Comparison of Incision and Drainage against Needle Aspiration for the Treatment of Breast Abscess

2012 ◽  
Vol 78 (11) ◽  
pp. 1224-1227 ◽  
Author(s):  
Muhammad Naeem ◽  
Muhammad Kazim Rahimnajjad ◽  
Nasir Ali Rahimnajjad ◽  
Qazi Jalaluddin Ahmed ◽  
Pyar Ali Fazel ◽  
...  

We aim to compare the incision and drainage against ultrasound-guided aspiration for the treatment of breast abscesses. Sixty-four patients were randomly allocated to Group A (incision and drainage) and Group B (needle aspiration). Incision and drainage was done under general, whereas aspiration was done under local anesthesia with antibiotic coverage after the pus sample was taken for cultures. Time taken to resolve symptoms including point tenderness, erythema and hyperthermia, recurrence of breast abscess, and healing time was recorded. Patients were followed until 8 weeks. Culture and sensitivity of the pus were done. Data were analyzed in SPSS 16.0. The mean difference of healing time was significant ( P = 0.001). A total of 93.3 per cent were healed in Group B and 76.6 per cent in Group A ( P = 0.033). Twenty-two samples (34.37%) had no bacterial yield and the remaining 42 samples (65.6%) yielded 11 anaerobic cultures (17.18%) and 31 aerobic cultures (48.4%). Ultrasound-guided aspiration of breast abscesses with the judicious use of antibiotics is a better treatment modality than incision and drainage.

2017 ◽  
Vol 5 (1) ◽  
pp. 261
Author(s):  
Amandeep Saharan ◽  
Satish Dalal ◽  
Mahavir Singh ◽  
Chisel Bhatia ◽  
Tulit Chhabra

Background: Incidence of breast abscess is 0.4 to 11% of all lactating mothers. Traditionally the treatment of breast abscess has been incision and drainage. Recently aspiration under ultrasound guidance is emerging as another treatment option and rapidly replace incision and drainageMethods: Authors carried out a prospective, randomized study involving 50 lactating women with breast abscess. In group A - 25 patients were managed by ultrasound guided needle aspiration and in group B - 25 patients were managed by incision and drainage.Results: In patients of group A, most breast abscesses resolved with one or two aspirations only, with early healing and lesser number of hospital visits as compared to patients in group B. There was no surgical scar and early resumption of breastfeeding was seen in group A.Conclusions: Ultrasound guided percutaneous aspiration is an effective modality of treatment of lactational breast abscess and it should be the first line of treatment, especially for smaller and unilocular breast abscesses while incision and drainage should be reserved for larger and multilocular abscesses with imminent skin changes.


2020 ◽  
Vol 22 (1) ◽  
pp. 11-15
Author(s):  
Md Fardhus ◽  
AMSM Sharfuzzaman ◽  
Md Nayeem Dewan ◽  
Dipak Chandra Kirttania ◽  
Ahmed Sami AI Hasan ◽  
...  

Background: Breast abscess is defined as an acute inflammatory lump which yields pus on incision/aspiration. The frequency of occurrence is highly related to pregnancy and caused due to nipple cracking by a child during breast feeding and bacterial colonization due to improper nursing technique and incomplete emptying of the breast. Objective: The present study compares the outcome and effectiveness of traditional treatment incision and drainage against needle aspiration in the treatment of breast abscess. Methods: This is a comparative study carried out in department of general surgery, SherE- Bangla Medical College Hospital, Barisal between January 2014 and December 2014. 50 female patients of age between 20-40 years and diagnosed breast abscess with abscess size of 5'7 cm in diameter on ultrasonography were included in the study after taking written consent form. Of these 25 had undergone aspiration of the breast abscess (group A) and 25 had undergone incision and drainage (group B). Results: The mean age of the female patients in group A was 23.42 years and in Group B was 23.31. 91% of the cases were lactating. S. aureus was the common organism isolated in both lactating and non-lactating cases, encountered in 27 patients (54%). Out of that were in the aspirated group 17patients (56.67%). 10 patients were in the incised group (33.33%). The mean healing time and cosmetic outcome was significantly (p =0.001) very good in patients treated with needle aspiration compared to incision and drainage. There was no recurrence of breast abscess observed in needle aspiration group during the study. There was 3.3% recurrence rate observed in the incision and drainage group. Conclusion: Breast abscess in patients with diameter of 5'7 cm can be treated with needle aspiration successfully and with a good cosmetic outcome. Journal of Surgical Sciences (2018) Vol. 22 (1): 11-15


2017 ◽  
Vol 24 (01) ◽  
pp. 89-94
Author(s):  
Muhammad Umar Javed ◽  
Sidra Aleem ◽  
Sheraz Jamil Asif ◽  
Javed Iqbal

