Mugihe umuganga ubaga ahagaze hejuru yumurwayi kugirango afunge igikomere, icyemezo gikomeye kibaho mumasegonda abiri. Ntabwo ari ukuziba icyuho gusa; ni bijyanye no guhitamo igikoresho cyiza kugirango umubiri ukire neza. Mugihe amagambo akunze kuzunguruka mubiganiro, kubashinzwe ubuvuzi nabashinzwe gutanga amasoko, itandukaniro ni ngombwa. Turimo tuvuga kuri kubaga. Agace gato k'ibikoresho nintwari itavuzwe mucyumba cyo gukoreramo. Niba ari kubaga mu nda cyane cyangwa kwisiga bito byo mumaso, the suture ifite urufunguzo rwo gukira. Gusobanukirwa ubwoko bwa suture, the ibikoresho bya suture, kandi niba ugomba gukoresha ibintu byoroshye cyangwa idashobora gukururwa amahitamo ni ngombwa kugirango utsinde gufunga ibikomere.
Ni irihe tandukaniro nyaryo riri hagati yo kudoda no kudoda?
Birasanzwe kumva abarwayi babaza, "Bangahe ubudozi nabonye? " Ariko, mwisi yubuvuzi, ubunyangamugayo nibintu byose. Hariho itandukaniro ritandukanye hagati ya a suture na a ubudozi. The suture ni Ifatika ibikoresho byakoreshejwe-Umutwe ubwawo. Ni ibikoresho by'ubuvuzi byakoreshejwe gusana ibikomere. Ku rundi ruhande ,. ubudozi ni tekinike cyangwa loop yihariye yakozwe nabaganga kugirango bafate tissue hamwe.
Tekereza nko kudoda. Uwiteka suture ni umugozi n'urushinge, mu gihe i ubudozi ni umuzingo ubona ku mwenda. A. kubaga ikoresha a suture kurema a ubudozi. Iyo ibitaro byategetse ibikoresho, baragura suture, ntabwo ubudozi. Gusobanukirwa n'iri jambo bifasha muguhitamo neza ibikoresho bya suture Kuri Urubuga rwo kubaga. Niba intego ari kura ubudozi nyuma cyangwa bakareka bagashonga, inzira ihora itangirana nubwiza buhanitse suture ubwayo.
Gusesengura Imiterere: Monofilament na Suture Braide
Iyo urebye neza a suture, uzabona ubwubatsi bwayo butandukanye. Ntabwo ari impanuka; imiterere itegeka uko suture ikora kandi ikorana na tissue. A monofilament suture ni a umugozi umwe y'ibikoresho. Ingero zirimo nylon, PolyproPylene, na polydioxanone (PDS). Inyungu nyamukuru ya a monofilament imiterere ni uko yoroshye. Iranyura tissue hamwe no gukurura gake cyane, bigabanya reaction reaction n'ihahamuka. Kuberako ari umugozi umwe woroshye, ntigira aho uhurira na bagiteri, igabanya cyane ibyago byo kwandura.
Ibinyuranye, a suture (cyangwa suture nyinshi) igizwe n'imigozi mito mito ihujwe hamwe, nkumugozi muto. Suture na Vicryl ni ingero rusange. Uwiteka braid i suture byinshi byoroshye kandi byoroshye kubyitwaramo kuri kubaga. Irema ubushyamirane buhebuje, bivuze ko ifite umutekano mwiza- ipfundo guma guma. Ariko braid Irashobora gukora nka wick, ishobora gushushanya amazi na bagiteri mu gikomere, niyo mpamvu monofilament ni byiza cyane kubikomere byanduye. Guhitamo hagati monofilament na a suture akenshi biza mubucuruzi hagati yo gukemura ibibazo byoroshye no kwandura.
