Iipateni zeSuture eziqhelekileyo (3)
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.
E. Tension Sutures
1. Ukuphazamiseka kwe-Horizontal Mattress Suture
- Inaliti idluliselwa ukusuka kwelinye icala lenxeba ukuya kwelinye (2–5 mmkude nomgca wenxeba), emva koko ubuyele umva ngokuthe tye kwinxeba, ushiye umsantsa omfutshane (6–8 mm) phakathi kokulunywa.
- Oku kudala aumthungo othe tyemacala omabini enxeba.
- Iqhina ke libekwe ukudibanisa imathiriyeli yokuthunga kwicala lokuqala.
- Le sutureisetyenziswa kakhulu ukuthoba uxinzelelo.
- Ukulungelelaniswa kwipateni ye-everting suture ngokuxhomekeke kubunzima bokujula.
- Ngabaukukrwitsha igazi.
Ukusetyenziswa
- Ukuvalwa kwiindawo zoxinzelelo oluphezulu okanye ngamanye amaxesha kusetyenziswa ukuvalwa kweimisipha flatokanye isihlunu ngeiinqanawa ezincinci ze-fasciaemacaleni amanxeba.
2. I-Suture yeMatrasi eMisiweyo ephazamisekileyo
- Kuthathwe ukulunywa8–10 mmkude nenxeba kwaye udlulele kwi-umgama olinganayokude nenxeba kwelinye icala.
- Umthungo ke uphinda ubuyele umva kwinxeba, kodwa ngeli xesha, ukulunywa kuthathwa ngokuthe nkqo kwindawo yokuqala.3–4 mmkude nenxeba,ukwenza i-suture ethe nkqongapha nangapha.
- Iqhina ke libekwe ukudibanisa imathiriyeli yokuthunga kwicala lokuqala.
- Lo mthungo usebenza kakhulu ekudambiseni uxinezeleko kunomandlalo othe tye.
- Eyongezelelweyo kwi-everting.
- Omelele kwizicubu eziphantsi koxinzelelokunomandlalo othe tye.
- Kuncinci ukuvala iinqanawa ezincinci kumda wenxeba.
Ukusetyenziswa
- Ukuvalwa kwiindawo ezinoxinzelelo oluphezulu (okt ezinye iimeko zokuvalwa kwesikhumba).
3. Kude-Kude-Kufuphi-Kufuphi-Kufuphi-Kude-Kufuphi-Kufuphi-Kude-Kude-Kude-Kude iPhatheni yeSuture
- Ukwahluka komandlalo othe nkqo.
- Inokubonelela ngoxinzelelo oluyimfunekouqikelelo lwenxebangaphandle koxinzelelo oluthe ngqo kumda wenxeba.
Ukusetyenziswa
- Ulusu, i-subcutaneous, kunye nokuvalwa kwe-fascial phantsi koxinzelelo.
4. I-Interlocking Loop Suture
- Umthungo wokuziqinisa 'itshixa' kwithishu.
- Ifakiwe1/3 umgamaukusukaumphetho wethoni, iqhubele phambili ecaleni kwethenda, inqumle umsantsa, ijijelwe kwi-tendon, kwaye yadlula umva nge-1/3 ukusuka kwelinye icala, ibotshiwe kwaye ibotshelelwe.
- Imisipha encinci ene-tendon
- Ilophu yokutshixa kabini isetyenziswe kuyoi-gastrocnemius tendon
- Incanyathiselwe kwi-calcaneus ngokucokisekileyogqobhoza umngxuma
Ukusetyenziswa
- Ukulungiswa kwethenda.
5. Three Loop Pulley Suture
- Iilophu ezintathu ze-suture ezijolise120 degreeskwiluphu yangaphambili.
- Ifana nohlobo lwepateni ekufutshane kodwaijikeleza i-tendon 360º.
- Umjikelo wokuqala ngu akufuphi-kude,Okulandelayophakathi, yokugqibela ngukude-kufuphi.
- Amandla okuqina aphezulukunye nokuchasana ngakumbi ekubunjweni kwe-gap kune-loop yokutshixa
Ukusetyenziswa
- Ukulungiswa kwethenda.
F. Ezinye iipateni zeSuture
1. Ipateni ye-Suture Trap yaseTshayina
- Olu hlobo lwe-suture lusetyenziselwaimibhobho ekhuselekileyo(ezifana nesifuba) kwindawo yazo yokungena emzimbeni.
- Uxinzelelo kwityhubhuukwanda njengoko ityhubhu itsalwa, ngaloo ndlela ithintela ukususwa kwayo.
- Ukuluma kuthathwa kwelinye icala letyhubhu kwaye aiqhina lesikwereibekwe ngeenxa zonke kumbhobho.
- Iimpahla yomthungokuthathwa kwakhona kujikelezwe ityhubhu kwaye iqhina likagqirha wotyando libotshwe.
- Oku kuphindaphindwa amaxesha angama-5-10 malunga netyhubhu ephela kunye nelinye iqhina lesikwere.
Ukusetyenziswa
- Iityhubhu ezikhuselekileyo(ezifana nesifuba) kwindawo yazo yokungena emzimbeni
Naziiintlobo ezininzi zeepateni ze-sutureekhoyo ukuvala amanxeba kunye namanxeba afunyanwa imihla ngemihla ekusebenzeni.Kubalulekile ukukhetha uhlobo olufanelekileyo lwepateniukuphumeza hayi nje intsonkothileukupholisa amanxeba,kodwa kwakhona okulungileyoinkangeleko yezithambiso.