Breast abscess is an acute inflammatory process resulting in the formation and collection of pus under the skin in breast tissue. Abscesses associated with lactation usually begin with an abrasion or tissue at the nipple, providing an entry point for bacteria. The infection often presents in the second postpartum week and is often precipitated in the presence of milk stasis. There is an increase in the incidence of methicillinresistant Staphylococcus aureus (MRSA) breast abscess which is susceptible to antimicrobials such as trimethoprimsulfamethoxazole, fluoroquinolones, and clindamycin. Avoidance of repeated aspiration was the advantage of antibiotics into abscess cavity is probably beneficial. Furthermore Residual abscess, Secondary infection, time for complete healing and hospital stray is better with closed drainage of breast abscess.
Background: Layered closure of the abdomen has been considered to be ideal until recently however single layer mass (retention) closure technique, in which all the layers of the abdominal wall are closed in single layer is being increasingly used by surgeons. We conducted this study to analyze outcome measures in patients in whom wound closure was done by retention closure and layered closure.Methods: This was a prospective comparative study in which 60 patients undergoing elective or emergency laparotomy were included on the basis of a predefined inclusion and exclusion criteria. In 30 cases (50%) layer closure was done whereas in remaining 30 (50%) patients retention closure technique was used. Major outcome measures studied were time required for wound closure and post-operative complications.Results: Out of 60 studied cases there were 42 (70%) males and 18 (30%) females with M: F ratio of 1: 0.42.The time required for closure in layered suture group (group A) was 26.76±3.36 whereas in case of retention closure suturing it was 19.36±4.35. The difference was found to be statistically highly significant (p<0.0001). The complications rates were found to be statistically significantly higher in layer suturing (Group A) as compared to retention suture group (Group B).Conclusions: We conclude that retention suturing is preferable as compared to layered suturing in patients undergoing midline laparotomy in terms of time required for closure of wound and post-operative complication rates.
Background: Breast abscess is a common inflammatory condition among lactating women. Although initial stages of breast abscess can be managed through antibiotics, surgery may be required in the presence of advanced stages in the form of incision and drainage with or without placement of surgical drain. This study was carried out to evaluate the outcomes between open and closed incision and drainage. Methods: This randomized control trial was carried out among 60 cases clinically diagnosed breast abscess. The participants were randomly allocated to experiment group (30 patients) consisting of closed primary suction closure and control group (30 patients) open incision and drainage. Postoperative outcomes in terms of recurrence, pain, secondary infection and duration of hospital stay were recorded. Results: Postoperative pain was present among six participants in the experimental group as compared to 18 participants in the control group, none of the participants in the experimental group experienced residual abscess, scar formation or secondary infections. Moreover, the mean duration of hospital stay among experimental group was 9.1 days as against 11.6 days in the control group. Conclusion:Considering the potent clinical, surgical and financial advantages associated with closed primary suction closure, this method may be routinely used for effective management of acute breast abscess, especially in lactating women.
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