umkhiqizo

Ukuthuthukiswa kweubuchwepheshe obuhlekudinga ulwazi kanye nokuqonda kwemishini enengqondo ehilelekileukuthunga.

Lapho uthatha ukulunywa kwezicubu, inaliti kufanele iphushwe ngokusebenzisa i-aisenzo sesihlakala, uma kuba nzima ukudlula izicubu, inaliti engalungile ingase ikhethwe, noma inaliti ingase ibe buthuntu.

Ukushuba kweimpahla ye-suturekufanele igcinwe yonke indawo ukuze kuvinjelwe ama-slack sutures, futhi ibanga phakathi kwama-sutures kufanele lilingane.

Ukusetshenziswa kwento ethile iphethini ye-suturekungase kwehluke kuye ngendawo eshutshulwayo, ubude bokusikeka, ukungezwani emgqeni we-suture, kanye nesidingo esithilei-apposition, inversion,nomai-eversionkwezicubu.

Amaphethini we-Suturezingahlukaniswa kabanzi ngokuthiukuphazamiseka noma okuqhubekayo.

A. Amaphethini Aphazamisekile

Ukuthungatha okuphazamisekilezisetshenziselwa ukudambisa ukushuba, noma ezindaweni lapho kudingeka amandla engeziwe. Azikho ukonga njenge-aumthungo oqhubekayonjengoba aifindokufanele iboshwe ngemva kokubekwa kwe-suture ngakunye, kusetshenziswa i-suture material enkulu kakhulu. Uma enye ye-sutures ihluleka, lokhu ngeke kuthinte amanye ama-sutures abekwe enxebeni.

• Kuthatha isikhathi.
• Inani elikhulu lezinto ze-suture.
• Ukuba khona kwamanani engeziwe weizinto ze-suturengaphakathi kwezicubu.
• Ikhono lokugcinaamandla kanye nesimo sezicubuuma ingxenye yomugqa we-suture ihluleka noma izinyembezi.
• Nikeza umphetho onembe kakhudlwana emaphethelweni e-apposition.
• Izibazi ezincaneukwakheka esilondeni esipholile

B. Amaphethini Aqhubekayo

Amaphethini aqhubekayo awuhlobo olushesha kakhulu lwephethini ye-suture, esetshenziselwa izindawo zokungezwani okuphansi njengokuvalwa kwemigodi yomzimba, izendlalelo zemisipha, izicubu ze-adipose, nesikhumba, futhi ayonga kakhulu kunamaphethini aphazamisekile.

Nokho, uma sidonswa siqine kakhulu, isilonda singase siqhume. Uma noma iyiphi ingxenye yesilonda iphuka ngenxa yokwehluleka komthungo oqhubekayo, ingxenye esele yesilonda ingase ithinteke futhi iphinde ivuleke ngobude baso.

• Kudla isikhathi esincane.
• Amanani ambalwaizinto ze-suture.
• Izinto ezimbalwa ze-suture ngaphakathi kwethishu.
• Ayikwazi ukuligcina, uma ifindo elilodwa lishelela, lehluleka noma liklebhule lonkeumugqa we-suture uyaxebuka.
• Kunzimaukuze uthole ukwaziswa okwengeziwe ukuze uthole ukwaziswa okwengeziwe.
• Isibazi esengeziweukwakheka kwezicubu.

C. Amaphethini Akhethiwe

1. I-Suture Ephazamisekile Elula

• Kuthathwa ukulunywangokulinganisakweibanga elilinganayokusukela nhlangothi zombili zenxeba futhi wadonsa waqinisa.
• Aifindoibekwe, futhi i-suture material iyasikwa ngaphambi kokuphinda indlela kuze kube yilapho isilonda sivalwa.
• Lolu hlobo lwe-suture luwusizo ekuvaleni i-linea alba ngesikhathi sokuhlinzwa kwesisu noma ezinye izindawo ezidinga amandla engeziwe.
• Kulula ukufaka isicelo.
• Kuvikelekileukuvalwa kwe-anatomical.
• Ivumela ukulungiswa kwei-suture tension.

Ukusetshenziswa

• Isikhumba, izicubu ezingaphansi, i-fascia, imikhumbi, izinzwa, i-gastrointestinal kanye ne-urinary tract.

2. I-Intradermal Suture Elula Ephazamisekile

• Ukubheke phansi kulula kuphazanyiswe 'ngcwaba ifindo'.
• Lezi zibekwe ngephethini elula ephazamisekile ngaphansi kwesikhumba futhi ukulunywa kwe-suture kumile ku-incision.
• Sebejwayelesusa indawo efilefuthi kunciphisa ukungezwaniesikhumbeni se-sutures.
• Ziwusizo ukunciphisa ukuphazamiseka kwesiguli kanye nokuukuqeda isidingo sokususwa kwe-sutureezindaweni ezibucayi.
• Le phethini kufanele isetshenziswe ngokuhambisana ne(amafindo) engcwatshiwe.
• Umthungo obambekayoimpahla kufanele isetshenziswe.

