imveliso

Uphuhliso lweubuchule obuhleifuna ulwazi kunye nokuqonda ubuchwephesha obunengqondo obubandakanyekayoukuthunga.

Xa uthatha i-tissue, inaliti kufuneka ityhale ngokusebenzisa kuphela aisenzo sesihlahla, ukuba kuba nzima ukudlula kwi-tissue, inaliti engalunganga inokuthi ikhethwe, okanye inaliti inokuba buthuntu.

Uxinzelelo lweimpahla yomthungokufuneka igcinwe yonke indawo ukukhusela i-slack sutures, kwaye umgama phakathi kweesutures kufuneka ulingane.

Ukusetyenziswa kwento ethile ipateni yomthungoinokwahluka ngokuxhomekeke kwindawo ethuthiweyo, ubude bokusikwa, ukutsaleka kumgca we-suture, kunye nemfuno ethilei-apposition, inversion,okanyeeversionkwezicubu.

Iipateni zeSutureingahlelwa ngokubanzi njengeuphazamisekile okanye uqhubekile.

A. Iipateni eziphazamisekileyo

Imithungo ephazamisekileyozisetyenziselwa ukunciphisa uxinzelelo, okanye kwiindawo apho kufuneka amandla angaphezulu. Azikho njengezoqoqosho njengeumthungo oqhubekayonjengeiqhinakufuneka ibotshelelwe emva kokubekwa komthungo ngakunye, kusetyenziswa imathiriyeli eninzi ye-suture. Ukuba enye ye-sutures iyasilela, oku akuyi kuchaphazela yonke i-sutures ebekwe kwisilonda.

• Itya ixesha.
• Izixa ezikhulu zezinto ze-suture.
• Ubukho bemali eyongezelelweyoizinto zokuthungangaphakathi kwethishu.
• Ukukwazi ukugcinaamandla kunye nendawo yezicubuukuba inxalenye yomgca we-suture ayiphumelelanga okanye iinyembezi.
• Ukubonelela ngomphetho ochaneke ngakumbi kumda we-apposition.
• Izihlunu ezincinciukwakheka kwinxeba eliphilileyo

B. Iipateni eziqhubekayo

Iipateni eziqhubekayo luhlobo olukhawulezayo lwepateni ye-suture, esetyenziselwa iindawo zoxinzelelo oluphantsi njengokuvalwa kwemigodi yomzimba, i-muscle layers, izicubu ze-adipose, kunye nesikhumba, kwaye zinoqoqosho ngaphezu kweepatheni eziphazamisekileyo.

Ukuba utsalwe ngokuqinileyo kakhulu, nangona kunjalo, inxeba linokuthi liphuke. Ukuba nayiphi na indawo yesilonda iyaphuka ngenxa yokusilela kwe-suture eqhubekayo, inxeba eliseleyo lingachaphazeleka kwaye livuleke kwakhona ngobude balo.

• Ixesha elincinci lidla.
• Izixa ezimbalwa zeizinto zokuthunga.
• Izinto ezincinci ze-suture ngaphakathi kwethishu.
• Ukungakwazi ukugcina, ukuba iqhina elinye liyatyibilika, lingaphumeleli okanye likrazule lonkeumgca we-suture uyakhululeka.
• Kunzimaukufumana umphetho ochanekileyo ukuya kumda wesicelo.
• Isiva ngakumbiukwakheka kwezicubu.

C. Iipateni zokumisela

1. I-Suture elula ephazamisekileyo

• Kuthathwe ukulunywangokulinganayokwiumgama olinganayoukusuka macala omabini enxeba kwaye utsalwe ngokuqinileyo.
• Aiqhinaibekwe, kwaye i-suture material iyasikwa ngaphambi kokuphindaphinda indlela de inxeba livalwe.
• Olu hlobo lwe-suture luluncedo ekuvaleni i-linea alba ngexesha lotyando lwesisu okanye ezinye iindawo ezifuna amandla amaninzi.
• Kulula ukufaka isicelo.
• Khuselaukuvalwa kwe-anatomical.
• Ivumela uhlengahlengiso lweuxinzelelo lwe-suture.

Ukusetyenziswa

• Ulusu, izicubu eziphantsi kwesikhumba, i-fascia, iinqanawa, imithambo-luvo, i-gastrointestinal kunye ne-urinary tract.

2. I-Suture ye-Intradermal ephazamisayo elula

• Ujonge phantsi uphazamisekilengcwaba iqhina'.
• Ezi zifakwe kwipateni elula ephazamisekile ngaphantsi kwesikhumba kwaye ukulunywa kwe-suture kulala ngokuthe nkqo kwi-incision.
• Baqhelileukususa indawo efileyokwaye kuukunciphisa uxinzelelokwi sutures ulusu.
• Ziluncedo ukunciphisa ukuphazamiseka kwesigulane kunye nokuukuphelisa imfuno yokususwa kwe-suturekwiindawo ezibuthathaka.
• Le pateni kufuneka isetyenziswe kunye ne(amaqhina) engcwatyiweyo.
• Umthungo obambekayokufuneka kusetyenziswe imathiriyeli.

