LONG-TERM OUTCOMES AND RECURRENCE PREDICTORS IN NON-LACTATIONAL PURULENT MASTITIS

Abstract

Recurrence is the principal challenge in surgical treatment of non-lactational purulent mastitis (NPM): with standard incision and drainage (I&D) the recurrence rate reaches 15–50% [5]. The main causes include incomplete excision of the mature pyogenic membrane; β-lactam therapy for Corynebacterium kroppenstedtii infection with 70% penicillin resistance [1]; and non-radical treatment of periductal mastitis with fistulas [3]. Targeted rifampicin-based antibiotherapy achieves remission in Ck infection in 89% of cases, significantly exceeding monotherapy outcomes [2]. The need for a differentiated approach to the surgical treatment of purulent diseases of the abdominal cavity and thoracic organs is emphasised in the surgical literature [4]. Total ductectomy for recurrent periductal mastitis reduces recurrence to 4–8% versus 28–42% with standard drainage [3].