I have some questions for the "Lactnut" group.

I have been working with this mom of twins who developed a mastitis, was
treated for 10 days, did not have marked improvement so changed antibotics
and was being watched closely, encouraged to keep that breast emptied, rest,
ect.  Two days later is dx with an abcess, 6cm x 8cm.  A surgeon excised the
breast starting with a 2cm incision but expanded it to 3cm because of the
thick drainage.  The incision was on the areola, then he dressed the wound
covering the whole breast including the nipple advising the mom not to touch
it till the next day when she came back for a dressing change.  The mom was
devastated by the whole procedure and results and was unhappy that I did not
prepare for how gross the whole process was.  I have never seen an abcess
drained or even a post wound other than pictures in a book.
I talked with the surgeon today and he helped describe when a needle
aspiration can be done and when an incision with a wick is called for.  He
also said the incision needed to be over the abcess and that happened to be
by the areola.  When discussing the dressing and not touching the breast for
at least 12 hours he said the nerve endings exposed are too sensitive for a
mom to nurse or pump and that she should wait a day or two.  I tried to
explain that the breast will continue to fill and this engorgement would feel
worse to the wound ( not to mention the potential of lost milk production )
but he wouldn't agree.
I'd love anyone's own experience or what I can show this surgeon so this does
not happen again.  You may e-mail me privately.  Sorry for the long post.
I hope some day I can observe this procedure to help support the mom going
through it and understand what is going on.

Ann Perry RN IBCLC