pediatric surgeon is sufficient to recognize omphalitis. To determine the causative agent of a bacterial infection and select antibacterial therapy, bacteriological culture of the detachable umbilical wound is carried out for flora with sensitivity.

To exclude complications of omphalitis (phlegmon of the abdominal wall, abdominal abscesses, peritonitis), the child is shown an ultrasound of soft tissues, an ultrasound of the abdominal cavity, and an abdominal radiography. Without fail, a child with omphalitis should be examined by a pediatric surgeon.

When prescribing treatment for omphalitis, its shape and the general condition of the newborn are taken into account. On an outpatient basis, under the supervision of a pediatrician, only catarrhal omphalitis can be treated; in other cases hospitalization of the newborn is shown.

With a simple omphalitis, a local treatment of a weeping umbilical wound is performed 3-4 times a day, first with hydrogen peroxide, then with aqueous or alcoholic solutions of antiseptics - furacilin, dioxidine, chlorophyllipt, brilliant green. All manipulations (treatment, drying of the umbilical wound) are carried out with separate cotton swabs or swabs. Physiotherapy treatment is used - UV, microwave, UHF-therapy, helium-neon laser. When the fungus grows, it is cauterized with silver nitrate. During the treatment of omphalitis, the child is bathed in a weak solution of potassium permanganate.

In the phlegmonous form of omphalitis, in addition to the above measures, bandages with antibacterial and antiseptic ointments (bacitracin / polymyxin B, Vishnevsky) are applied to the area of ​​​​inflammation, the focus is chipped with antibiotics, systemic antibacterial drugs and infusion therapy are prescribed, anti-staphylococcal immunoglobulin is introduced. When forming an abscess, they resort to its surgical opening.

With the development of necrotic omphalitis, excision of necrotic tissues is performed, dressings are performed, active general treatment is carried out (antibiotics, vitamin therapy, plasma transfusions, physiotherapy, etc.).

Forecast and prevention of omphalitis

Catarrhal omphalitis is easily treatable and usually ends in recovery. The prognosis of phlegmonous and necrotic omphalitis depends on the adequacy and timing of the start of treatment, the addition of secondary complications and the condition of the child. With generalized septic complications, a lethal outcome is possible.

Prevention of omphalitis involves asepsis in the treatment of the umbilical cord, daily care of the umbilical wound, and hygiene by caring staff. It is strictly unacceptable to forcibly tear off the crusts from the umbilical wound, cover it with a bandage or diaper, and seal it with adhesive tape, as this provokes wetting and infection. In case of reddening of the umbilical wound, the appearance of swelling and discharge, you should immediately consult a pediatrician.

Omphalitis(lat. Omphalitis) is a bacterial inflammation of the bottom of the umbilical wound, the umbilical ring and subcutaneous fat around the navel. There are simple, phlegmonous, necrotic forms of omphalitis.

Omphalitis - cause (etiology)

The inflammatory process is localized in the umbilical fossa or spreads to the skin and other tissues around the navel.

Infection from the umbilical wound often spreads to the umbilical vessels, is fixed in the umbilical arteries, vein.

Omphalitis - the mechanism of occurrence and development (pathogenesis)

Purulent-septic diseases of the navel in newborns, in terms of frequency and practical significance, occupy one of the first places in the structure of morbidity in children of the 1st month of life. A purulent infection of the navel has a variety of clinical manifestations, among which one can find a rather pronounced local process without severe general septic manifestations, as well as a severe picture of sepsis with the most minor local inflammation. Purulent infection of the navel is a common source of sepsis in young children and severe illness in older children.

An umbilical infection is often caused by staphylococci and streptococci, less often by other microbes (E. coli, pneumococci, diphtheria bacillus).

Infection in rare cases can occur before birth, during the ligation and alloying of the umbilical cord. However, most often infection occurs between the 2nd and 12th day of life, when the stump can become contaminated with urine, child's feces, or infection occurs from surrounding objects or hands of personnel; infection can also occur through droplet transmission from caregivers.

