Ze względu na dużą podatność na zakażenia kikut pępowiny noworodka powinien być traktowany jak gojąca się rana. Nie należy polewać go alkoholem ani stosować antybiotyku. Podstawą pielęgnacji jest regularna higiena pępka oraz jego dokładne osuszanie.
Kikut pępowiny to tkanka, która jest pozostałością pępowiny. Sam kikut nie posiada unerwienia, więc jest bezbolesny dla dziecka. Gdy pępowina zostaje odcięta po porodzie kikut ulega martwicy. W tym czasie może zmieniać barwę z białoniebieskiej/szaroniebieskiej na żółtobrązową i czarnobrązową. Zwykle między 5. a 15. dobą życia dziecka kikut pępowiny odpada. Czasem ten proces może się wydłużać, jednak jeżeli kikut nie odpada przez długi czas – należy zgłosić się do lekarza.
Pielęgnacja kikuta pępowinowego – suchość i czystość
Kikut pępowinowy jest najbardziej podatną na zakażenia częścią ciała noworodka, dlatego do momentu odpadnięcia należy traktować go jak gojącą się ranę. Bardzo ważne jest utrzymywanie go w czystości i suchości.
Konieczne jest zabezpieczenie kikuta jałowym gazikiem. Raz na dobę zalecane jest oczyszczanie pępka dziecka zwilżonym w wodzie czystym gazikiem. Jeżeli dojdzie do zabrudzenia, czynność tą można powtarzać częściej. Kikuta można również delikatnie umyć ciepłą wodą z mydłem. Po umyciu kikut należy osuszyć i pozostawić odsłoniętym do dokładnego wyschnięcia. Należy jednak pamiętać, by nie dopuszczać do ciągłego namaczania kikuta pępowiny. Gdy kikut odpadnie już od pępka noworodka, zalecana jest dalsza wyżej opisana pielęgnacja tego miejsca.
Pępka nie należy polewać alkoholem, fioletem goryczki, jodyną oraz środkami odkażającymi, które zawierają np. 70 proc. alkoholu etylowego. Nie jest wskazane stosowanie soli ani innych substancji drażniących. Zastosowanie alkoholu może wydłużyć odpadanie kikuta. Pępka nie można smarować antybiotykiem oraz opatrywać szczelnym opatrunkiem. Gojący się kikut powinien mieć dostęp do powietrza, dlatego wystarczy, że będzie przykryty jałowym gazikiem. Należy również zwracać uwagę, by brzegi pieluszki nie drażniły, ani nie przykrywały kikuta.
Jakie mogą być powikłania procesu gojenia kikuta pępowiny?
Kikut, który nie odpadł po 15 dniach od porodu zazwyczaj nie jest poważnym zaburzeniem, ale należy skonsultować to z lekarzem. Pępowina nie odpada zazwyczaj w wyniku małej wagi urodzeniowej dziecka, w przypadku cesarskiego cięcia, zaburzenia funkcji białych ciałek krwi lub z powodu wady wrodzonej – przetrwałego przewodu łączącego pępek z pęcherzem moczowym. Ponadto stosowanie alkoholu lub miejscowych antybiotyków może opóźnić odpadnięcie kikuta. Jeżeli pojawiło się silne krwawienie, ropa u nasady kikuta, wyraźne zaczerwienienie (przekraczające 5 mm), bolesność, nierówna tkanka wokół kikuta, obrzęk lub wyciekanie płynu z pępka i nieprzyjemny zapach – należy zgłosić się do lekarza.
Nierówna tkanka u nasady kikuta, która pokrywa kikut pępowiny może świadczyć o rozwijającej się ziarninie pępka. W praktyce klinicznej w takich przypadkach lekarz przepisuje środki ograniczające jej rozrost. Wydzielina ropna, surowicza lub krwista, której towarzyszy zaczerwienienie i obrzęk, a także wzmożone ocieplenie tej okolicy, może natomiast świadczyć o zapaleniu okołopępkowym. Taki stan wymaga pilnej konsultacji lekarskiej i wdrożenia leczenia antybiotykami lub miejscowego w szpitalu. Obfite krwawienie z pępka wskazuje z kolei na zaburzenia krzepnięcia i wymaga badań laboratoryjnych. Konieczna jest wówczas konsultacja lekarska.
Źródło: mp.pl, poloznazsercem.pl, mamapediatra.pl
Przeczytaj także: Zapalenie pępka u noworodka – jak mu zapobiegać?
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