Umbilical Infections in Infants: Causes and Solutions

The child's umbilical area is red, swollen, and has pus?

Dear Doctor,
My child underwent surgery for an umbilical fistula at 2 months old.
Now, at 10 months, the belly button suddenly became red, and two days later, it swelled and protruded.
We took him to see a pediatric surgeon, who initially diagnosed it as an abscess caused by internal suture material that was not absorbed by the body.
The surgeon immediately incised the swollen area, finding pus, blood, and black suture material.
We are currently applying medication.

I would like to ask the following questions:
1.
What is the likelihood of this occurring?
2.
Is it true that the suture material from the umbilical fistula does not need to be removed?
3.
The doctor only found one piece of suture material.
How many pieces are typically present?
4.
If my child does not absorb the suture material, does that indicate a potential issue if he undergoes a circumcision in the future?
5.
Besides using sutures, are there other safer methods available?
6.
Aside from non-absorbable sutures causing redness and abscess, are there other possible reasons for the redness and swelling of the belly button?
Thank you, doctors.

Sincerely, a concerned new mother.

R and Z, 30~39 year old female. Ask Date: 2010/06/21

Dr. Huang Yuanhui reply Surgery

1.
The incidence of postoperative suture abscess is approximately 10%.

2.
In umbilical fistula surgery, some suture ends are non-absorbable sutures used to ligate blood vessels, while others are absorbable sutures, such as those used for subcutaneous closure, which do not require removal.

3.
The number of suture ends is known only to the surgeon; in the case of umbilical fistula surgery, there are typically about 5 to 10.

4.
Whether the suture ends are absorbable depends on the type of suture and the individual's physiology; the same person may not necessarily experience the same outcome in different surgeries.

5.
Sutures are essential tools for surgery; if the surgical wound is small and there are no major blood vessels, different types of sutures can be used, and the wound may be closed with tissue adhesive or staples.

6.
Aside from suture abscesses, the most common causes of complications are residual fistula or simple bacterial infections.
Wishing you safety.

Reply Date: 2010/06/21

More Info

Dear Concerned Mother,
Thank you for reaching out with your questions regarding umbilical infections in infants. It’s understandable to be worried, especially when it comes to your child's health. Let’s address your concerns one by one.

1. Incidence of Umbilical Infection Post-Surgery: The occurrence of umbilical infections or complications after umbilical cord surgeries, such as the one your child underwent for a patent urachus, is relatively low but can happen. Factors that may increase the risk include improper wound care, the presence of foreign materials (like non-absorbable sutures), and the infant's overall health and immune status. In your case, the presence of a non-absorbed suture leading to infection is a known complication.

2. Absorbable Sutures: Typically, absorbable sutures are used in umbilical surgeries, which means they are designed to dissolve over time without needing to be removed. However, if non-absorbable sutures were used, they would need to be removed manually. It’s essential to clarify with your surgeon what type of sutures were used during your child's procedure.

3. Number of Sutures: The number of sutures used can vary depending on the complexity of the surgery and the surgeon's technique. Generally, a few sutures are sufficient to close the incision, but it’s not uncommon for surgeons to use multiple sutures for added security. If only one suture was found, it could be that it was the only one that failed to absorb properly, or it might have been the most prominent one.

4. Future Surgical Considerations: If your child has shown a tendency not to absorb sutures, it may raise concerns for future surgeries, such as circumcision. However, each surgical procedure is unique, and the choice of sutures can be tailored to the individual. Discussing your child's history with the surgeon performing the circumcision will help determine the best approach.

5. Alternative Techniques: Besides traditional suturing, there are other techniques for closing surgical sites, such as using tissue adhesives or staples. These methods can sometimes reduce the risk of infection and complications associated with sutures. However, the choice of technique depends on the specific procedure and the surgeon's preference.

6. Other Causes of Umbilical Redness and Swelling: Besides non-absorbed sutures, other potential causes for umbilical redness and swelling include infection from bacteria (such as Staphylococcus or Streptococcus), granuloma formation (a small area of inflammation), or even hernias. It’s crucial to monitor the site for any changes and report them to your healthcare provider.

In conclusion, while the situation you described is concerning, it is manageable with proper medical care. Continue following your pediatrician's advice regarding wound care and medication. If you notice any worsening symptoms or new concerns, do not hesitate to seek further medical attention.
Your vigilance as a parent is vital in ensuring your child's health, and I hope this information helps alleviate some of your worries. Please feel free to reach out if you have more questions or need further clarification.

Best wishes for your child's speedy recovery!
Sincerely,
Doctor Q&A Teams
[Your Credentials]

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