The development of the pathological process in a purulent infection of the navel can go in different ways, in connection with which its various clinical forms are observed. So the most common form that the pathological process takes is Omphalitis.

The causative agent (mainly staphylococcus) of omphalitis penetrates into the tissues adjacent to the navel through the stump of the umbilical cord or through the wound after it falls off. The infection can spread and be fixed in the umbilical vessels (more often in the arteries, less often in the veins), causing a productive, purulent or necrotic inflammation. The spread of inflammation leads to the development of phlegmon in the navel. When the umbilical vein is involved in the process, phlebitis occurs (see full body of knowledge), which can spread along the portal vein to its intrahepatic branches. Often, purulent foci form along the course of the veins, sometimes after the umbilical wound has healed.

Omphalitis - pathological anatomy

The rest of the umbilical cord is not mummified, but becomes inflamed, moist, swollen, acquires a dirty brown color, and emits an unpleasant odor. At first, the general condition of the child does not suffer, and then the body temperature rises, loss of appetite is noted, lethargy appears. When the gangrenous umbilical cord falls off, a festering long-term non-healing wound remains, which can be a source of sepsis.

The most common and prognostically favorable form of the disease is simple Omphalitis (weeping navel), in which a long-term non-healing granulating wound with scanty serous purulent discharge appears on the navel. The child's condition is satisfactory. Periodically, the wound is covered with a crust; granulations may grow excessively, forming a mushroom-shaped protrusion (fungus umbilici).

Phlegmonous Omphalitis is characterized by acute inflammation around the umbilical wound (edema, tissue infiltration, skin flushing, protrusion of the umbilical region). The edges of the wound are undermined, the probe determines the course, which is often associated with an abscess. The progression of the process can lead to phlegmon of the abdominal wall.

Necrotic omphalitis is extremely rare as a complication of phlegmon around the navel in severely weakened areactive children. The skin in the navel area has a purple-cyanotic color, tissue necrosis quickly spreads to all layers, a deep wound is formed, which can lead to bowel eventration.

The most dangerous complications of a tumor are septicemia and sepsis (see Sepsis). Local complications include phlegmon of the abdominal wall (see Phlegmon of the abdominal wall), contact peritonitis (see Peritonitis), pylephlebitis (see Pylephlebitis), liver abscesses (see Liver abscess), to distant ones - portal hypertension (see Hypertension).

Omphalitis - symptoms (clinic)

Omphalitis - a simple form

The simple form, known as the "weeping navel", is characterized by the fact that after the remnant of the umbilical cord falls off, the infected umbilical wound heals poorly, becomes covered with granulations, on the surface of which droplets of serous or serous-purulent fluid appear. Drying, the discharge forms crusts, which are gradually rejected. Healing of such an umbilical wound occurs within a few weeks. The general condition of the child remains satisfactory, all physiological functions (stool, sleep, appetite) are normal, the child's body weight increases.

With prolonged healing of the umbilical wound, sometimes there is an excessive growth of granulations that form a tumor-like mass with a wide base or on a thin stalk in the region of the umbilical fossa, which resembles a mushroom in shape and therefore was called fungus. Fungus is quite dense to the touch, painless, has a pale pink color, becomes covered with a fibrinous coating when infected, and then the child becomes restless, especially when swaddling and shifting.

Omphalitis - phlegmonous form

The phlegmonous form of omphalitis is characterized by the spread of the inflammatory process around the navel, into the tissues adjacent to it. The skin near the navel becomes hyperemic, edematous and infiltrated, and the umbilical region bulges above the surface of the abdomen. At the bottom of the umbilical fossa, in some cases, an ulcer is formed. The inflammatory process can spread to the anterior wall of the abdomen or remain local. Often, when pressing on the umbilical region, pus is released from the umbilical wound.

The general condition with phlegmonous omphalitis is disturbed, body temperature rises, appetite decreases, body weight decreases, there may be dyspeptic disorders. The severity of the general condition of the patient depends on the prevalence of the process: an increase in temperature to 37.5-38 ° C and moderate anxiety are characteristic of limited forms, and an increase in temperature to 39-40 ° C with symptoms of toxicosis is for extensive phlegmon.

