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

Abstract

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.

Select Choices in Benign Breast Disease: An Initiative of the American Society of Breast Surgeons for the American Board of Internal Medicine Choosing Wisely® Campaign

“…In a randomized trial of 45 patients comparing I&D to percutaneous aspiration, surgical drainage was associated with poor cosmesis in 70% patients and prolonged healing time (45 vs. 20 days). 14,15 As shown by these and other authors, the majority of patients treated with aspiration do experience complete resolution without surgery (54–100%), sparing the need for general anesthesia, dressing changes, and interruption of breastfeeding. This should be the first step in management of women with abscesses.…”

Novel Therapy for Pseudocyst of Pinna – An Institutional Study

“…It is not such that a cavity with collection should always be drained openly, for example, in breast abscesses, aspiration of the abscess is the initial treatment of choice recommended now. 14 If a patient comes with cystic swelling of the pinna because of collection of hemorrhagic fluid and the aspiration shows no frank pus, no evidence of distraction of the cartilage, instead of incision and drainage a conservative approach can taken by simply aspirating the fluid inside and instilling equal amount of a mixture of Inj. Dexamethsone and Inj.…”

Management of Superficial Abscesses: Scope for Day Case Surgery

“…The current management of abscesses has been shown to be variable [ 5 ], but in our experience most abscesses have traditionally been treated with incision and drainage and packing to allow healing by secondary intention. In certain areas, such as breast abscesses, it is now routine practice to perform aspirations rather than incision and drainage [ 2 , 6 , 7 ]. This practice could be applied to abscesses in other sites.…”