Acute mastitis

Overview of acute mastitis is a breast acute suppurative infections, the vast majority occurred in breastfeeding postpartum women, especially in the early maternal styles, often in the incidence of postpartum 3 ~ 4 weeks. Pathology and pathogenesis of acute mastitis causes, in addition to postpartum systemic resistance drop, there are two major incentives. (1) milk pregnancy : this refers to the incidence of the major reasons for the deposition of milk for the growth and reproduction of bacteria provided favorable conditions. Milk deposition of factors : nipple dysplasia (too small or inversion) obstructing breastfeeding; Baby milk over breast pump or less, to milk not completely emptying; Duct barrier affecting the milk. (2) Bacterial invasion : ruptured nipple and areola surrounding skin erosion, causing cells along lymphatic invasion, This is the main routes of infection. Baby oral infections, breast pump or nipple with sleep, causing bacteria directly into the duct infection is one of the ways pathogens to Staphylococcus aureus. Clinical manifestations in patients with early breast swelling pain; The surface of the skin induration of tenderness there, the surface skin red heat; Meanwhile, there will be fever and other systemic symptoms. Continued development of inflammation, these symptoms increase, at this time, the pain was pulsatile, patients may have chills, fever, tachycardia, and so on. Regular ipsilateral axillary lymph node swelling, and tenderness. Leukocyte count increased significantly and nuclear bits. Often inflammatory mass in a few days to soften formed abscess, the abscess can be superficial touches fluctuations, the abscess deep puncture need can be determined. Breast abscess can be the single-sex, it can also be a result of not timely drainage and room for expansion of; Or from the outside to break the skin, or abscess rupture of milk into the overflow pipe nipple abscess formation; the same breast can also exist a number of lesions and the number of abscess formation. Deep abscess rupture of the field except slow, but also to the deep to wear breast and the breast tissue osteoporosis, breast abscess formation. Severe Acute mastitis can lead to breast tissue necrosis, or even with sepsis. Treatment of acute mastitis without abscess formation of the treatment include : (1) to suspend the affected breast lactation, so as not to affect infant health; also taking steps to promote milk smooth discharge (eg breast pump sucked milk, etc.) Removal of milk pregnancy factors. (2) local physiotherapy, hot pack, to disperse early inflammation; Edema were available to 25% of the magnesium sulfate deposition humid. (3) partially closed : available containing one million units of penicillin 20 ml saline in the surrounding inflammatory mass closure If necessary, every 4 ~ 6 hours a repeat injection. or by 0.5% solution of procaine 60 ~ 80 ml around the breasts and breast after closed; Early prompting inflammation dissipate. (4) systemic anti-infection : sulfa drugs or antibiotics. (5) Medical treatment : Shugan Qingre, stagnation of milk-based links. Available dandelion, wild chrysanthemum, and so on Qingrejiedu drugs. Acute mastitis abscess formation, the treatment is timely to Incision and exhaling empyema. Incision should pay attention to the following points : (a) To avoid injury surgical breast milk and fistula formation. Spoke incision made for the direction of radial incision to areola Department; deep abscess or breast abscess. along the lower edge for breast curved incision, breast space Seal; This can prevent the milk duct injury, as well as drainage and drainage must be made. Areola under abscess, should be along the edge of the areola curved incision. (2) if the inflammation and no obvious fluctuations, not passively waiting to be the most obvious tenderness Department puncture, Early detection of deep abscess. (3) abscesses after incision, in-depth Vomica fingers, gently separated during the fiber spacing to facilitate drainage thoroughly. (4) In order to make the drainage and the exploration Vomica, Vomica find the lowest position, I made another cogent counterparts drainage. (Chart 2-12,2-13,2-14). Figure 2 -12 breast abscess in a different location. 2 superficial abscess. Areola abscess under 3. deep abscess 4. Breast abscess Figure 2-13 breast abscess incision Figure 2-14 breast deep abscess Because the drainage bacteria milk is a good medium, it was argued that women with acute mastitis, and if the situation permits, should stop breastfeeding, in order to avoid the spread of the infection. But this may lead to pregnancy and breast milk affect normal infant nutrition, it is not appropriate as the conventional treatment; only serious infection or abscess drainage after fistula with milk when I consider. For the termination of milk secretion of ways : (1) speculation malt and 60 grams, with Decoction after two uniforms, a daily, Even two-serving on the 3rd; (2) oral diethylstilbestrol, a ~ 2 mg three times a day for a total of 2 ~ 3 days; (3) intramuscular injection of estradiol benzoate, each 2 mg, once daily, admission to the time of milk. Prevention is key to prevention of pregnancy milk, while avoiding nipple injury, and maintaining local clean. Late pregnancy (especially early maternal) should always wash with warm soapy water on both sides of nipple; If inverted nipple. generally available through regular corneas, Tira corrected (individual needs surgical correction). To cultivate regular breastfeeding, infant sleep without nipple and excellent breastfeeding habits. Milk per lactation should suction air, if pregnancy, or through breast pump to help massage emptying milk. After washing nursing nipple. Nipple found damaged or broken, timely treatment. Attention to the baby's oral health and the timely treatment of oral inflammation.