Omphalitis - necrotic form

The necrotic form of omphalitis is very rare, usually in malnourished children. Flowing at first as phlegmonous omphalitis, the process spreads in depth. The skin in the umbilical region becomes dark red with a bluish tinge, its necrosis occurs and detachment from the underlying tissues with the formation of an extensive wound. This form of omphalitis is the most severe, accompanied by severe intoxication and ends in most cases with sepsis.

With any form of omphalitis, there is always a real danger of infection spreading to the umbilical vessels, from which umbilical sepsis most often originates.

Omphalitis - treatment

The appointment of antibiotics is indicated. Local treatment consists in the speedy removal of the remainder of the umbilical cord by cutting off the stump in compliance with all asepsis rules. The wound is cauterized with a 5% alcohol solution of iodine, and in the following days - with a 3% solution of silver nitrate. With the appearance of swelling and hyperemia of the skin around the navel, the appointment of physiotherapeutic procedures is indicated - ultraviolet irradiation and UHF currents.

With a simple form of omphalitis, only local treatment is required, which can be performed on an outpatient basis. The weeping navel is cauterized 1-2 times a day with a 5% solution of silver nitrate or a 5% solution of potassium permanganate, or a 1% alcohol solution of iodine. If pus is released from the umbilical wound, then first it is washed with hydrogen peroxide, then cauterized with the indicated solutions and sprinkled with powder of white streptocide, xeroform, dermatol, vioform. If after the remnant of the umbilical cord falls off after 5-7 days, the umbilicus remains weeping and granulations form, then bathing the child is allowed with the addition of potassium permanganate to the water (the water should be light pink in color).

With the phlegmonous form of omphalitis, a more vigorous treatment is carried out. Broad-spectrum antibiotics are administered intramuscularly for 10-14 days. Breastfeeding is of great importance. It is necessary to prescribe vitamins (B) and (C), repeated intravenous blood transfusions at intervals of 5-6 days. Intravenous plasma infusions, intramuscular injections of gamma globulin are advisable. According to the indications, glucose, cardiac drugs are prescribed.

Locally, if there is no suppuration, the affected area around the navel is chipped with a solution of antibiotics. The daily dose of one or another antibiotic is dissolved in 20-25 ml of a 0.25% solution of novocaine and tissues around the navel are infiltrated from two or three points.

UHF currents or irradiation with a mercury-quartz lamp are also used locally. A bandage is applied to the affected area with Vishnevsky ointment, with ethacridine lactate (rivanol), furatsilin, etc. If an abscess is found, then they resort to surgical intervention.

In the necrotic form of omphalitis, in all cases, surgical intervention is required along with vigorous general treatment (antibiotics, blood transfusions, plasma, vitamin therapy, the introduction of gamma globulin, physiotherapy).

With omphalitis, severe complications are possible, which in themselves can serve as a source of septicemia and septicopyemia. Among the severe complications of omphalitis are peritonitis, liver abscess, hematogenous osteomyelitis, suppuration of the lungs, which most often develop against the background of sepsis.

The prognosis for simple omphalitis is favorable. With phlegmonous and necrotic form, the prognosis is made with caution due to the possibility of developing umbilical sepsis.

Omphalitis - prevention

To avoid the development of omphalitis in a newborn, it is necessary to carefully care for the umbilical wound. To do this, you need to wash the umbilical wound daily, twice a day with antiseptic agents so that bacteria do not penetrate into it, and also monitor the color of the umbilical ring.

Purulent omphalitis is an inflammatory process that occurs in the bottom of the umbilical wound, umbilical ring and blood vessels, paraumbilical subcutaneous fatty tissue. The cause of the disease is bacteria. The pathological process begins most often in the 2nd week of a baby's life, in many cases with a catarrhal form of omphalitis.

The disease often occurs in the absence of proper care for the newborn. In the first weeks of his life, the skin is very sensitive to various injuries, in addition, there is an open wound in the umbilical region during this period.

