Abstract\nBackground: Umbilical granuloma is the commonest umbilical lesion in the neonates. Several treatment options were proposed. The objective of this study is to report our experience and the outcomes of local excision of the umbilical granuloma prior to silver nitrate cauterization.\nMethod: During a 12-year period, 243 infants were presented to our outpatient clinic with umbilical granuloma after the failure of medical treatment with local alcohol and antibiotics application. Local excision of the granuloma was performed under complete aseptic conditions followed by silver nitrate cauterization in all patients. Patients were discharged with home care instructions and returned for a follow-up visit after 1 and 2 weeks of the procedure. \nResults: The study included 129 girls (53%) and 114 boys (47%). Mean age at presentation was 41 days and ranged from 9 to 49 days and weight was 3512 grams (range: 1524-4231 grams). 5% of the patients had associated umbilical hernia. 100 patients achieved complete healing after 1 week. 143 patients achieved complete healing in the second-week follow-up visit and no complications or treatment failure were reported.\nConclusion: local excision of the umbilical granuloma prior to silver nitrate cauterization is a safe and effective outpatient procedure even if associated with an umbilical hernia.

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