Puerperal breast abscesses; percutaneous ultrasound guided drainage compared with conventional incision and drainage

ABSTRACT

The aim of this study was to compare the management of puerperal breast abscess by ultrasound guided percutaneous drainage v/s incision and drainage with special attention to resolution time and complications. Allied Hospital Faisalabad. Jan 2005- June 2007. 60 patients with puerperal breast abscess were studied. Patients were divided into two groups randomly after informed consent. In Group A; patients were treated with percutaneous drainage under local anesthesia while Group B patients were treated by conventional incision and drainage, and results were compared with reference to resolution time and complications rate using student's t-test. 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 breast parenchyma. Breast-feeding was interrupted in four patients [13%] only due to milk fistula [one case], recurrent abscess [one case] and patient's own preference [two cases]. On the other hand by conventional method healing took 15-25 days with pain and discomfort of daily dressings, scarring and cessation of breastfeeding in most of the cases. Percutaneous ultrasound guided placement of suction drainage catheter in puerperal breast abscess for 5-8 days is less invasive, high resolution rate, scarless, low complication rate and preserves the function of breast-feeding as compared to conventional incision and drainage