The baby's body, due to its physiological characteristics, is not able to fully deal with various damaging factors. Therefore, parents of newborns need to be very careful and careful when caring for their navel and skin.

Symptoms

The disease most often begins with catarrhal omphalitis. At the same time, the navel constantly gets wet, and after a while, suppuration occurs from the umbilical wound.

Purulent omphalitis in newborns is manifested by a local inflammatory process. At the same time, the general condition of the child is disturbed. The umbilical ring, as well as the tissues surrounding it, are edematous and hyperemic. The navel due to edema increases in size and protrudes above the anterior wall of the abdomen.

At the site of inflammation, the skin is hot, dilated veins are visible. Body temperature depends on the prevalence of the process - it can be 38 degrees or subfebrile. Further signs of general intoxication join: the child is lethargic, restless, he has no appetite, weight gain decreases.

With severe purulent omphalitis, the general condition of the newborn suffers even more - the shape of the navel changes, it becomes protruding or ringed. Body temperature rises to 38-39 degrees and more, the child begins to lose weight. A thick crust appears on the umbilical wound, pus accumulates under it. If such a wound is accidentally torn off or injured, then ulcers may appear on the surface of the navel.

Ulceration may cover plaque and surround a dense roller that forms from inflamed skin. In the case of the development of a severe form of the disease, the inflammatory process covers a large part of the umbilical region, purulent discharge becomes abundant.

At the same time, the child is naughty, sleep is disturbed, body temperature rises, frequent regurgitation occurs and appetite decreases. If the baby has such symptoms, he needs urgent hospitalization.

It must be remembered that in a premature baby with the development of omphalitis, changes around the navel may not occur, or they may be minimal, since the immune system of such babies is not yet able to actively fight the infection. In such children with omphalitis, signs of toxicosis with lethargy, refusal of the breast, high body temperature and other clinical manifestations predominate.

Then a severe form of the disease develops rapidly and there is a high probability of developing complications - metastatic purulent foci (enterocolitis, destructive pneumonia, osteomyelitis), sepsis.

Diagnostics

Diagnosis of purulent omphalitis is not difficult. It is based on characteristic local manifestations (purulent discharge from the umbilical wound, hyperemia of the skin around it).

In the general blood test, inflammatory changes are possible - the ESR and the level of leukocytes increase. If the development of phlegmon of the abdominal wall is suspected, an ultrasound of the soft tissues is performed, and if peritonitis is suspected, an ultrasound of the abdominal organs is performed.

Prevention

To prevent the possibility of developing purulent omphalitis, it is necessary to properly treat the umbilical wound. For this you need:

• First treat the umbilical wound with a 3% hydrogen peroxide solution, and then treat the dry wound with a 2% brilliant green solution or alcohol.
• The frequency of processing per day is 3-4 times.
• Processing is carried out daily until complete healing.

In addition, if catarrhal omphalitis occurs, it is necessary to take care of its adequate treatment, since very often purulent omphalitis develops precisely from this form.

Treatment

Specific treatment for purulent omphalitis is carried out by a surgeon. To prevent the development of inflammation in nearby tissues, an outflow of purulent contents is necessary. This can be achieved using drainage. An incision is made in the umbilical ring and a probe is inserted, so the pus is released.

With the help of this procedure, it is possible to clear the focus of purulent contents in a short time, thereby reducing inflammation. For the purpose of additional cleansing of the wound, hypertonic solutions of magnesium sulfate and common salt are used. After cleaning the wound, the use of antibiotic-based ointments (for example, levomekol or synthomycin ointment) is indicated. In addition to local treatment, antibiotic therapy and vitamin therapy are indicated.

Treatment of purulent omphalitis is quite complicated, but the approach of a qualified specialist to it contributes to the recovery of the child. The prognosis for complex timely therapy is favorable, but sometimes generalization of the process and the occurrence of foci of infection as a result of metastasis are possible.

The occurrence of an inflammatory process of the skin in the navel can be not only in newborns, but also in older children.

• One of the reasons why a child may have omphalitis is the congenital anatomical features of the structure of the navel.
• The umbilical canal may be narrow or retracted, which increases the risk of accumulation of dead skin cells and sebaceous glands.
• Damage to the navel in a child can also lead to the development of omphalitis. When an injury occurs, infection can occur and the inflammatory process begins.
• If the wound that has arisen in the umbilical canal is not properly cared for, omphalitis occurs.
• The development of the disease is especially likely in children with reduced immunity. With a reduced efficiency of the immune system, the body cannot cope with the development of infection. In these children, the likelihood of complications is significantly increased.

Symptoms

It is easy to determine the inflammatory process in a child on the skin in the navel area. Signs of omphalitis vary depending on the form of the disease.

• With purulent omphalitis, purulent masses form in the umbilical canal, as well as swelling and redness of the skin around the navel.
• There is an expansion of the veins on the anterior abdominal wall, which is clearly visible.
• The child may be naughty, anxious, sleep poorly, his appetite decreases.
• With the rapid development of purulent omphalitis, the navel begins to bulge above the surface of the skin.
• If the baby has a weeping form of omphalitis, instead of pus, a liquid appears in the umbilical canal.
• If the liquid dries up, crusts form on the navel.
• With weeping omphalitis, the child may feel good, but this form of the disease provokes the spread of the inflammatory process to neighboring areas of the skin.

Diagnosis of omphalitis in a child

• The doctor can diagnose the inflammatory process of the umbilical canal during the initial examination. The child must be shown to the pediatrician and surgeon.
• To determine the causative agent of an infectious disease, it is necessary to pass a sample of secretions for bacteriological culture.
• Tank culture helps to determine the sensitivity of the pathogen to antibacterial drugs.
• The child may be assigned an ultrasound examination to prevent complications in the form of abscesses or phlegmon of the abdominal cavity.
• Abdominal radiography can also be performed to identify complications of omphalitis in a child.
• To determine the general condition of the body, the child is assigned a general blood and urine test.

Complications

The occurrence of complications of the disease in children is rare. With timely diagnosis and correctly prescribed treatment, there are no consequences and complications after omphalitis. But what is the danger of the disease, in case of complications? There is a possibility of developing pathologies of various organs and systems.

• Perhaps the development of an inflammatory process of the lymph nodes called lymphangitis.
• The occurrence of a purulent process in soft and bone tissues, as well as in the bone marrow.
• The development of phlebitis - inflammation of the veins.
• The beginning of the inflammatory process in the intestinal mucosa or enterocolitis.
• development of sepsis. Sepsis is a blood poisoning that can be fatal.
• The onset of inflammation in the arteries called arthritis.
• Inflammatory process in the abdominal wall.

Therefore, the child may be hospitalized to prevent the development of complications.

Treatment

What can you do

• If the disease proceeds without complications, the child is treated at home.
• It is impossible to determine the treatment on your own: you need to show the baby to the doctor and follow the medical recommendations.
• In a simple form of omphalitis, treatment occurs by treating the navel with a solution of hydrogen peroxide, after which an alcohol or aqueous solution of an antiseptic is used.
• Parents should treat the resulting wound in a timely manner, at least 3 times a day.
• Moms and dads should use clean cotton swabs or sticks to prevent further infection of the inflamed skin area.
• Bathing a child for the duration of treatment should be carried out in water with the addition of a weak solution of potassium permanganate.
• If dressings and plasters are used, they must be changed in a timely manner.

What does a doctor do

• If a child has a complicated form of the disease, treatment takes place within the walls of a hospital under the supervision of doctors.
• The doctor prescribes antibiotics.
• To cure omphalitis in the shortest possible time, physiotherapeutic procedures, laser, UHF are used.
• With complicated omphalitis, in some cases, surgical intervention is required. The doctor removes damaged and dead tissue. To reduce the intoxication of the child's body, special drugs are administered intravenously.
• For a speedy recovery, antibiotics and immuno-boosting drugs are prescribed.
• In order for the wound to heal after surgery, wound healing agents are used.

Prevention

You can prevent the development of the inflammatory process in a child in the navel area by following simple rules.