Objectives: To compare the recurrence rate between incision drainage andmultiple needle aspiration for breast abscess treatment. Study Design: Randomized ControlledTrial. Setting: Department of General Surgery, Bahawal Victoria Hospital, Bahawalpur. StudyDuration: 29th September 2015 to 29th June 2016. Materials & Methods: A total of 60 femalepatients with breast abscess of <2 cm in size and of duration <2 weeks between 20 to 40 yearsof age were included. Patients with multiple breast abscesses, recurrent breast abscesses andcomplicated abscesses were excluded. The patients were randomized into Group A (incisionand drainage) & Group B (needle aspiration), by using lottery method. Follow up was done forup to 7 days and recurrence was noted. Results: The mean age of patients in group A was30.83 ± 5.67 years and in group B was 31.53 ± 5.73 years. Mean duration of disease was 7.58± 2.83 days. Mean size of abscess was 0.86 ± 0.43 cm. Recurrence was found in 07 (23.33%)patients in group A (incision drainage) while in 21 (70.0%) patients in group B (multiple needleaspiration) with p-value of 0.000 which is statistically significant. Conclusion: The recurrencerate is less after incision & drainage as compared to multiple needle aspirations for treatingbreast abscess.


2008 ◽  
Vol 15 (04) ◽  
pp. 431-436
Author(s):  
SAIRA SALEEM ◽  
TARIQ FAROOQ ◽  
NAEEMULLAH KHAN ◽  
Muhammad Shafiq ◽  
Muhammad Azeem ◽  
...  

. Objectives: The aim of this study was to compare the management of puerperal breast abscess by ultrasound guidedpercutaneous drainage v/s incision and drainage with special attention to resolution time and complications. Setting: Allied Hospital Faisalabad.Period: Jan 2005- June 2007. Patients and Methods: 60 patients with puerperal breast abscess were studied. Patients were divided into twogroups randomly after informed consent. In Group A; patients were treated with percutaneous drainage under local anesthesia while GroupB patients were treated by conventional incision and drainage, and results were compared with reference to resolution time and complicationsrate using student’s t-test. Results: By percutaneous method abscess healed in 5-8 days time. Recurrent abscess was found in one case (3%),milk fistula formation in one case (3%) and no residual abscess was found. There was no scar formation, induration or distortion of the breastparenchyma. Breast-feeding was interrupted in four patients (13%) only due to milk fistula (one case), recurrent abscess (one case) andpatient’s own preference (two cases). On the other hand by conventional method healing took 15-25 days with pain and discomfort of dailydressings, scarring and cessation of breast feeding in most of the cases. Conclusion: Percutaneous ultrasound guided placement of suctiondrainage catheter in puerperal breast abscess for 5-8 days is less invasive, high resolution rate, scarless, low complication rate and preservesthe function of breast-feeding as compared to conventional incision and drainage.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yuki Tanisaka ◽  
Masafumi Mizuide ◽  
Akashi Fujita ◽  
Tomoya Ogawa ◽  
Ryuichiro Araki ◽  
...  

Background. Accurate diagnosis of benign and malignant lymphadenopathy is important for determining the appropriate treatment and prognosis. This study evaluated the diagnostic accuracy and usefulness of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with a conventional needle compared to endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) with a Franseen needle for diagnosing lymphadenopathy. Methods. Patients who underwent EUS-FNA or EUS-FNB for mediastinal or abdominal lymphadenopathy between July 2013 and August 2020 were enrolled in the study. The outcomes between EUS-FNA patients (July 2013 to January 2017; 22-gauge conventional needle; Group A) and EUS-FNB patients (February 2017 to August 2020; 22-gauge Franseen needle; Group B) were compared. Results. A total of 154 patients (Group A: 83; Group B: 71) were analyzed. The diagnostic accuracy (differentiating between malignant and benign lesions) was 88.0% (95% confidence interval [CI], 79.2–93.3%) in Group A and 95.8% (95% CI, 88.3–98.8%) in Group B. Group B had high diagnostic accuracy, but there was no difference between the groups ( p = 0.14 ). Group B had significantly fewer passes (median 2, interquartile range (IQR): 2-4) than Group A (median 3, IQR: 3-4) ( p < 0.001 ). No procedural adverse events occurred in either group. Conclusions. Although the diagnostic accuracy between the groups was not statistically significant, EUS-FNB with a Franseen needle provided high diagnostic accuracy and required fewer passes to establish a diagnosis. Thus, EUS-FNB is useful for diagnosing lymphadenopathy.


