To explore the clinical effect of vacuum-assisted minimally invasive resection without catheter drainage for necrotic breast abscess.

According to the inclusion and exclusion criteria, 73 patients with puerperal necrotic mammary abscess in the Haidian Maternal and Child Health Hospital from January 2015 to July 2018 were enrolled for a prospective study. The patients were divided into study group (35 cases) and control group (38 cases) by random number table method. The study group was treated with vacuum-assisted minimally invasive resection without catheter drainage, and the control group was treated by catheter flushing and drainage. The differences of treatment indicators (length of postoperative hospital stay, times of subsequent visits), complications (breast fistula) and prognosis (weaning, recurrence) were compared between the two groups. The quantitative data with skewed distribution were expressed as M(P₂₅-P₇₅), and Mann-Whitney U test was used to compare length of postoperative hospital stay and times of subsequent visits. The χ² test and Fisher’s exact test were used to compare the weaning rate, recurrence rate and incidence of breast fistula.

The length of postoperative hospital stay, times of subsequent visits after discharge and the incidence of breast fistula in the study group and control group were 5.0(3.0-7.0) d and 10.5(8.0-13.3) d, 3.0(2.0-6.0) and 7.5(3.0-10.0), 2.9% (1/35) and 21.1% (8/38), respectively, indicating a significant difference (Z=-5.704, P<0.001; Z=-3.626, P<0.001; P=0.029). There was no significant difference in the weaning rate and recurrence rate [weaning rate: 20.0% (7/35) vs 39.5% (15/38), χ²=3.282, P=0.070; recurrence rate: 8.6% (3/35) vs 7.9% (3/38), P=1.000].

For the breast abscess with necrotic tissues in the cavity, vacuum-assisted minimally invasive resection without catheter drainage is feasible, with the advantages of no special nursing, short length of hospital stay, reduced subsequent visits and improved quality of life for puerperal women.