Igabana Rikomeye: Absorbable vs Non-Absorbable Sutures
Ahari ibyingenzi byingenzi mubyiciro suture ubwoko ni ukumenya niba umubiri uzabimena. Absorbable suture byashizweho kugirango bisenyuke mumubiri mugihe runaka. Ni mbere na mbere ikoreshwa imbere kuri imyenda yoroshye gusana aho udashobora gusubira inyuma kugirango ubikureho. Ibikoresho nka catgut (ibintu bisanzwe) cyangwa synthique poliglecaprone na polydioxanone zakozwe muburyo bwo gutesha agaciro binyuze muri hydrolysis cyangwa igogorwa ryimisemburo. Ibi nibyo abarwayi bakunze kwita kudoda gushonga.
Ibinyuranye, idashobora gukururwa suture iguma mumubiri burundu cyangwa kugeza ikuweho kumubiri. Nylon, PolyproPylene, na suture shyira muri iki cyiciro. Ntibishobora suture isanzwe ikoreshwa kuri gufunga uruhu aho suture irashobora gukurwaho igikomere kimaze gukira, cyangwa kubice byimbere bikeneye inkunga yigihe kirekire, nko muri umutima kubaga cyangwa tendon gusana. Uwiteka suture ikora nkinzego zifatika zihoraho. Guhitamo hagati suture kandi idashobora gukururwa Biterwa na aho igikomere kiri Igihe kingana iki tissue akeneye inkunga kugirango agarure imbaraga.
Kwibira Byimbitse Mubikoresho bisanzwe na sintetike
Amateka ya suture irashimishije, igenda iva mumibiri karemano igera kuri polymers yateye imbere. Amashusho arakorwa Kuva karemano na sintetike Inkomoko. Kamere ibikoresho bya suture ikubiyemo silk, imyenda, na catgut (bikomoka kuri subucosa y'intama cyangwa amara y'inka, akungahaye kolagen). Mugihe catgut cyari gisanzwe mu binyejana byinshi, ibikoresho karemano akenshi bitera hejuru reaction reaction kuko umubiri ubamenya nka proteine zamahanga.
Uyu munsi, ibikoresho bya sintetike Bikunzwe cyane. Synthetic suture, nka nylon, polyester, na polipropilene suture, byakozwe muburyo bwo guhanura. Bitera bike reaction reaction kandi bifite igipimo gihoraho cyo kwinjiza cyangwa imbaraga zihoraho. Synthetic amahitamo nka poliglecaprone tanga intangiriro imbaraga hanyuma unyure tissue byoroshye. Mugihe a kubaga irashobora gukoresha suture kubikorwa byayo byiza kandi ipfundo umutekano, inzira yubuvuzi bugezweho yegamiye cyane sintetike Amahitamo Kuri suture ikora neza nkuko byari byitezwe idateye gutwika bitari ngombwa cyangwa kubyimba.
Sobanukirwa n'imbaraga za Tensile n'umutekano w'ipfundo
Ibintu bibiri bifatika bisobanura kwizerwa kwa a suture: imbaraga na umutekano w ipfundo. Imbaraga bivuga ingano yuburemere cyangwa gukurura suture Irashobora kwihanganira mbere yuko ivunika. Hejuru imbaraga ni ingenzi mu gufata hamwe imyenda iri munsi yubusa, nka an inda gufunga urukuta cyangwa agace gahuriweho. Niba suture kumeneka, igikomere kirakinguka, biganisha ku ngorane. Polypropilene na polyester bazwiho gukomeza imbaraga zabo mugihe.
Ariko, umunyembaraga suture ni ubusa niba i ipfundo kunyerera. Umutekano ni ubushobozi bwa ibikoresho bya suture gufata a ipfundo bitabaye ibyo. Amashanyarazi muri rusange umutekano mwiza kubera ko braid itanga ubushyamirane. Monofilament suture, kuba neza, birashobora kunyerera kandi birashobora kugira umutekano muke niba bidahujwe nibindi byongeweho (loop). A. kubaga igomba guhuza ibyo bintu. Kurugero, nylon irakomeye ariko bisaba kwitonda tekinike yo gukoresha Kuri ipfundo gumana umutekano. Niba ipfundo birananirana ,. gufunga birananirana.