• If the anatomical structure of the umbilical canal predisposes the development of omphalitis, it is necessary to monitor the skin in this area.
• Upon receipt of damage to the navel, the resulting wound should be disinfected in a timely manner. For this, water or alcohol antiseptics are used, as well as hydrogen peroxide.
• If necessary, dressings or patches should be used, which must be changed frequently.
• Increase the efficiency of the immune system with fresh vegetables and fruits, as well as vitamin and mineral complexes. But the intake of vitamins should occur after consulting a doctor. To increase immunity, the child must be in the fresh air every day, observe the daily routine and eat well.

You will also learn how untimely treatment of omphalitis in children can be dangerous, and why it is so important to avoid the consequences. All about how to prevent omphalitis in children and prevent complications.

And caring parents will find on the pages of the service full information about the symptoms of omphalitis in children. How do the signs of the disease in children at 1.2 and 3 years old differ from the manifestations of the disease in children at 4, 5, 6 and 7 years old? What is the best way to treat omphalitis in children?

Take care of the health of your loved ones and be in good shape!

Omphalitis is an inflammation of the navel. The disease occurs in both children and adults. In this article, we will consider this pathology in more detail.

General view

Such an insignificant organ as the navel, in fact, is a useless part of the human body. Only during the period of gestation does it play a crucial role in the life and development of the child. After birth, it becomes unnecessary. The navel is a natural scar that appears after excision of the umbilical cord in an infant on the anterior abdominal wall.

The obstetrician cuts and pinches the cord, and ten days later its remnants fall off, forming a wound. After it heals, a neat navel appears on the stomach. However, things don't always go so smoothly. Sometimes mothers notice that the navel begins to get wet. This is due to infection of the umbilical wound, which manifests itself in the form of redness, swelling, purulent discharge, fever, abdominal pain. This phenomenon cannot be ignored.

Inflammation of the navel can also appear in adults. The disease is called "omphalitis". It is characterized by the development of an inflammatory reaction of the skin and subcutaneous tissue in the navel. In advanced stages, there is a threat of development of umbilical sepsis. Pathology is accompanied by a change in the shape of the navel. It becomes convex and hot, especially near the inflammatory focus.

Omphalitis in adults may be complicated by the appearance of an umbilical fistula. In this case, surgical intervention is required. The causes of omphalitis can be different, which determines further treatment tactics. Therefore, with a similar problem, you should immediately contact a specialist. Most often, the development of the disease is provoked by a bacterial and fungal infection.

Omphalitis in adults may appear after piercing or improper wound care after the procedure. Depending on the underlying cause, two main forms of the disease are distinguished:

• primary - the infection penetrates directly into the umbilical wound;
• secondary - the infection joins the fistula.

Depending on the form, omphalitis is acute and chronic. And there is also a classification that divides the pathology into categories depending on the nature of the inflammation:

• catarrhal. This is the most common type of disease. A serous fluid is released. Crusts appear;
• phlegmonous;
• gangrenous - difficult to treat;
• purulent. The navel protrudes above the abdominal wall. Ulcers and purulent discharge are formed. The gangrenous and purulent form is referred to as a necrotic form of omphalitis.

Causes

The disease develops as a result of infection. Provoking factors that can contribute to the introduction of pathogenic microflora include the following:

• failure to properly comply with the rules of personal hygiene;
• improper treatment of the umbilical wound;
• use of dirty bed or underwear, towels;
• contamination by urine or faeces;
• improper treatment of the resulting skin lesions;
• touching the umbilical wound with dirty hands.

An important role is played by infectious diseases, to which a woman is more susceptible during pregnancy. Pathogenic microflora can easily affect the umbilical cord. The most common causative agents of omphalitis are the following microorganisms:

• staphylococci,
• streptococci,
• coli,
• Pseudomonas aeruginosa.

Features of the anatomical structure are also associated with the likelihood of the onset of the disease. If the umbilical canal is narrow and deeply retracted, dying skin cells and secretions of the sebaceous glands can accumulate in it. Omphalitis in children mainly occurs as a result of improper or insufficient care.

