Efficacy and Safety of Common Salt and other Topical Agents in the Treatment of Umbilical Granuloma in Neonates and Infants: A Systematic Review and Meta-analysis.

Umbilical granuloma (UG) is an occasional sequel after umbilical cord separation in neonates with an incidence of 0.2% to 3.01% of live births. It is characterized by moist, fleshy tissue at the umbilicus and presents as umbilical discharge, redness or frank infection. Treatment options include topical application of silver nitrate, copper sulphate, steroids, and common salt. Silver nitrate, though effective, can cause skin burns and needs caution. Common salt is popular as it is cheap, easily available and relatively safe. In this meta-analysis, we intend to compare the efficacy and safety of common salt with other topical agents for treating umbilical granuloma in neonates and infants. This meta-analysis was done as per the PRISMA guidelines and randomized controlled trials (RCTs) comparing common salt with other topical agents were included. Databases like Cochrane, MEDLINE and Scopus were searched. Data was extracted by two independent reviewers and analysed using RevMan software. Outcomes measured were resolution of UG after application and adverse effects of treatment. We observed that common salt is effective and safe for treatment of umbilical granuloma and has a similar success rate when compared to other topical agents. There are no significant adverse effects with its use. It can even be safely applied by caregivers at home.