Guhitamo Urushinge Rwiza ninsanganyamatsiko kumurimo
A suture ni gake ikoreshwa nta a inshinge. Mubyukuri, muri iki gihe sterile suture hamwe nurushinge gupakira ,. suture ni swage (yometse) kuri inshinge. The inshinge bigomba guhitamo neza nkurudodo. Inshinge ziza muburyo butandukanye (bugoramye cyangwa bugororotse) hamwe ningingo (zapanze byoroshye tissue, gukata uruhu rukomeye).
The diameter ya suture ni ngombwa. Ingano Bisobanuwe na Amerika. (Reta zunzubumwe za Amerika Pharmacopeia), mubisanzwe bigaragazwa numubare nka 2-0, 3-0, cyangwa 4-0. Umubare munini mbere ya zeru, inanutse ya suture. A 6-0 suture ni byiza cyane, bikoreshwa kuri kwisiga kubaga mu maso cyangwa amaso uburyo bwo kugabanya inkovu. A 1-0 cyangwa 2-0 suture ni umubyimba kandi uremereye, ukoreshwa ahantu hahanamye cyane nka inda fasia. Gukoresha umubyimba suture ku buryo bworoshye Ibara byatera ihahamuka ridakenewe, mugihe ukoresheje inanutse suture kumitsi iremereye byaviramo gucika. Uwiteka inshinge na suture igomba gukora ihuje na tissue.
Porogaramu zihariye: Kuva mu gifunga cyo munda kugeza kwisiga
Ibice bitandukanye byubuvuzi birasaba ubwoko butandukanye bwa suture. Muri umutima kubaga, polipropilene suture akenshi nibisanzwe bya zahabu kuko ntabwo ari trombogenic (ntutere akajagari) kandi biramba ubuziraherezo. Kuri an inda kubaga, aho fassiya ikeneye kwihanganira umuvuduko wo guhumeka no kugenda, bikomeye, buhoro byoroshye loop cyangwa ihoraho idashobora gukururwa suture irakenewe.
In kwisiga kubaga, intego ni ugusiga bike ntakigaragara. Hano, ihazabu monofilament nka nylon cyangwa poliglecaprone ni bikunze gukoreshwa kuko irema bike reaction reaction bityo bikaba bito inkovu. Kuri mucosal imyenda, nko mumunwa, kwihuta cyane amara cyangwa Vicryl irahitamo kugirango umurwayi atagomba gusubirayo gukuramo suture. Hashyizweho ibishishwa ingamba zishingiye ku gihe cyo gukiza cyihariye tissue. A tendon bifata amezi kugirango ukire, bityo bikenera kuramba suture. Uruhu ikiza mu minsi, bityo suture irashobora gukurwaho vuba.
Kumenya ubuhanga bwa Suture: Gukomeza v
The ibikoresho bya suture ni kimwe cya kabiri gusa; i tekinike ikoreshwa na kubaga ni ikindi gice. Hariho suture zitandukanye ingero. A. suture (kwiruka kudoda) byihuse gushira no gukwirakwiza impagarara zingana zose gufunga ibikomere. Ikoresha igice kimwe cya ibikoresho bya suture. Ariko, niba uwo mugozi umwe ucitse kumwanya uwariwo wose, yose gufunga Birashobora gukurwaho.
Ubundi, byahagaritswe suture igizwe yubudozi bwa buri muntu, buriwese uhambiriye ukundi ipfundo. Niba umwe ubudozi kumeneka, abandi bakomeza kuba ntamakemwa, bakomeza gufunga. Ubu buhanga butwara igihe kirekire ariko butanga umutekano mwinshi. Uwiteka tekinike yo gukoresha biterwa n'uburebure bw'igisebe n'ingaruka zo kwandura. Kurugero, imbere ya an ibibyimba cyangwa kwandura, suture zahagaritswe zifite umutekano kuko zemerera amazi nibiba ngombwa. Uwiteka kubaga hitamo tekinike ijyanye neza nubukanishi bukenewe bwa tissue n'umutekano w'umurwayi.
