Does mastitis require surgery?

Mastitis suppuration is a very painful thing for women. It can cause breast swelling and pain, body fever, and milk accumulation. So how should mastitis with suppuration be treated? If an abscess is formed, experts recommend surgery and incision and drainage if possible. Let the pus be discharged from the breast quickly. I hope women will not be afraid of surgery to avoid causing greater harm.

Clinical manifestations

In the early stages, patients experience swollen and painful breasts; tender lumps appear in the affected area, and the surface skin is red and hot; systemic symptoms such as fever may also occur. If the inflammation continues to develop, the above symptoms will worsen. At this time, the pain will be pulsating and the patient may have chills, high fever, rapid pulse, etc. The axillary lymph nodes on the affected side are often enlarged and tender. The white blood cell count was significantly increased and the nuclei were shifted to the left. The inflammatory mass often softens within a few days to form an abscess. Superficial abscesses may be palpable and fluctuant, while deep abscesses require puncture to be identified. Breast abscess can be unilocular or expand to multilocular due to untimely drainage; or it can penetrate the skin from the outside, or the abscess can rupture into the milk duct and form nipple pus discharge; several lesions can also exist in the same breast at the same time and form multiple abscesses. In addition to slowly breaking outward, deep abscesses can also penetrate deep into the loose tissue between the breast and pectoral muscle, forming a retromammary abscess. Severe acute mastitis can lead to large-scale necrosis of breast tissue and even sepsis.

treat

1. No abscess formed

(1) General treatment is to stop breastfeeding on the affected breast to avoid affecting the health of the baby. At the same time, measures should be taken to promote smooth milk discharge (such as using a breast pump to extract milk) and eliminate factors causing milk stasis.

(2) Local physical therapy and hot compresses are helpful for early dissipation of inflammation. For those with obvious edema, 25% magnesium sulfate hot compresses can be used.

(3) Local blockade can promote the dissipation of early inflammation.

(4) Antibiotics for systemic infection (cephalosporins, ofloxacin, methoxazole).

2. Abscess formation stage

The key to treatment is timely incision and drainage to remove the pus. The key is to prevent and treat milk stasis, avoid nipple damage, and keep the area clean. In the late stages of pregnancy (especially for primiparas), the nipples on both sides should be washed frequently with warm soapy water; if the nipples are inverted, they can generally be corrected by frequent squeezing and pulling (some cases require surgical correction). It is important to develop good breastfeeding habits, such as regular breastfeeding and letting the baby sleep without the nipple. The milk should be completely sucked out during each breastfeeding session. If there is any congestion, a breast pump or massage can be used to help drain the milk. Nipples should be cleaned after breastfeeding. If you find that your nipple is damaged or cracked, you should seek timely treatment. Pay attention to your baby's oral hygiene and treat oral inflammation in time.