Comparison of Standard Incision and Drainage Versus Percutaneous Suction Drainage in the Management of Acute Breast Abscess

Acute breast abscess is a common surgical condition requiring prompt intervention. Conventional incision and drainage (I\&D) has been the standard treatment; however, it is associated with increased pain, prolonged healing, and frequent dressings. Minimally invasive techniques such as percutaneous suction drainage (PSD) have emerged as alternatives with potential advantages.

This prospective comparative interventional study was conducted at GSVM Medical College, Kanpur, from May 2025 to Feb 2026. Eighty patients diagnosed with acute pyogenic breast abscess were allocated into two groups: Group A (I\&D) and Group B (PSD).

Outcomes assessed included postoperative pain (VAS score), duration of hospital stay, wound healing time, number of dressings, complications (residual abscess, fistula), and recurrence at 3 months. The study aims to compare the efficacy and safety of both treatment modalities.

• Incision and Drainage (Procedure): Standard surgical incision and drainage of breast abscess with evacuation of pus.
• Percutaneous Suction Drain (Procedure): Minimally invasive placement of suction catheter for drainage of breast abscess.

Primary outcomes

• Postoperative pain [Day 1, 3, 7, 14, 30, 60, and 90 post procedure]: Postoperative pain will be assessed using the Visual Analog Scale (VAS), a patient-reported pain assessment scale ranging from 0 to 10, where: 0 = no pain 10 = worst imaginable pain Higher scores indicate greater pain severity. Pain scores will be recorded on postoperative Day 1, Day 3, Day 7, Day 14, Day 30, Day 60, and Day 90 after the procedure.
• Number of Dressings [Within 30 days post-procedure]: Total number of postoperative dressings required per patient in number
• Length of Hospitalization [Up to 15 days post-procedure]: Length of hospital stay measured in days from procedure to discharge
• Wound healing [From procedure to complete wound healing (up to 30 days)]: Time to complete wound healing, defined as the number of days from the procedure to full epithelialization of the wound with absence of discharge, assessed by clinical examination.

Secondary outcomes

• Residual Abscess [Within 30 days post-procedure]: Incidence of residual abscess, defined as the presence of a persistent or recurrent fluid collection at the original site confirmed by clinical examination and/or ultrasonography after the initial procedure.
• FISTULA FORMATION [Within 30 days post-procedure]: Incidence of fistula formation, defined as the development of a persistent abnormal tract with discharge from the wound site following the procedure, confirmed by clinical examination.

Sex: All, ages: 18 Years to 70 Years

Inclusion Criteria:

* Patients diagnosed with acute pyogenic breast abscess
* Abscess size ≥ 3 cm on ultrasonography
* Willing to participate and provide written informed consent

Exclusion Criteria:

* Abscess size < 3 cm on ultrasonography
* Patients unwilling to provide informed consent
* Pre-existing skin disorders involving the breast
* Significant comorbid conditions (e.g., coagulopathy, diabetes mellitus, HIV infection, hepatitis B or C)
* Diagnosed cases of antibioma
* Tuberculous mastitis
* Breast malignancy

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