>Does anyone have experience with a breast abcess that was I & Ded and
>left open to heal by secondary intention ?

Yes, often breast abscesses are left open because the surgeon is concerned
that the wound will not heal if closed completely. The wound will leak milk,
and often takes weeks to heal. I have found that wounds closer to the
nipple/areola and in the lower part of the breast usually take longer to
heal. If this woman is 4 weeks postpartum and not feeding on that breast,
she is probably over the worst of it. But leaking will probably continue
another 4 weeks or more. A fistula is a possibility, but I've not seen this
happen. If the surgeons are concerned, advice from a wound expert may help -
a moist type dressing (?colloid or gel-type - I would need to check a
reference about this) may be more appropriate than the dry dressing.

I always wonder in these cases if the first doctor had prescribed an
appropriate antibiotic (NOT amoxycillin) if this would have occured.
Sometimes abscesses develop after appropriate antibiotics - but at least
then you can just blame the wretched staph and not the doctor.

>24 hours later ultrasound revealed probable abcesses.
In my experience, when an abscess is ready to be drained, it is an obvious
abscess on ultrasound. Perhaps the breast could have left another day or few
days, until the abscesses were "ripe". Again, we can only speculate if this
would have made a difference. I have seen women who have had the breast
drained, but no abscess was found - then they have had a GA and an open
wound - both unnecessary.

Also sometimes the abscess can be managed by needle aspiration, repeated
every couple of days. Not pleasant - but much better than this drawn-out
leaking scenario.

Please keep us up to date with this one!

Lisa Amir
GP/LC in Melbourne, Australia.