Balaji, P K (2023) A Prospective study on Efficacy of Ultrasound Guided Aspiration Over Incision & Drainage in the Management of Lactational Breast Abscess. Masters thesis, Madras Medical College, Chennai.
Full text not available from this repository.Abstract
INTRODUCTION: Lactational Breast Abscess refers to accumulation of pus in an area or segment of breast in lactating mothers & it usually occurs as result of inadequately treated infectious mastitis. Bacterial Mastitis is the most common variant of mastitis & it is associated with lactation in vast majority of the cases. Though its overall incidence is gradually on the decline, Breast abscess is still a commonly encountered problem in the developing countries owing to poor maternal hygiene, decreased nutrition, poor breastfeeding techniques, poor standard of living, delay in prompt diagnosis & antibiotics administration. Lactational Mastitis is mainly caused by Staph aureus or Streptococcus species & in case of hospital-acquired infections,they’re likely to be Penicillin-resistant. The intermediary is usually the infant, as about 50% of infants harbour Staphylococci in their nasopharynx by the third day of life. Eventhough mastitis is initiated by ascending infection from a sore/cracked nipple, in majority of the cases, the lactiferous ducts get blocked by epithelial debris resulting in stasis. AIMS AND OBJECTIVES: 1. To determine the efficacy of Ultrasound guided Aspiration over the Conventional Incision & Drainage procedure in the Management of Lactational Breast Abscess in terms of Healing rate, Cost Effectiveness & Cosmesis. 2. To consider Ultrasound guided Aspiration as first line of treatment in cases of Lactational Breast Abscess. 3. To determine the advantages of USG guided aspiration in reducing hospital stay & postop pain. 4. To find out its effectiveness in reducing post-operative complications & recurrence. MATERIALS & METHODS: STUDY DESIGN: Prospective Observational Study. STUDY CENTRE: Institute of General Surgery - Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai – 03 SAMPLE SIZE: This study involved 60 patients who met the Inclusion criteria and were randomly allocated into two treatment groups of 30 each. INCLUSION CRITERIA: All Lactating females diagnosed with Breast abscess by clinical examination as well as sonographic confirmation. EXCLUSION CRITERIA: • Non-lactating females with breast abscess • Recurrent/Chronic Breast abscess at presentation • Fistula/Sinus/Skin necrosis overlying Breast abscess • Immuno-compromised patients like Diabetes, Renal Failure, Tuberculosis, Patients on Steroid therapy and Patients of suspected malignancy of breast. CONCLUSION: Lactational Breast Abscess still remains a common concern in the developing countries. Any lactating female in her early postpartum period with history of pain over the breast, associated with fever & redness should arouse a strong suspicion of Lactational abscess. Once the clinical examination as well as the patient’s history favor the diagnosis of Breast abscess, the patient must be immediately subjected to Ultrasound examination to reaffirm the condition as well as to guide the drainage of abscess. Once proven, it is essential to treat the abscess at the earliest and the treatment modality has to be decided based on various factors such as patient’s acceptance, ease of technique, feasibility, the need for repeated aspiration/drainage, time for resolution as well as cosmetic & functional outcome. Ultrasound guided Needle aspiration under antibiotic cover has superseded the conventional incison & drainage procedure in the management of lactational breast abscesses owing to it’s colossal superiority over the other as cited in our study. Based on the various factors mentioned above & the numerous advantages of USG guided aspiration over the incision & drainage procedure, we can conclude that Ultrasound guided needle aspiration is a very safe & efficient modality of treatment of lactational breast abscess and it must be considered as first-line of management in cases of lactational breast abscess.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 220120100506 |
| Uncontrolled Keywords: | Efficacy, Ultrasound Guided Aspiration, Over Incision, Drainage, Management, Lactational Breast Abscess. |
| Subjects: | MEDICAL > General Surgery > MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 15 Jan 2024 06:06 |
| Last Modified: | 19 Jan 2024 16:09 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/21296 |
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