EFFECT OF COTTON PAD PLACEMENT REINFORCED WITH AN ELASTIC CREPE BANDAGE IN EARLY RESOLUTION OF INFANTILE UMBILICAL HERNIA

Background: Umbilical hernia (UH) in infants is typically identified as a bulge in umbilical region in early couple of months, appearing after the shedding off the umbilical cord. It occurs when a sac lined by peritoneum protrudes from umbilical ring, due to its incomplete closure.1 This failure of the umbilical ring to close properly contributes to the formation of an umbilical hernia. Objectives: To evaluate the effectiveness of a conservative approach using a cotton pad reinforced with a crepe bandage (Ammannaya’s technique) in promoting the resolution of infantile umbilical hernia. Methods: This RCT was conducted at The Children’s Hospital, Lahore. Ethical approval from institutional review board obtained and trails was also registered to Thai Clinical Trials Registry. A total of 108 infants (≤3 years) with umbilical hernia were enrolled and randomly allocated into an intervention group (cotton pad with crepe bandage) and a control group (observation only), with 54 patients in each arm. Patients were followed at 4 and 8 weeks, and chi-square test was used for comparison of resolution rates. Results: Of these 108 patients, 65 (60.2%) were male and 43 (39.8%) female, with most infants younger than 6 months (77.8% intervention vs. 87.0% control). At 4 weeks, resolution found in 25.9% of the intervention group whereas occurred in 9.3% of the control group (p = 0.023). By 8 weeks, cumulative resolution was found to be higher in the intervention group (59.2%) in comparison with the control group (37.1%) (p = 0.029). Closure was more common in infants