The Use of an Elastic Band to Prevent Haemorrhage from the Umbilical Cord.

When describing the effectiveness of a plastic clamp in eliminating the risk of haemorrhage from the umbilical cord, as compared with the ineffectiveness of standard umbilical tape in some 750o of instances under laboratory conditions, Neligan and Smith (1963) suggested that the use of a rubber band merited further study. This was on account of the clamp's cost, its rather startling appearance in some mothers' eyes, and the need to remove it before the cord became too gangrenous. During further clinical trials we encountered two cases in which the clamp slipped off the end of the cord stump within an hour or two of being applied. This accident caused no harm to the babies concerned, but caused the manufacturers to improve the design of the clamp's jaws-and accelerated our investigation of the use of a rubber band. D. A. J. Williamson (1963, personal communication) had kindly described to us a method of using a commercial elastic band, as supplied by stationers, which had been used in his unit for some years. We began by investigating this method, with particular reference to the most suitable type of band, its effectiveness when tested in the laboratory, the technique of applying it to the cord, and its clinical use.