Inzira y'ingenzi yo gukuraho Suture
Kuri idashobora gukururwa kudoda, inzira irangira hamwe gukuramo suture. Kumenya igihe kura ubudozi ni ubuhanzi. Niba hasigaye igihe kirekire, i suture Irashobora gusiga "inzira ya gari ya moshi" cyangwa igashyirwa muri kubyimba. Niba ikuweho hakiri kare, igikomere gishobora dehisc (gufungura).
Muri rusange, suture mumaso bakurwaho muminsi 3-5 kugirango birinde inkovu. Amashusho ku mutwe cyangwa ku gihimba gishobora kumara iminsi 7-10, mugihe abari ku ngingo cyangwa ingingo bashobora kuguma iminsi 14. Inzira irasaba sterile imikasi n'imbaraga. Uwiteka ipfundo yazamuwe, i suture yaciwe hafi y'uruhu, kandi akururwa. Ni ngombwa kutigera ukurura hanze yanduye igice cya suture unyuze imbere mu gikomere. Birakwiye gukuramo suture iremeza isuku, kwisiga kurangiza kuri kubaga.
Kuberiki Gushakisha Ibikoresho Byukuri Byibikoresho byibitaro
Kubaguzi babika amasahani, gusobanukirwa Ubwoko butandukanye ya suture ni ikibazo cyumutekano wumurwayi no gukora neza ingengo yimari. Ibitaro ntibishobora gukora bidafite ibarura ritandukanye. Ukeneye catgut kuri ward ya OBGYN, iremereye nylon kuri ER Ibara gusana, kandi neza monofilament kubaga plastique.
Amashanyarazi arakoreshwa hafi ya buri shami ry'ubuvuzi. Ubwoko butandukanye bwa suture gukemura ibibazo bitandukanye. Gukoresha a suture ku gikomere cyanduye gishobora gutera ibibazo, kimwe no gukoresha intege nke suture ku gikomere cyinshi gishobora gutera guturika. Niba aribyo karemano na sintetike, cyangwa suture kandi idashobora gukururwa, ubuziranenge buhoraho ni urufunguzo. Turemeza ko buri suture dukora, guhera i inshinge ubukana kuri imbaraga y'urudodo, yujuje amahame akomeye. Kuberako iyo a suture ishyizwe, ifite akazi kamwe: gufata byose hamwe kugeza umubiri ukize.
ABAFATANYIJE
- Itandukaniro ryasobanuwe: A suture ni ibikoresho (urudodo); a ubudozi ni loop / tekinike yakozwe na kubaga.
- Ubwoko bw'ibikoresho: Monofilament suture (nka nylon) byoroshye kandi bigabanya ibyago byo kwandura; suture (nka suture) gutanga uburyo bwiza kandi umutekano w ipfundo.
- Absorbability: Absorbable suture (nka catgut cyangwa Vicryl) gushonga kandi bikoreshwa imbere; idashobora gukururwa suture (nka PolyproPylene) bigomba kuvaho cyangwa gutanga inkunga ihoraho.
- Imyitwarire y'inyama: Ibikoresho bya sintetike muri rusange bitera bike reaction reaction n'inkovu ugereranije fibre karemano.
- Imbaraga: Imbaraga Kugena niba i suture irashobora gufata igikomere munsi yuburakari; umutekano w ipfundo yemeza ko ikomeza guhambirwa.
- Ingano: Ingano ikurikira Amerika. ibipimo; umubare munini (urugero, 6-0) bisobanura suture yoroheje kubikorwa byoroshye, mugihe imibare yo hasi (urugero, 1-0) ni iyinshingano ziremereye gufunga.
Igihe cyo kohereza: Mutarama-16-2026