Effectiveness of table salt versus copper sulphate in treating umbilical granuloma: A pilot randomized controlled trial

Background: Umbilical granuloma is a common infantile condition which usually responds to non opera-tive management. Copper sulphate (CuSO4) is often used as chemical cauterization but can cause super-ficial skin burns. An alternative is table salt (NaCl), which osmotically dehydrates wet granulation tissue causing necrosis. We aimed to compare the effectiveness of NaCl versus CuSO4 in treating umbilical gran-uloma. Method: We performed a multi centerrandomized controlled trial involving three regional pediatricsur-gical units. We included children who presented with umbilical granuloma from December 2018 to May 2020. Children who received treatment prior to index visit were excluded. They were randomly allocated to receive NaCl (twice/day application for 5 days by caregiver) or CuSO4 (single application by clini-cian). Demographic data, compliance in the NaCl group by pill counting method, treatment outcomes, and complications were recorded. Treatment success was defined as complete lesion resolution. Partial or no response was considered treatment failure. Subsequent treatment then reverted to the respective center's routine management. Result: We recruited 70 participants with 6 dropouts (2 defaulters, 1 vitellointestinal duct, 3 urachal rem-nants), leaving 64 subjects for final analysis: 31 NaCl, 33 CuSO4. Compliance rate of 77.4% was recorded for NaCl, with 6 (20%) 'poor compliance' participants stopping therapy before completion owing to com-plete resolution. NaCl group had a significantly higher complete resolution rate (90.4%) compared to CuSO4 (69.7%), p = 0.040. No NaCl participant developed complications versus 9% (n = 3) in CuSO4 (peri-umbilical superficial skin burn). Conclusion: Table salt is an ideal treatment choice for umbilical granuloma as it is effective, saf e, and readily available. (C) 2021 Elsevier Inc. All rights reserved.

Automated summary

This study compared the effectiveness of table salt (NaCl) and copper sulphate (CuSO4) in treating umbilical granuloma. The results showed that the complete resolution rate was significantly higher in the NaCl group compared to the CuSO4 group, and no complications were observed in the NaCl group. Therefore, table salt is an ideal choice for treating umbilical granuloma.