2020 ◽  
Vol 33 (1) ◽  
pp. 1-4
Author(s):  
Md Nowshad Ali ◽  
Md Abdul Hannan ◽  
Shah Md Ahsan Shahid ◽  
Taibatul Kubba ◽  
Dipankar Roy

Breast abscess is the localized collection of pus in breast tissue. Various treatment protocols used now a day like oral drugs, hot compression, surgical incision and drainage and ultrasound guided needle aspiration. Aim of this article was to identify the ultrasound guided needle aspiration of breast abscess is an alternative to surgical incision and drainage by analysis of previous study reports. It was found that though ultrasound guided aspiration of breast abscess has some benefit than traditional surgical drainage but it not applicable for all cases. TAJ 2020; 33(1): 1-4


2021 ◽  
Vol 8 (12) ◽  
pp. 3501
Author(s):  
Ruksana Parvin ◽  
Ahmed Sharif ◽  
Mosammat Bilkis Parvin ◽  
Kazi Sohel Iqbal ◽  
Golshan Ara Kohinoor ◽  
...  

Background: The incidence of breast abscess ranges from 0.4 to 11% of all lactating mothers. Although breast abscess is a serious common complication of mastitis with high morbidity rate, there is a lack of high-quality randomized trial to demonstrate the best treatments.Methods: The Study was conducted in the Department of Surgery of Universal medical college and hospital, Dhaka, Bangladesh and MH Samorita hospital and medical college. It was a randomized controlled trial to see the efficacy of primary closure following incision and drainage of lactational breast abscess over traditional open method. Total 120 population were randomly selected in group A (60 patients) and group B (60 patients) and data was collected with their signed ethical consent. The study was conducted from January 2014 to December 2019. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using Statistical package for social sciences (SPSS) version 22.Results: In patients of group A, most breast abscesses healed successfully with a nicer circumareolar scar, earlier healing, lesser number of hospital visits and lower total cost as compared to patients in group B. There was early resumption of breastfeeding and better patient satisfaction seen in group A.Conclusions: Primary closure of lactational breast abscess following incision and drainage is an effective modality of treatment of lactational breast abscess and it should be the first line of treatment, especially for larger and multilocular breast abscesses while traditional incision and drainage should be reserved for abscesses with gangrenous skin changes, where primary closure is not justified.


2019 ◽  
Vol 6 (6) ◽  
pp. 1931
Author(s):  
Nimesh B. Thakkar ◽  
Pranav Patel ◽  
Gautam Sonagra

Background: The present study of evaluation of the use of electrocautery to incise the skin has been done to evaluate and assess basically. The advantages and disadvantages of the electrocautery to incise the skin when compared with that of scalpel. The results of the use of electrocautery on skin wound are then assessed to formulate the criteria for proper case selection for this procedure.Methods: A total of 100 patients were taken for this study. 50 patients underwent electrocautry monopolar mode incision (group A) who were compared with 50 scalpel incision patients (group B). Study was done from 01 January 2016 to 30 September 2017. Variables used in this study were complication like pain, lack of apposition and skin infection at the site of incision, pain, sinus formation and induration. This method was also evaluated with respect to following parameters: days of hospitalization, cosmetic result, rate of infection, wound apposition and requirement of secondary suturing.Results: As per our study, results are in favour of electrocautry by means of hemostasis. But we found that infection rate and complications are more with it. Moreover number of dressings required and hospital stay was also more with patient undergoing skin incision with electrocautry.Conclusions: For locally overlying healthy skin with no compromise of vascularity or any oedema and there is less fat, electrocautery use for skin incision can still be recommended for better cosmetic result and shorter healing time with less complication and rapid surgery.


2018 ◽  
Vol 7 (1) ◽  
pp. 56-59
Author(s):  
Meenakshi Basnet ◽  
Rajkumar Bedajit ◽  
Bijay Neupane ◽  
Bibek Ghimire

Background: The optimal conservative treatment protocol of parotid abscess in children is evaluated.Material and Methods: This is a randomized, prospective, cross-sectional study conducted between November 2013 and June 2017 in Nobel Medical College and Teaching Hospital. Thirty children (below 14 years age) suffering from parotid abscess diagnosed by ultrasonography were included in this study. Recurrent parotid abscess cases were excluded. The children were divided into 2 groups by computer assisted randomization into15 patients each. Group A were treated with intravenous Clindamycin while group B were given intravenous Ampicilin + Cloxacillin combination. Results: Five patients of group B did not respond to treatment and were then put on intravenous Clindamycin. Three of these patients responded to treatment but 2 developed multi-lobulated fluctuation and required incision + drainage. Remaining 10 patients in group B and all patients in Group A responded to medical treatment without recurrence. Five patients in group B developed severe diarrhea during antibiotic treatment but none of the patients in group A had this complaint. No patient developed any complications like parapharyngeal abscess or septicemia. Conclusion: Parotid abscess in children can be managed conservatively with intravenous Clindamycin without the need for incision and drainage. Journal of Nobel Medical College Volume 7, Number 1, Issue 12, January-June 2018, Page: 56-59 


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