Umzuzwana ugqirha omile phezu kwesigulane ukuvala i-incision, isigqibo esibalulekileyo senzeke kwisibini esiqhekezayo. Asikokuvala nje umsantsa; imalunga nokukhetha isixhobo esigqibeleleyo sokuqinisekisa ukuba umzimba uphilisa ngokuchanekileyo. Ngelixa imigaqo ihlala iphoswa ngapha nangapha ngokukhululekileyo kwincoko, kwiingcali zonyango kunye nabaphathi beentengo, umahluko ubalulekile. Sithetha nge umthungo wotyando. Lo mcu omncinci wezinto eziphathekayo ligorha elingaqanjwanga legumbi lotyando. Ingaba lutyando olunzulu lwesisu okanye ukulungiswa okuncinci kwezithambiso ebusweni, i umthungo uphethe isitshixo sokubuyisela. Ukuqonda i uhlobo lomthungo, impahla yomthungo, kwaye nokuba kusetyenziswe into efunxayo okanye engafunxwanga ukhetho lubalulekile kwimpumelelo ukuvalwa kwenxeba.
Ngowuphi uMahluko wokwenyani phakathi kweSuture kunye nomthungo?
Kuyinto eqhelekileyo ukuva izigulane zibuza, "Zingaphi imithungo ndiyifumene?" Nangona kunjalo, kwihlabathi lezonyango, ukuchaneka kuyo yonke into. Kukho umahluko ocacileyo phakathi kwe-a umthungo kwaye a umthungo. I umthungo ngowona mzimba izinto ezisetyenzisiweyo—umsonto ngokwawo. Yeyona isixhobo sonyango esisetyenziswayo ukulungisa umonakalo. Kwelinye icala, i umthungo bubuchule okanye iluphu ethile eyenziwe yingcibi ukubamba izicubu kunye.
Yicinge njengokuthunga. I umthungo Ingaba i intambo kunye nenaliti, ngelixa i umthungo sisiluphu osibona elaphuni. A Ugqirha wonyango isebenzisa a umthungo ukwenza i umthungo. Xa isibhedlele si-odola iimpahla, bayathenga imithungo, hayi imithungo. Ukuqonda esi sigama kunceda ekukhetheni esichanekileyo impahla yomthungo Ngokobuthi Indawo yoNyango. Nokuba injongo kuku susa imithungo kamva okanye bavumele ukuba bachithe, inkqubo ihlala iqala ngomgangatho ophezulu umthungo ngokwayo.
Ukuhlalutya iSakhiwo: I-Monofilament vs. Braided Suture
Xa ujongisisa a umthungo, uya kuqaphela ukwakhiwa kwayo kuyahluka. Oku akuzenzekelanga; ulwakhiwo luchaza indlela i umthungo iphatha kwaye inxibelelane nayo izicubu. A i-monofilament suture yenziwe nge umsonto omnye yezinto eziphathekayo. Imizekelo ibandakanya nylon, polyproplene, kwaye polydioxanone (PDS). Eyona nto iluncedo a i-monofilament Ulwakhiwo kukuba lugudile. Iyadlula izicubu ngokutsalwa okuncinci kakhulu, okunciphisa ukusabela kwezicubu kunye nokwenzakala. