scholarly journals Management of Breast AbscessbyOpen Drainage with Primary Closure versus Standard Incision and Drainage- ARandomised Trial

2021 ◽  
Author(s):  
Monish Raj ◽  
Satyavrat Arya ◽  
Raj Kumar Chejara ◽  
Rohit Chaudhary ◽  
Vignesh Mani
Keyword(s):  
Primary Closure ◽  
Premenopausal Women ◽  
Reproductive Age ◽  
Breast Abscess ◽  
Open Drainage ◽  
Incision And Drainage ◽  
Randomised Study ◽  
Suction Drain ◽  
Group B ◽  
Negative Suction

Introduction: Breast abscess is a localised collection of purulent material within the breast, which can be a complication of mastitis. In women of reproductive age, these are predominantly lactational but non-lactational abscesses are also seen in premenopausal women. Abscesses generally require drainage in conjunction with antibiotics. For the treatment of breast abscesses, surgical incision and drainage are usually carried out under general anaesthesia, as a traditional method. Aim: To compare conventional incision and drainage versus open drainage with primary closure with negative suction drain modalities of treatment of breast abscess in terms of different aspects including duration and quality of healing, number of dressings required, length of hospitalisation, postoperative complications. Materials and Methods: The present study was a randomised study conducted in the Department of General Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. There were 30 patients in group A undergoing open drainage with primary closure with negative suction drain and 30 patients in group B undergoing conventional incision and drainage. They were evaluated for the study period of 18 months, between October 2018 and April 2020. The data collected were analysed with Statistical Package for the Social Sciences (SPSS) version 17.0. Results: The incidence of breast abscess was more common in age group of 21-30 years with right side affected more than left side. Both the surgical procedures were comparable with each other in terms of incidence of recurrence. The primary closure group fared better with less incidence of postoperative pain (duration of analgesics requirement 2.40 vs 5.43 days), reduced hospital stay (3.63 vs 6.67 days) and dressings requirement was also less (2.33 vs 12.27 days) compared to standard incision and drainage drainage which were statistically significant. Conclusion: Hence, it can be concluded that open drainage with primary closure with negative suction drain placement can be considered as a safe and effective alternative to the standard incision and drainage in patients with breast abscess.

scholarly journals The efficacy of primary closure following incision and drainage of lactational breast abscess over traditional open method

2021 ◽  
Vol 8 (12) ◽  
pp. 3501
Author(s):  
Ruksana Parvin ◽  
Ahmed Sharif ◽  
Mosammat Bilkis Parvin ◽  
Kazi Sohel Iqbal ◽  
Golshan Ara Kohinoor ◽  
...  
Keyword(s):  
Primary Closure ◽  
Morbidity Rate ◽  
High Morbidity ◽  
Breast Abscess ◽  
Incision And Drainage ◽  
Open Method ◽  
Medical College ◽  
High Morbidity Rate ◽  
Group A ◽  
Group B

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.

scholarly journals Surgery without knife: an ideal treatment for lactational breast abscess

2017 ◽  
Vol 5 (1) ◽  
pp. 261
Author(s):  
Amandeep Saharan ◽  
Satish Dalal ◽  
Mahavir Singh ◽  
Chisel Bhatia ◽  
Tulit Chhabra
Keyword(s):  
Randomized Study ◽  
Needle Aspiration ◽  
Breast Abscess ◽  
Ultrasound Guided ◽  
Incision And Drainage ◽  
Skin Changes ◽  
Lactating Mothers ◽  
Group A ◽  
Group B ◽  
Early Healing

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.

Comparison between aspiration and incision and drainage of breast abscess

2020 ◽  
Vol 22 (1) ◽  
pp. 11-15
Author(s):  
Md Fardhus ◽  
AMSM Sharfuzzaman ◽  
Md Nayeem Dewan ◽  
Dipak Chandra Kirttania ◽  
Ahmed Sami AI Hasan ◽  
...  
Keyword(s):  
Bacterial Colonization ◽  
Needle Aspiration ◽  
Cosmetic Outcome ◽  
Breast Abscess ◽  
Incision And Drainage ◽  
Female Patients ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Drainage Group

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

scholarly journals A prospective study in peritonitis patients to compare the impact of subcutaneous negative suction closure, conventional primary closure of skin and subcutaneous tissue and open skin technique following laparotomy

2019 ◽  
Vol 6 (9) ◽  
pp. 3293
Author(s):  
Mano Zac Mathews ◽  
Sriram Gopalakrishnaiah Subramanyam ◽  
Nivedita Mitta
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Abdominal Wall ◽  
Subcutaneous Tissue ◽  
Site Infection ◽  
Abdominal Wall Closure ◽  
Suction Drain ◽  
Group A ◽  
Group B ◽  
Negative Suction

Background: Abdominal wall closure in the presence of sepsis presents a challenge to the surgeon. The objective of this study is to determine the advantages and disadvantages of each method to individualise the techniques based on patient profile about surgical site infection, duration of hospitalisation and morbidity.Methods: A prospective comparative study was conducted among 102 operated patients of peritonitis in the Department of General Surgery at St John’s Medical College and Hospital. The patients were divided into three groups, group A, group B and group C. In group A, skin and subcutaneous tissue was closed after draining the subcutaneous space by a negative-suction drain. In group B, the patient’s skin and subcutaneous tissues were closed primarily with continuous sutures without negative suction drain. In group C, the laparotomy wound was closed and the skin was left open. And the outcome compared in the form of wound infection, hospital stay and morbidity. Patients on immunosuppressive therapy and paediatric patients were excluded. Demographic and clinical variables were recorded at the time of admission. SPSS version 18 was used for analysis.Results: The study showed male preponderance and the mean age was 43.2 years. Duodenal perforation was the commonest cause of peritonitis in this study (38.2%). Incidence of surgical site infection was less in Group A (20.6%) compared to group B (52.9%) and group C (29.4%). Duration of hospital stay was also less in Group A patients (9.3±3.6 days) compared to other two groups. 37 patients who were included in the study were diabetic, out of which 25 patients (67.6%) developed surgical site infection.Conclusions: It can be concluded from this study that abdominal wall closure using a sub cutaneous negative suction drain in peritonitis cases reduces the incidence of surgical site infection, duration of hospital stays, subsequent surgeries related to wound dehiscence and its associated morbidity.  

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 ◽  
...  
Keyword(s):  
Needle Aspiration ◽  
Healing Time ◽  
Breast Abscess ◽  
Ultrasound Guided ◽  
Incision And Drainage ◽  
Two Samples ◽  
Group A ◽  
Group B ◽  
Bacterial Yield ◽  
Point Tenderness

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.

A COMPARATIVE STUDY OF CONVENTIONAL INCISION AND DRAINAGE VERSUS INCISION AND DRAINAGE WITH PRIMARY CLOSURE OF THE WOUND IN ACUTE ABSCESSES

2021 ◽  
pp. 44-46
Author(s):  
T. Babu Antony ◽  
S. Thirunavukkarasu ◽  
Karthick Chandran ◽  
Gowtham G. ◽  
Sudhishnaa S.
Keyword(s):  
Primary Closure ◽  
Tertiary Care ◽  
Healing Time ◽  
Open Drainage ◽  
Tertiary Care Centre ◽  
Time Duration ◽  
Incision And Drainage ◽  
Secondary Intention ◽  
Post Operative Pain ◽  
Wound Healing Time

Acute abscesses are a surgical emergency and almost always require drainage, especially from supercial sites. This is a study among 100 patients in a tertiary care centre in South India to compare the efcacy of two methods of management of supercial – skin and soft tissue- abscesses in terms of post operative pain, wound healing time, duration of inpatient treatment and recurrence of abscess at primary site. The rst method was the conventional Incision and Open drainage and healing by secondary intention. The second method involved Incision and Drainage and primary closure of the wound with a negative pressure drain. The latter method was found to be signicantly superior to the conventional method in all the above mentioned outcomes. Hence, this method can be promoted along with the use of appropriate antibiotics to lessen the inconveniences of the patients.

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