EXPLANATION ABOUT BREAST (MAMMARY) ABSCESS

Definition

Breast abscess:- Is a cavity containing pus lined with granulation in the breast.

§  Often follow acute mastitis

§  May also occur during post partum as a complication due to fissures and cracks in the nipple which allow staphylococci to enter and thrive in the milk.

SOURCES OF INFECTION

Some as mastitis

Prevention

1.      Careful preparation of the nipple in the last 2 months of pregnancy

2.      Scrupulous hygiene during lactation with H₂O and soap and massage them.

3.      Rolling the nipple between the fingers may get them accustomed to the function of sucking

4.      A suitable ointment may be applied twice per week but not necessary.

SIGNS AND SYMPTOMS

1.      The area is sensitive and ducky red.

2.      Nipple may discharge pus

3.      Mass is palpable (swelling)

4.      Pain

5.      Tends to reoccur in case of subareola abscess

6.      Tenderness

7.      Fluctuation

MANAGEMENT AND NURSING CARE

1.      Stop feeding baby on the affected breast

2.      Support the breast by elevating with sling

3.      Incision and drainage

4.      Pack the wound and continue with prescribed solution e.g. normal Saline

5.      Systemic antibiotics according to culture and sensitivity of pus

6.      Analgesics P.R.N

7.      Hot wet dressing increase the drainage and hasten resolution

8.      Isolate the patient P.R.N and use a separate tray as the soiled dressing are highly infectious.

9.      Use Montgomery straps to prevent skin irritation by adhesive tapes

10.  Massage the neck and shoulder muscles of the affected side to decrease pain and relax them.

11.  Support arm and shoulder with pillows when in bed.

PATIENT EDUCATION

1.      Don’t shave the axillary on the affected side as infection may spread to it due to minor cuts.

2.      Teach her how to prevent infection spreading to other parts of the body e.g. The eyes etc.