Ukusetshenziswa

• Ukuvalwa kwe-Intradermal noma subcuticular.

3. Isiphambano Esiphazamisekile (CrosiMumlingisi)I-Suture

• An'X' umumokudalwe phezu kwesilonda.
• Ukuluma kuthathwa ukusuka kolunye uhlangothi, kudlulele kolunye, ngaphambi kokuqhubekela phambili8-10 mmbese uphinda ohlangothini lokuqala lokuluma.
• Ifindo libe selibekwa ukuhlanganisa iziphetho ze-suture, ngaphezulu kwesilonda.
• Ukuze kube njalongempumelelo kakhulu, isikwele kufanele sidalwe ngamakhona we-suture.
• Le suture isetshenziselwaukukhululeka kwengcindezi.
• Inamandla futhi iyasheshakunama-sutures aphazamisekile alula, njengoba isilonda esiningi sivaliwe nge-suture ngayinye ebekwe.
• Ivimbelai-eversion.

Ukusetshenziswa

• Isikhumba.

4. I-Suture Eqhubekayo Elula

• Beka i ifindo lokuqala.
• Thatha kancane0.5-1 cmkusukela nhlangothi zombili zesilonda.
• Donsa impahla ye-suturekuqinile ukuze imiphetho yenxeba ivumelane.
• Phinda i-suture ibanga elifushane ukusuka kweyokuqala; ukuluma kufanele kuqale ohlangothini olufanayo njalo lapho ukulunywa kwasekuqaleni kuze kube yilapho isilonda sesivaliwe.
• Faka ifindo ukuze uvikelekeukuvalwa kwesilonda.
• Ngokushesha kunokuthungatha okuphazamisekileamaphethini.
• Iyakhuthazaumnotho we-suture.
• Inikeza okwengeziweumoya-mpilonomauketshezi oluqinileuphawu.
• Okuninginzimaukulungisa ukushuba.
• Ingahluleka ngokupheleleuma ifindo libuthakathaka noma lingenele.

Ukusetshenziswa

• Isikhumba, izicubu ezingaphansi,i-fascia, umgudu wamathumbu kanye nomchamo.

5. I-Intradermal Suture Eqhubekayo

• Okunyeukuguqulwakwe aelula eqhubekayofuthimodified umatilasi umthungo ovundlile.
• I-suture idlula ngokuvundlile ezingxenyeni ze-dermis, ithatha i-bite kusuka emaphethelweni amanxeba ashintshanayo, futhi isikhumba sidonswa sivaliwe ngaphandle kwe-sutures ebonakalayo.
• Lokhu kuyi-suture yamandla aphansi ngakho-ke kuvame ukusetshenziswa ezindaweni ezinomfutho ophansi, noma kunjalo, esilondeni sokucindezeleka okuphezulu, ama-sutures esikhumba angasetshenziswa ngaphezu kwalokho.
• I-Intradermal sutureszikhululeke kakhudlwana esigulini futhi zisiza ukuvimbela ukugxambukela kwesiguli, zigwema ukulandelela ukutheleleka esilondeni futhi kunezibazi ezincane.
• Ithuthukisa umnotho we-suture.
• Ihlinzekaukufakwa kahle kwesikhumba.
• Ibuthakathaka kune-sutures yesikhumba.
• Awekho ama-sutures okufanele asuswe.

Ukusetshenziswa

• Ukuvalwa kwe-Intradermal noma ngaphansi kwesikhumba.

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

• Aukuguqulwawe-suture elula eqhubekayo.
• Vikela impahla ye-suture ngefindo.
• Kuthathwa ukulunywa ohlangothini ngalunye lwesilonda.
• Ngaphambi kokudonsa i-suture iqine, i-material ifakwa ku-loop kushiye i-Umthungo omise okwe-'L'.
• Phinda kuze kube yilaphoisilonda sivaliwe.
• Lokhu kudalaukufakwa okungcono kwesikhumbakune-suture elula eqhubekayo.
• Kunzima kakhulu ukususa.

Ukusetshenziswa

• Isikhumba

7. Gambee Suture

• Aukulungiswa okulula kuphazamisekile, kodwa kunzima kakhulu ukufaka isicelo.
• Isiza ukulawulaukuvuvukala kwe-mucosa.
• Ngaphansisengoziniukugoqa kwebhaktheriya.
• Lokhu yiumthungo okhethekileesetshenziswa ekulungiseni amathumbu.
• AI-Gambee eshintshiweibekwe ngendlela efanayo kodwa ayingeni kulume lwamathumbu.

Ukusetshenziswa

• I-anastomosis yamathumbu.