This is an elective surgical condition.

See resources for referral form, parent information and more.

Assessment and when to refer

History and physical examination

• Common condition resulting from low-grade infection of umbilical stump. Presents soon after cord separation as red, friable granulation tissue in region of umbilicus.
• Discharge of urine or faeces from umbilicus suggests Urachal or Vitello-intestinal duct anomalies - both conditions exceedingly rare.
• The key to treatment is early application of silver nitrate three times daily applied directly onto granulation tissue. Protect surrounding skin with Vaseline.
  • Refer to the OPD General Surgery if not responding to silver nitrate after one week, spreading erythema around umbilicus or one of the rare conditions suspected.
  • Please provide history and any investigations undertaken.

Contact information

For clinical advice call RCH Switchboard tel (03) 9345 5522 and ask for:

• General surgery registrar or fellow on-call
• Department of General Surgery - clinical advice
• Emergency Department - for clinical advice after hours

For outpatient bookings

• Fax to 03 9345 5034 (number also on referral form)
• For urgent appointments please also call 03 9345 6180
• For private referrals see Paediatrician Listing for private surgeon contact details.

Admission enquiries call RCH Switchboard tel (03) 9345 5522 and ask for:

• General admission enquiries (or direct dial 03 9345 6172)
• ED admission enquiries: (or direct dial 03 9345 6477)

• RCH OPD referral form (word)
• Generic parent handout (about RCH pre-referral guidelines)
• Kids Health Info - parent information website
• Kids Connect (Primary Care Liaison) www.rch.org.au/kidsconnect
  OPD resources for GPs page contains all referral forms, clinic information, referral process information, other pre-referral guidelines, MBS Enhanced Primary Care Items and parent information.
• Paediatric Pharmacopoeia

References

Urgent paediatric surgical conditions - management guidelines by Tom Clarnette MBBS, MD, FRACS (Paeds). Consultant Paediatric Surgeon, RCH, Melbourne, Australia.

Feedback

Please give feedback on this guideline - kids.connect@rch.org.au / telephone: (03) 9345 4645 / fax (03) 9345 4650

Thanks to Consultant Paediatric Surgeon Tom Clarnette for permission to adapt existing guidelines.  Many thanks to the GPs involved in the review.  First published Dec 2007. Reviewed August 2009. Please read Copyright and Disclaimer.