EFFECTIVENESS OF TABLE SALT VERSUS COPPER SULPHATE IN TREATING UMBILICAL GRANULOMA: A PILOT RANDOMISED CONTROLLED TRIAL

ABSTRACT BACKGROUND : Umbilical granuloma is a common infantile condition which usually responds to non-operative management. Copper sulphate (CuSO4) is often used as chemical cauterization but can cause superficial 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 granuloma. METHOD : We performed a multi-centre randomized controlled trial involving three regional paediatric surgical units. We included children who presented with umbilical granuloma from December 2018-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 clinician). 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 centre's routine management. RESULT : We recruited 70 participants with 6 dropouts (2 defaulters, 1 vitellointestinal duct, 3 urachal remnants), 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 due to complete 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 (periumbilical superficial skin burn). CONCLUSION : Table salt is an ideal treatment choice for umbilical granuloma as it is effective, safe, and readily available.