Surgical treatment of neonatal mastitis by periareolar drainage

Neonatal mastitis is a rare but challenging problem that commonly appears within the first 8 weeks after birth. Abscess formation in an infant's breast can lead to acute complications and longterm dysfunction. To our knowledge, no publication focuses on surgical techniques and postoperative care to avoid breast scarring in neonates. We herein present our surgical approach by periareolar drainage to avoid this long term complications.

After reviewing the medical database of our hospital from 2002 to 2012, 11 cases (6 females and 5 males; 10 unilateral and 1 bilateral) of neonatal mastitis were found. Four cases required surgery, performed by periareolar drainage (n = 4, 4:11). Our data were compared with data obtained from a literature review using Medline and Cochrane databases.

In all our patients that underwent surgery, clinical symptoms were reduced directly after surgery. Our results were comparable with those reported in the literature, which included 163 patients (105 [64.42%] required surgery) from seven publications. Regarding our surgical technique, we have not observed any long-term complications during follow up examinations (range 12-116 months postoperative; mean, 77.36 months), which have been reported in the literature.

Even if the acute infection can be cured by parenteral antibiotics and surgical incision if necessary, the longterm problems of scarring after mastitis, especially from surgical incisions at the site of maximum swelling, can lead to severe functional and aesthetic problems. To avoid such scarring, we herein present our surgical approach to mastitis by periareolar drainage.