Large lactational breast abscess: primary closure with drain versus conventional incision and drainage

Background: Surgical management of breast abscess is a routinely performed technique. Objective: To assess the outcome of primary closure with drain and conventional incision and drainage of large lactational breast abscess. Methodology: This was an experimental study and we selected 50 patients of aged 16 to 42 years, with lactational breast abscesses larger than 5 cm in size, st th admitted from 1 April to 30 April 2018, in Sheikh Zayed Medical Hospital, Rahim Yar khan. We randomly divided the patient in two groups of 25 patients each. Informed consent was taken from each patient. First group (close group) was named as primary closure group treated by incision and drainage followed by primary closure after placing a Nelton drain in the abscess cavity. Drain was attached with drainage bag without negative suction. Second group (open group) was named as open group treated by conventional incision and drainage and left open, to heal by secondary intention. Lactation suppression was carried out in both groups by using bromocriptine. Data was entered in SPSS version 16 and analyzed. Results: The mean hospital stay in primary closure group was 1.4±0.7 days and 2.7±0.92 day in open group. The mean healing time in primary closure was 8.1±2.1 days and 19.1±8.3 days in open group. The mean post operative hospital visits in primary closure group were 2.8±1.9 and 8.7±4.9 in open group. There was no recurrence in primary group while one patient presented with recurrence in open groups . Conclusion: The primary closure technique with drain in large lactational breast abscesses is better option than conventional incision and drainage in term of shorter hospital stay and healing time, less frequent hospital visits and with no increased risk of recurrence.