mankhwala

Mapangidwe anjira yabwinozimafunikira chidziwitso ndi kumvetsetsa kwamakanika omveka omwe akukhudzidwakuwotcha.

Mukaluma minofu, singano iyenera kukankhidwa pogwiritsa ntchito akuchita pa dzanja, ngati zimakhala zovuta kudutsa mu minofu, singano yolakwika ikhoza kusankhidwa, kapena singanoyo ingakhale yosamveka.

Mkangano wasuture zakuthupiziyenera kusamalidwa ponseponse kuti zisawonongeke, ndipo mtunda pakati pa ma sutures ukhale wofanana.

Kugwiritsa ntchito kwapadera suture chitsanzoZitha kusiyanasiyana kutengera dera lomwe likudulidwa, kutalika kwa chodulidwacho, kugwedezeka kwa mzere wa suture, komanso kufunikira kwapadera.kukhumudwa, kukhumudwa,kapenaeversionza tishu.

Mitundu ya sutureakhoza kugawidwa mozama ngatikusokonezedwa kapena mosalekeza.

A. Zitsanzo Zosokonezedwa

Kusokoneza ma suturesamagwiritsidwa ntchito kuti athetse mavuto, kapena m'madera omwe amafunika mphamvu zambiri. Iwo si monga ndalama monga asuture mosalekezangati amfundoAyenera kumangirizidwa pambuyo pa kuyika kwa suture, pogwiritsa ntchito zida zambiri za suture. Ngati imodzi mwa ma sutures ikalephera, izi sizingakhudze zina zonse zomwe zimayikidwa pabalalo.

• Zotha nthawi.
• Kuchuluka kwa suture zipangizo.
• Kukhalapo kwa ndalama zowonjezerasuture zipangizomkati mwa minofu.
• Kutha kusungamphamvu ndi minofu malongati gawo la mzere wa suture likulephera kapena misozi.
• Perekani mbali yolondola kwambiri yofikira m'mphepete.
• Minofu yochepa ya chipseramapangidwe mu bala lochiritsidwa

B. Zitsanzo Zopitilira

Mapangidwe opitirira ndi mtundu wofulumira kwambiri wa suture, womwe umagwiritsidwa ntchito m'madera otsika kwambiri monga kutsekedwa kwa mitsempha ya thupi, zigawo za minofu, minofu ya adipose, ndi khungu, ndipo zimakhala zotsika mtengo kusiyana ndi zosokoneza.

Koma ngati chikoka molimba kwambiri, chilondacho chikhoza kuphulika. Ngati mbali ina ya chilondayo imasweka chifukwa cha kulephera kwa suture yopitirira, bala lonselo likhoza kukhudzidwa ndikutsegulanso motsatira kutalika kwake.

• Zochepera nthawi.
• Zochepa zasuture zipangizo.
• Zida zochepa za suture mkati mwa minofu.
• Kulephera kusamalira, ngati mfundo imodzi yatsetsereka, ilephera kapena kung'amba lonsechingwe cha suture chimamasulidwa.
• Zovutakuti mukhale ndi mwayi wokwanira wopambana.
• More chipseramapangidwe minofu.

C. Zitsanzo Zosankha

1. Suture Yosavuta Yosokoneza

• Kuluma kumatengedwasymmetricallyku amtunda wofananakuchokera mbali zonse za bala ndikukoka zolimba.
• Amfundoimayikidwa, ndipo zida za suture zimadulidwa musanabwereze njirayo mpaka bala litatsekedwa.
• Mtundu uwu wa suture ndi wothandiza kutseka kwa linea alba panthawi ya opaleshoni ya m'mimba kapena madera ena omwe amafunikira mphamvu zambiri.
• Zosavuta kugwiritsa ntchito.
• Otetezekakutsekedwa kwa anatomical.
• Amalola kusintha kwasuture mavuto.

Zogwiritsa

• Khungu, subcutaneous minofu, fascia, ziwiya, mitsempha, m'mimba ndi mkodzo thirakiti.

2. Zosavuta Zosokoneza Intradermal Suture

• Mozondoka mophweka kusokonezedwa kuti 'kwirira mfundo'.
• Izi zimayikidwa mu njira yosavuta yosokonezedwa pansi pa khungu ndipo kulumidwa kwa suture kumakhala molunjika mpaka kudulidwa.
• Azolowerakuchotsa malo akufandi kukuthetsa mikanganopa khungu sutures.
• Iwo ndi zothandiza kuchepetsa kusokoneza odwala ndi kutikuthetsa kufunika kochotsa suturem'malo ovuta.
• Njira iyi iyenera kugwiritsidwa ntchito limodzi ndi mfundo zokwiriridwa.
• Suture wonyezimirazinthu ziyenera kugwiritsidwa ntchito.