The photo shows one of the most common causes of omphalitis - piercing

Inflammation can occur if the baby was bathed under unboiled tap water or the vest was not washed well enough. This can easily cause infection of the umbilical wound. As a result, liquid begins to accumulate in it, on the surface of which a crust appears.

After it dries up and falls off, small sores remain in its place. Such omphalitis is called simple, or catarrhal. If a purulent secret is released from the wound, the skin is redder and swells, the baby's temperature rises, then we are talking about a purulent form. Treatment is carried out in a hospital.

Omphalitis in adolescents and adults is much less common. And this is understandable, because the umbilical wound has healed for a long time, and the likelihood of a pathological focus is negligible. However, the disease can still occur if a person does not wash the navel area too thoroughly and does not remove the dirt accumulated in it.

Various factors can contribute to the progression of the disease:

• weakened immunity;
• hypothermia;
• overwork;
• prematurity, low weight (children's omphalitis);
• infectious diseases of the skin;
• scratches, cuts, scratching in the navel;
• the presence of scars or tattoos;
• rubbing the navel with tight clothing or a belt buckle;
• inflammation after surgery;
• excess weight;
• the presence of diabetes.

Important! At risk are young women who like to decorate their tummies with piercings.

Another reason for infection can be a fistula. It is a channel through which different cavities are connected. Fistulas are congenital and acquired. Of these, a yellow liquid, feces, urine can stand out.

With an incomplete fistula, conservative treatment is prescribed. Baths with potassium permanganate, dressings with a solution of chlorophyllipt will be effective. You can dry the wound with iodine or brilliant green. If the fistula does not heal, an operation is performed.

Symptoms

In newborns, an umbilical wound usually heals within two weeks. When properly processed, it tightens. However, if an infection enters, the wound does not heal for a long time, and serous-purulent fluid is released from it. First, a crust appears, then it peels off, reopening the wound. The main symptoms of omphalitis include redness, swelling, and discharge.

In adults, a mild form of omphalitis most often develops. It manifests itself in the form of swelling, redness and the appearance of discharge. In more severe cases, the secret is bloody and purulent. The navel does not just get wet, an unpleasant smell comes from it. It becomes bulging and hot to the touch. Omphalitis is characterized by the appearance of not only local signs, but also general ones.

A person's body temperature rises, he becomes lethargic and lethargic. At the necrotic stage of the disease, all layers of the abdominal wall are affected. Inflammation even extends to the internal organs. The skin becomes dark blue. The danger of this condition lies in the development of peritonitis and sepsis - complications that can lead to death.

Kinds

Experts distinguish three forms of omphalitis. Each of them is a consequence of the previous one and occurs in the absence of treatment. So, omphalitis has three stages of development:

• weeping navel, or simple form;
• phlegmonous variety;
• necrotic or gangrenous inflammation.

Simple

The general condition of the patient is not disturbed. In the navel area, weeping is observed with secretions of a serous or purulent nature. The pathological secret dries up, becoming covered with a thin crust. At the bottom of the wound, with a long-term pathological process, mushroom-shaped tumors can form.

The child is calm. He has a normal body temperature, restful sleep and a healthy appetite. The edges of the wound usually do not change or may be slightly swollen. The umbilical vessels cannot be palpated.

Important! Catarrhal omphalitis causes exclusively local changes.

The causative agents of the inflammatory process are most often staphylococci. The occurrence of a catarrhal form in infants is facilitated by intrauterine hypoxia, a thick umbilical cord, and a violation of asepsis rules when processing the navel. And also apply tetracycline ointment or synthomycin emulsion.

Despite the fact that this is a mild form of omphalitis, treatment must be started immediately, otherwise the disease will cause serious complications. Therapy can be carried out on an outpatient basis. Several times a day, you need to treat the wound with an antiseptic solution. During processing, do not forget to remove the formed crusts. From physiotherapeutic procedures, ultraviolet irradiation is applied locally.

