Clinical application of vacuum sealing drainage in patients with idiopathic granulomatous mastitis.

BACKGROUND

Idiopathic granulomatous mastitis (IGM) is a chronic inflammatory breast disease with an unclear etiology. Patients with IGM remain at risk of recurrence even after clinical cure. We assessed the long-term clinical outcomes of segmental mastectomy paired with vacuum sealing drainage (VSD)-based integrated wound management for IGM patients eligible for surgical intervention.

METHODS

Patients were divided into two groups according to the clinical treatment protocol: 87 patients underwent segmental mastectomy combined with VSD (VSD comprehensive group), and 63 underwent segmental mastectomy combined with conventional drainage (conventional drainage group). Postoperative pain score, number of dressing changes, incision healing time, length of hospital stay, hospitalization cost, breast morphology, and 2-year recurrence rate were compared between groups.

RESULTS

Compared with the conventional drainage group, the VSD comprehensive group had a significantly lower 2-year recurrence rate [4.59% vs. 20.63%; odds ratio (OR) =0.185, 95% confidence interval (CI): 0.057-0.600; P=0.003] and a significantly higher rate of excellent breast morphology (68.97% vs. 49.21%; OR =2.294; 95% CI: 1.173-4.487; P=0.02). Significant intergroup differences were observed in pain score (5.989±0.896 vs. 3.984±0.813, P<0.001), number of dressing changes (14.862±3.638 vs. 10.730±5.074, P<0.001), incision healing time (38.081±7.007 vs. 19.048±12.681 days, P<0.001), length of hospital stay (9.931±1.797 vs. 8.984±2.703 days, P=0.01), hospitalization cost (¥12,186.471±1,348.616 vs. ¥11,628.571±1,274.002, P=0.01).

CONCLUSIONS

Segmental mastectomy paired with VSD-based integrated wound management was associated with improved breast morphology and a lower 2-year postoperative recurrence rate in patients with IGM, although early postoperative recovery was slower and hospitalization cost was higher.