Diagnosis, Treatment, and Prevention of Umbilical Granulomas Based on Current Knowledge of Their Causes and Effects

Abstract

Objective: The etiopathogenesis, diagnosis, and treatment of umbilical granulomas at MTI/LRH, Peshawar, as we know them now.
Methods & Material: The Umbilical Granuloma in Infants Under 24 Months of Age Study was done at MTI/LRH, Peshawar. All hospital and outpatient department (OPD) claim data from January 2019 to December 2021 were used to estimate incidence, age, sex, treatment complications, and current understanding of umbilical granuloma etiopathogenesis, diagnosis, and therapy. Umbilicus abnormalities may cause stress. Umbilicectomy. Umbilicus. Hooded umbilicuses are best—ugly umbilicuses. Umbilical surgery normalizes appearance. Umbilicoplasty Umbilical granuloma is umbilicus-base granulation tissue. Infants. Subclinical infection or umbilical cord stump epithelialization may cause granuloma—umbilical edema. Physical examination shows a small, moist, fragile, pinkish/red umbilicus lesion. Check benign soft tissue tumors for vitellin duct anomalies and urachal remnants. Debatable. Most treatments employ silver nitrate. Salt, topical antibiotics, steroids, ligation, excision, electrocautery, cryotherapy, and silver nitrate fail. Treatment-resistant people require excision. A full workup is essential if the lesion exhibits unclear clinical symptoms or does not respond to therapy.
Umbilical granulomas may occur in newborns. Parents and outpatient physicians fear umbilical granulation tissue. Spheres imply—umbilical granuloma. Umbilical granuloma treatment is restricted.
Results: Granulomas form when inflammation occurs in the umbilical stump. Effective double- ligature. 7–14 days. Double-ligature outperforms silver nitrate injections for pedunculated umbilical granulomas in children. Topical concentrated silver nitrate solutions or sticks treat umbilical granulomas. Peridex, alcohol (75 percent). This method may induce periumbilical chemical burns. 3–5 Umbilical exudate drying reduces chemical burns and discoloration. Lubricate umbilicus. Cryosurgery works. Umbilical granulomas seldom necessitate surgery.Umbilical granulomas are deep. Double-ligature simplifies granuloma base ligation. Povidone-iodine-washed 3-0 periumbilical silk sutures. Only fragile umbilical granulomas need 4-0 silk sutures. Stay-ligature makes double-ligature. Better second-phase lesion base ligation. Hold, then insert—enhanced ligation. The umbilical cord remnant and granuloma die and fall off after 7–14 days. This approach leaks large sessile umbilical granulomas. Larger granulomas may need numerous double-ligatures. Only large sessile umbilical granulomas with a wide base, small deep lesions, and very friable lesions that may bleed during double-ligature are contraindications. Pathology-pre-ligate.
Conclusion: Most umbilical granulomas may be diagnosed by a patient's medical history and a physical exam. Silver nitrate application should be suited to healthcare facilities and family compliance. First-line treatment for those with easy access to healthcare. Non-health center patients can get topical steroid therapy (clobetasol propionate 0.05% or betamethasone valerate 0.12%) twice a day for 30 days, topical antibiotics (doxycycline) once a day for 5–10 days, or basic salt application with numerous alternatives, 24-hour once, or left the agent for 30 minutes to 1 hour, repeated two times a day for 3–5 days.