A simple form is manifested only by local signs

Phlegmonous

This is a dangerous stage of ophmalitis, in which the inflammatory process affects the surrounding tissues. There is a gradual deterioration in the general condition. With the development of phlegmon of the anterior abdominal wall, the temperature rises above 39 degrees. In this case, the umbilical fossa is an ulcer. When pressed, a purulent secret is released from it.

The discharge has an unpleasant odor. The area around the navel is inflamed and swollen. When pressed, severe pain occurs. Symptoms of intoxication join local manifestations.

The patient becomes lethargic and lethargic. He has no appetite. Children are naughty, they have frequent regurgitation. Phlegmonous omphalitis is an indication for hospitalization.

The child's body, due to physiological characteristics, is not able to fully deal with damaging factors. That is why, from the first days of life, the baby must be carefully cared for. Specific treatment is carried out by the surgeon. The specialist uses drainage to drain purulent contents. To do this, an incision is made in the umbilical ring and a drain is inserted.

Necrotic

It is extremely rare in debilitated patients with impaired immune system function. Inflammation spreads deep into, affecting the internal organs. The skin becomes dark. It resembles a bruise after a blow.

There is a high probability of developing peritonitis - inflammation of the peritoneum, which can be fatal. The spread of infection to the umbilical vessels can lead to sepsis - blood poisoning. Doctors prescribe broad-spectrum antibiotics as treatment. Often the patient needs surgery.

Treatment

It is simply impossible to independently determine the cause of inflammation of the navel. Consultation of the surgeon is necessary. And it will also require a bacteriological culture of the discharge from the umbilical wound. Treatment of omphalitis directly depends on the cause of the disease. Most often, it is treated conservatively, however, with the formation of fistulas, surgery is indispensable.

Important! Maintaining navel hygiene while it heals is the best prevention of omphalitis.

As treatment, antibacterial agents are used in the form of ointments and tablets. If the causative agent of inflammation is a fungal infection, antifungal drugs are prescribed. Injections also introduce anti-staphylococcal immunoglobulin. The main focus is on strengthening the immune system. For this, vitamin therapy is carried out.

Navel piercing should be carried out in a specialized salon by a professional master. The use of exclusively sterile materials, as well as high-quality products, will minimize the risk of unpleasant consequences. After the procedure, there is usually pain and swelling. In this case, a cold compress will help. To prepare it, it is enough to attach a towel moistened with water. And you can also wrap a piece of ice in a cloth.

If bleeding occurs, it is best to use a swab from a bandage. The patch should not be used. The umbilical region should be protected from damage and infection. Wash your hands with antibacterial soap before touching jewelry. And you should also remove dust and dirt from under the nails. Bed linen and personal towels should be changed at least once a week.

The navel area must be treated with disposable wet wipes. You should also limit contact with pets for a while. It is better to use antibacterial soap as a cleanser. Alcohol and hydrogen peroxide will not work. For processing, take a cotton swab. The procedure must be carried out carefully. Do not pull the decoration.

Salt solution has good disinfecting properties. To prepare it, you need to dissolve a quarter teaspoon of sea salt in a glass of warm boiled water. The finished product is used to prepare compresses. After disinfection, lightly lather the piercing and then gently blot it with a disposable cloth.

Until complete healing, you should not change the original decoration. No need to touch it, pull and rotate. Avoid wearing tight clothing and underwear. It is better to replace a hot bath with a shower with moderate temperature water. A jet of water will clean the wound well of dirt and detergent residues, preventing them from entering the wound.

Until complete healing, it is forbidden to swim in the pool and open water. In extreme cases, it is better to use a waterproof patch.

The most important thing

Omphalitis is an inflammation of the navel. In adults, the disease most often occurs after piercing if hygiene rules are not followed. Diabetes mellitus, excess weight can contribute to the onset of the disease. In infants, omphalitis is the result of improper care. The catarrhal stage is the mildest form of the disease, but if left untreated, it can turn into a purulent phase.

If the inflammation is caused by a bacterial infection, it should be treated with antibiotics. But first, a bacterial culture of the discharge is carried out. Treatment includes treating the wound with antiseptic solutions. In severe cases, surgery will be required.