Breast abscess incision and drainage

Breast abscess incision and drainage for the treatment of acute mastitis to form a breast abscess. Breast infections occur most during the puerperium and lactation periods. Catheter obstruction is the main cause. Most of the pathogens are Staphylococcus aureus. The infection starts from the nipple and spreads rapidly to the lactiferous duct and glandular tissue. Because the blood circulation of the breast is very strong after childbirth, once the inflammation occurs, it can quickly cause extensive destruction of the glandular tissue, and even cause sepsis, and should be actively treated comprehensively. Treatment of diseases: breast tuberculosis acute mastitis Indication Breast abscess incision and drainage The inflammatory mass applied around the nipple or breast tissue begins to soften and fluctuate, forming a deep infection of the abscess. The pus penetrates the breast fibrocyst into the cell tissue after the breast, and is ultrasonically examined or punctured. Pus, breast tuberculosis has a mixed infection. Preoperative preparation Apply antibiotics or other antibacterials. Local heat application promotes localization of abscess. Apply a bra to reduce congestion and swell. Surgical procedure 1. Make more radial incisions extending outward from the nipple, or make a slightly curved incision according to the position of the abscess. If both ends of the incision extend beyond the abscess to the normal breast tissue, it may cause chyle. The incision should not be too small. If the incision is in the shape of a bottle at the top of the abscess, the drainage is insufficient and the healing is delayed. An abscess around the nipple or above the breast can make an arcuate incision at the edge of the areola or concentric orientation. A deep abscess of the breast, located in the lower quadrant, can be selected along the chest and breast incision under the breast fold, which not only leads to smooth flow but also has less scar tissue. 2. First make a puncture puncture, clear the depth, and then cut in the top of the abscess, properly separate the subcutaneous tissue and in the direction of the needle, insert the vascular clamp straight into the abscess, after the pus discharge, the incision needs to be enlarged. 3. From the incision into the finger to separate the septum interval, so that the small interval is completely penetrated, and the separated necrotic tissue is discharged. 4. Superficial abscess, rinse the abscess with isotonic saline after drainage, and drain with Vaseline gauze or rubber sheet. If the finger probes the bottom of the abscess, if the abscess is larger and the incision is higher, the incision should be made at the optimal position of gravity drainage to drain the mouth. Place a Vaseline gauze or rubber sheet or rubber tube, fix it on the skin or use a safety pin to prevent it from slipping into the abscess. Place it around with a vaseline gauze and wrap it with gauze. 5. The posterior abscess of the breast is located between the breast and the pectoralis major fascia, and is not easy to drain from the front of the breast. During the operation, the breast is pushed upwards, along the folds at the junction of the breast and the chest wall, and the curved incision of the lower or inner lower edge of the breast is made according to the position of the bottom of the abscess. Then blunt dissection was performed with a vascular clamp, and the abscess was reached in the anterior space of the pectoralis major fascia. After pus drainage, the fingers were probed, and the septal fibers were separated to remove most of the necrotic tissue, and then the abscess was flushed with isotonic saline or 3% hydrogen peroxide solution. Place a drain rubber (or tube) or Vaseline gauze and secure the drain to prevent it from dislocating. Cover with gauze. 6. The pus should be cultured in bacteria. For repeated breast abscesses, the author should cut the wall of the abscess for pathological examination. Postoperative diet Diet should pay attention to light, mostly with food porridge, noodle soup and other foods that are easy to digest and absorb.