EMERGENCY SURGERY FOR TREATMENT OF OMPHALITIS IN NEONATES

Abstract

Introduction: Omphalitis is an infection of the umbilical cord that affects newborns and is an emergency condition that can lead to serious complications, such as sepsis, intra-abdominal abscesses, and even death. Early detection and appropriate treatment are crucial to reducing morbidity and mortality. Omphalitis can be caused by a variety of microorganisms, including gram-positive and gram-negative bacteria, and, in rare cases, fungi. In newborns, especially premature infants or those with compromised immune systems, umbilical cord infection represents a significant challenge. Objective: To analyze the main factors associated with emergency surgical treatment for omphalitis in newborns, identifying clinical interventions, types of surgery, and outcomes related to this treatment. Methodology: The review was conducted based on the PRISMA checklist criteria. The PubMed, Scielo, and Web of Science databases were consulted for articles published in the last 10 years. The descriptors used were “omphalitis”, “neonates”, “emergency surgery”, “umbilical infection” and “neonatal treatment”. The search was limited to studies in English, Portuguese and Spanish. Three inclusion criteria were: studies on neonates diagnosed with omphalitis, studies reporting surgical interventions, and articles providing data on clinical outcomes after treatment. Exclusion criteria were: studies focusing on umbilical infections in adults, reviews and non-original studies, and articles published before 2014. Results: The review found that emergency surgery is indicated in cases of severe omphalitis, with signs of necrosis of the umbilical tissue, abscesses or intestinal perforation. Most studies reported that surgical treatment reduces mortality and prevents serious septic complications. The most common surgical technique involved excision of infected tissue and drainage of abscesses. In high-risk neonates, such as premature infants, concomitant antibiotic treatment was essential for the success of the procedure. Conclusion: Urgent surgery is a vital intervention in the treatment of severe omphalitis in neonates. When performed early, it can significantly reduce mortality and prevent complications associated with neonatal sepsis. Rapid detection and effective therapeutic approach are crucial to improve clinical outcomes in these patients.