Abstract
Hospital experience of breast abscess is changing as nonpuerperal abscess associated with periductal mastitis assumes increasing importance. Clinical presentation, bacteriology, and management differ notably from acute puerperal abscess, but the latter can still cause severe morbidity.
The standard management of puerperal abscess by incision, breaking down loculi, and dependent drainage may still be used, but the author has shown that an alternative approach—curettage and primary obliteration of the cavity under antibiotic cover—can give equally good results with reduced morbidity.
Résumé
L'aspect de la pratique hospitalière en ce qui concerne les abcès du sein est en train de changer car on voit de plus en plus d'abcès non puerpéraux associés à la mastite péricanalaire. Les premiers signes cliniques, les données bactériologiques, et le traitement diffèrent des abcès puerpéraux aigus, mais ces derniers sont parfois responsables de morbidité.
Le traitement standard de abcès non puerpéraux est l'evacuation. L'effondrement des cavités loculaires et le drainage déclive, ont des adeptes, mais l'auteur a démontré que le curetage avec fermeture primitive sous couverture antibiotique peut également donner de bons résultats avec une morbidité moindre.
Resumen
La experiencia con el absceso mamario está en proceso de cambio en la medida que el absceso no puerperal asociado con mastitis periductal asume importancia creciente. La presentación clínica, la bacteriología, y el tratamiento difieren en forma notable del absceso puerperal agudo, pero éste, cuya incidencia está en franco descenso, todavía es causa de morbilidad pronunciada.
El tratamiento estándar del absceso no puerperal es la incisión para drenaje; el desbridamiento de tabiques y el drenaje de gravedad todavía pueden ser utilizados, pero el autor ha demostrado un enfoque que alternó: el curetaje y la obliteración primaria de la cavidad bajo cubrimiento antibiótico pueden dar resultados igualmente buenos pero con menor morbilidad.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Scholefield, J.H., Duncan, J.L., Rogers, K.: Review of a hospital experience of breast abscesses. Br. J. Surg.74:469, 1987
Leach, R.D., Eykyn, S.J., Phillips I., Corrin, B.: Anaerobic subareolar breast abscess. Lancet1:35, 1979
Ekland, D.A., Zeigler, M.G.: Abscess in the nonlactating breast. Arch. Surg.107:398, 1973
Benson, E.A.: Breast abscesses and breast cysts. The Practitioner226:1397, 1982
Benson, E.A., Goodman, M.A.: Incision with primary suture in the treatment of acute puerperal breast abscess. Br. J. Surg.57:55, 1970
Bates, T., Down, R.H.L., Tant, D.R., Fiddian, R.V.: The current treatment of breast abscesses in hospital and in general practice. The Practitioner211:541, 1973
Benson, E.A., Goodman, M.A.: An evaluation of the use of stilboestrol and antibiotics in the early management of acute puerperal breast abscess. Br. J. Surg.57:255, 1970
Elkeles, R.S., Hampton, J.R., Mitchell, J.R.: Effect of oestrogens on human platelet behaviour. Lancet2:315, 1968
Daniel, D.G., Bloom, A.L., Giddings, J.C., Campbell, H., Turnbull, A.C.: Increased factor ix levels in puerperium during administration of diethylstilboestrol. Br. Med. J.1:801, 1968
Daniel, D.G., Campbell, H., Turnbull, A.C.: Puerperal thromboembolism and suppression of lactation. Lancet2:287, 1967
Jeffcoate, T.N., Miller, J., Roos, R.F., Tindall, V.R.: Puerperal thromboembolism in relation to the inhibition of lactation by oestrogen therapy. Br. Med. J.4:19, 1968
Clinch, J., Tindall, V.R.: Effect of oestrogens and progestogens on liver function in the puerperium. Br. Med. J.1:602, 1969
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Benson, E.A. Management of breast abscesses. World J. Surg. 13, 753–756 (1989). https://doi.org/10.1007/BF01658428
Issue Date:
DOI: https://doi.org/10.1007/BF01658428