Incision and drainage and ultrasound-guided suction drainage for the management of breast abscess: A prospective randomized comparative study

Abstract

Background: Breast abscesses commonly arise during lactation, with the conventional treatment method involving incision and drainage. Nevertheless, a promising, less invasive alternative for managing extensive and multilocular abscesses involves employing ultrasound-guided suction drainage and a fistulotomy probe. Aims and Objectives: This study evaluates and contrasts the results of two approaches in treating breast abscesses: ultrasound-guided suction drainage and the conventional incision and drainage method. The comparison will be centered around various parameters, such as procedural duration, patient-reported pain levels, breastfeeding capability, incidence of complications, overall hospitalization duration, and cosmetic results. Materials and Methods: In this research, we enrolled a total of 60 patients who had been diagnosed with breast abscesses. These patients were randomly assigned to two groups of 30 individuals. The control group underwent the conventional incision and drainage procedure under general anesthesia. In contrast, the study group received an innovative treatment method involving ultrasound-guided suction drainage using a fistulotomy probe to address the abscess’s compartments. This intervention was carried out under local anesthesia. The process involved the percutaneous insertion of an 18Fr suction catheter connected to the fistula probe. The catheter was carefully guided into the abscess cavity with the assistance of ultrasound imaging, following its longest axis. In multilocular abscesses, the catheter was threaded through all the compartments. Subsequently, the fistulotomy probe was detached from the drain within the abscess cavity to disrupt the compartments. Results: Using ultrasound-guided suction drainage showcased numerous benefits compared to the conventional method. It led to a shorter procedure duration, decreased patient discomfort, no interference with breastfeeding, accelerated healing, reduced hospitalization periods, enhanced cosmetic results, and a lower incidence of complications compared to the traditional approach. Conclusion: Using ultrasound-guided suction drainage for breast abscesses provides all the benefits associated with a minimally invasive strategy. Furthermore, using a fistulotomy probe demonstrates the equal effectiveness of this technique in addressing both large and multilocular abscesses compared to the traditional incision and drainage method.