Zogwiritsa

• Kutsekedwa kwa intradermal kapena subcuticular.

3. Kusokoneza Cruciate (CrosiMwojambula)Suture

• An'X' mawonekedweamapangidwa pamwamba pa bala.
• Kuluma kumatengedwa kuchokera mbali imodzi, kupita ku ina, musanayambe kupita patsogolo8-10 mmkenako kubwereza kuchokera kumbali yoyambirira yoluma.
• Kenako mfundo imayikidwa kuti ilumikizane ndi nsonga za suture, pamwamba pa bala.
• Kuti izi zithekeogwira kwambiri, lalikulu liyenera kupangidwa ndi ngodya za suture.
• Suture iyi imagwiritsidwa ntchitokuchepetsa nkhawa.
• Wamphamvu komanso wachangukuposa zosavuta kusokoneza sutures, monga zambiri chilonda chatsekedwa ndi aliyense suture anayikidwa.
• Zimalepheretsaeversion.

Zogwiritsa

• Khungu.

4. Suture Yosavuta Yopitilira

• Malo a mfundo yoyamba.
• Kuluma0.5-1 cmkuchokera mbali zonse za bala.
• Kokani zida za suturezolimba kotero kuti m'mphepete mwa bala ndi appositional.
• Bwerezani suture patali pang'ono kuchokera koyamba; kuluma kuyenera kuyambira mbali imodzi nthawi zonse monga kuluma koyambirira mpaka chilonda chatsekedwa.
• Ikani mfundo kuti mutetezekutseka kwa chilonda.
• Mofulumira kuposa kusokoneza mkonomachitidwe.
• Imalimbikitsasuture economics.
• Amapereka zambirizoletsa mpweyakapenamadzimadzi-zolimbachisindikizo.
• Zambirizovutakusintha nyonga.
• Ikhoza kulephera kwathunthungati mfundoyo ndi yofooka kapena yosakwanira.

Zogwiritsa

• Khungu, subcutaneous minofu,fascia, m'mimba ndi mkodzo.

5. Suture ya Intradermal Yopitirirabe

• Winakusinthidwamwa azosavuta mosalekezandikusinthidwa yopingasa matiresi suture.
• The suture amadutsa yopingasa kupyola mu zigawo za dermis, kutenga kuluma alternating zilonda m'mphepete, ndipo khungu amakoka chatsekedwa popanda sutures kuonekera.
• Ichi ndi suture ya mphamvu yochepa choncho nthawi zambiri imagwiritsidwa ntchito m'madera omwe ali ndi vuto lochepa, komabe, mu bala lapamwamba kwambiri, sutures ya khungu ingagwiritsidwe ntchito kuwonjezera.
• Intradermal suturesamakhala omasuka kwa wodwalayo komanso amathandizira kupewa kusokoneza kwa odwala, amapewa kutsata matenda pabalalo ndipo pali zipsera zochepa.
• Imalimbikitsa chuma cha suture.
• Amaperekabwino khungu apposition.
• Zofooka kuposa ma sutures a khungu.
• Palibe sutures kuchotsa.

Zogwiritsa

• Kutsekedwa kwa intradermal kapena subcutaneous.

6. Ford Interlocking Suture (Reverdin – Blanket Stitch – Lock Stitch)

• Akusinthidwaa yosavuta mosalekeza suture.
• Tetezani zida za suture ndi mfundo.
• Kuluma kumatengedwa mbali iliyonse ya bala.
• Musanakoke mwamphamvu, zinthuzo zimadutsa pa lupu ndikusiya'L' mawonekedwe a suture.
• Bwerezani mpaka thebala latsekedwa.
• Izi zimapangabwino khungu appositionkuposa yosavuta mosalekeza suture.
• Zovuta kwambiri kuchotsa.

Zogwiritsa

• Khungu

7. Gambee Suture

• Akusinthidwa kosavuta kusokonezedwa, koma zovuta kugwiritsa ntchito.
• Imathandiza kulamuliramatenda a mucosal.
• Zochepatcheru kumatenda a bakiteriya.
• Izi ndisuture yapaderaamagwiritsidwa ntchito pokonza matumbo.
• AAdasinthidwa Gambeeimayikidwa mofanana koma sichimalowa m'matumbo a m'matumbo.

Zogwiritsa

• Anastomosis m'mimba.