After the separation of the cord, granulation tissue may persist at the base as a small mass. The tissue, usually light pink in color, is composed of fibroblasts and capillaries and is typically 1 to 10 mm in diameter.
Umbilical granuloma must be differentiated from umbilical polyps and from granuloma secondary to a patent urachus, both of which do not respond to silver nitrate cauterization.
Conventional treatment of umbilical granulomas includes cauterization with silver nitrate.
Generally, only a few applications of silver nitrate are required for successful treatment.
Caution should be exercised in applying silver nitrate because of the risk of chemical burns or temporary discoloration of the surrounding skin.
Persistence of a presumed umbilical granuloma or those that do not resolve with conventional measures may warrant further evaluation to rule out other pathologic abnormalities, including polyps, which require surgical exploration and excision.
There are other options of management in the literature, like salt, a topical antiseptic, and steroid.
The salt will create an osmolality difference resulting in drawing the water from the granuloma leading to drying of the granuloma and separation. This application of salt has shown to be effective for the treatment of pyogenic granuloma.
Apply a small pinch of the table or cooking salt onto the umbilical granuloma. Cover the area with a gauze dressing and secure it in place for 30 minutes. This should be repeated twice a day for at least two days. In approximately two or three days, the granuloma is expected to reduce in size, change color and dry off.
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