Comparison of Needle Aspiration and Incision & Drainage in the Management of Lactational Breast Abscess
BACKGROUND: Breast Abscess is a common condition in especially lactating mothers and poses a difficult period of a painful and tender abscess with constitutional symptoms with difficulty in breast feeding. The conventional incision and drainage extends the morbidity while aspiration is emerging as a technique to alleviate the problem more easily.
OBJECTIVE: To compare the results of needle aspiration against Incision & Drainage in the management of breast abscess among lactating patients.
METHODOLOGY: This cross-sectional comparative study was carried out at the Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, from July 2014 to June 2017. 108 patients with lactational abscess less than 5 cm and consenting to participate were included, randomly assorted into ‘Needle Aspiration’ and ‘Incision and Drainage’ groups and followed over four weeks. Re-aspiration and conversion to open drainage were considered for Aspirated patients. Descriptive statistics, t-test and chi-square test was used to analyze the data.
RESULTS: Mean healing time (days) in needle aspiration group was 8.59 + 1.89 versus 18.16 + 5.00 in Incision and Drainage, which was significant. Continued breast-feeding rate was 96 % in needle aspiration versus 69.6 % of Incision & Drainage (I &D). There was scar in only 5.76 % patients of needle aspiration group who converted to I & D as compared to scar in 100 % patients of I & D. Mean healing time, continued breast-feeding rate and cosmetic outcome were significantly better in needle aspiration group (P <0.001).
CONCLUSIONS: Needle Aspiration is a better management option with good healing time, healing rate, continued breast-feeding rate and better cosmetic outcome in patients with small lactational breast abscess.
KEYWORDS: Lactational Abscess, Incision and Drainage, Needle Aspiration.
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