In the treatment of umbilical granulomas, silver nitrate is applied to the umbilical site to burn off the excess tissue. The absence of nerve endings within the granuloma make this a painless treatment for the newborn. While painless, contact of silver nitrate to the adjacent, healthy, normal tissue may result in burns. Silver nitrate application to the infected site should not exceed three applications with an interval of 3-4 days. In this event, alternative treatments should be considered Following treatment with silver nitrate, the granuloma is expected to shrink and resolve within 7 days. Double-ligature treatment
In cases with deeply located umbilical granulomas, the double-ligature technique can be utilized to ligate the base of the granuloma. The procedure involves prepping and sterilizing the umbilical area with iodine solution, placing a silk suture around the base of the lesion to keep in place, and finally placing a more exact ligature around the granuloma. Much like the normal process of umbilical cord residue healing, the ligated granuloma will necrose due to lack of blood supply and will fall off naturally within 1 to 2 weeks. Minor complications of this technique include minimal bleeding and possibly requiring more ligatures than the original double ligation. Cryocautery
Cryocautery can be utilized to freeze the umbilical granuloma by using cryogenic nitrous oxide along with other equipment. During cryocautery procedures, the umbilical site is first cleaned. The physician will then hold a cyroprobe with nitrous oxide as a refrigerant directly to the granuloma for 3 minutes.
Early clamping is categorized as within the first 60 seconds after birth, whereas late umbilical cord clamping is classified as more than one minute after the birth. There is no evidence indicating that time to umbilical cord clamping has had an effect on umbilical granuloma formation or on additional neonatal morbidity outcomes. Complications
If an infection occurs, omphalitis may occur. Recurrence risk
The various treatment modalities of umbilical granuloma result in various recurrence risks. In a systematic review, following infants through weeks 1, 3 and 6 post-treatment for umbilical granuloma, newborns treated with silver nitrate presented with a 9% recurrence risk, whereas newborns treated with common salt presented null recurrence. See also
Teratoma
List of cutaneous conditions


== References ==