Ukusetyenziswa

• Ukuvalwa kwe-Intradermal okanye i-subcuticular.

3. Ukuphazanyiswa kwe-Cruciate (CirosMumlingisi)Suture

• An'X' imiloidalwe phezu kwenxeba.
• Ukulunywa kuthathwa ukusuka kwelinye icala, kudlulele kwelinye, ngaphambi kokuba uqhubele phambili8–10 mmemva koko uphinda kwicala lokuqala lokuluma.
• Iqhina ke ngoko lifakwa ukudibanisa iziphelo ze-suture, ngaphezulu kwenxeba.
• Ukuze le suture ibeeyona isebenzayo, isikwere kufuneka senziwe ngeekona ze-suture.
• Le suture isetyenziselwaisiqabu soxinzelelo.
• Inamandla kwaye ikhawulezakunokuba i-sutures elula yaphazamiseka, njengoko inxeba elingaphezulu livaliwe kunye nomthungo ngamnye obekwe.
• Iyanqandaeversion.

Ukusetyenziswa

• Ulusu.

4. Simple Continuous Suture

• Beka i iqhina lokuqala.
• Thatha kancinci0.5-1 cmukusuka macala omabini enxeba.
• Tsala imathiriyeli ye-sutureiqinile ngoko imiphetho yenxeba ichasene.
• Phinda i-suture kumgama omfutshane ukusuka ekuqaleni; ukuluma kufuneka kuqale kwicala elinye ngexesha ngalinye njengoko ukulunywa kwasekuqaleni de inxeba livaliwe.
• Beka iqhina ukukhusela iukuvalwa kwenxeba.
• Ngokukhawuleza kunokuphazamiseka kwe-sutureiipateni.
• Iyanyusauqoqosho lwe-suture.
• Ibonelela ngakumbiumoya-moyaokanyei-fluid-tightitywina.
• Kaninzinzimaukulungisa uxinzelelo.
• Inokusilela ngokupheleleyoukuba iqhina libuthathaka okanye alinelanga.

Ukusetyenziswa

• Ulusu, izicubu ezingaphantsi,ifascia, i-gastrointestinal kunye ne-urinary tract.

5. I-Intradermal Suture eqhubekayo

• Enyeukuguqulwakwe aelula eqhubekayokwayeumthungo othe tye umatrasi olungisiweyo.
• I-suture idlula ngokuthe tye kwimigangatho ye-dermis, ithatha i-bite ukusuka kumaphethelo amanxeba, kwaye ulusu lutsalwa luvaliwe kwaye lungabonakali i-sutures.
• Le yi-suture yamandla aphantsi ngoko idla ngokusetyenziswa kwiindawo ezinoxinzelelo oluphantsi, nangona kunjalo, kwinxeba eliphezulu loxinzelelo, i-sutures yesikhumba ingasetyenziselwa ukongezwa.
• I-Intradermal sutureszikhululekile ngakumbi kwisigulana kwaye zinceda ukuthintela ukuphazamiseka kwesigulana, ziyakuphepha ukulandela umkhondo wosulelo enxebeni kwaye kukho amanxeba amancinci.
• Ikhuthaza uqoqosho lwe-suture.
• Uyabonelelaulusu olulungileyo.
• Ibuthathaka kune-sutures yesikhumba.
• Akukho sutures ukususa.

Ukusetyenziswa

• Ukuvalwa kwe-Intradermal okanye i-subcutaneous.

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

• Aukuguqulwaye-suture elula eqhubekayo.
• Khusela izinto ze-suture ngeqhina.
• Ukulunywa kuthathwa kwicala ngalinye lenxeba.
• Phambi kokuba utsale i-suture ngokuqinileyo, i-material ithungelwa nge-loop ishiya i'L' umthungo omile.
• Phinda kwakhona de iinxeba livaliwe.
• Ezi zidalangcono isikhumba appositionkune-suture elula eqhubekayo.
• Kunzima ngakumbi ukususa.

Ukusetyenziswa

• Ulusu

7. Gambee Suture

• Auhlengahlengiso olulula luphazamisekile, kodwa kunzima ngakumbi ukufaka isicelo.
• Inceda ukulawulaisifo se-mucosal.
• Ngaphantsiesichengeniibhaktheriya 'ukutshatyalaliswa.
• Oku yiumthungo okhethekileyoesetyenziselwa ukulungiswa kwamathumbu.
• AIGambee elungisiweyoibekwe ngendlela efanayo kodwa ayingeni kwilumen yamathumbu.

Ukusetyenziswa

• I-anastomosis yamathumbu.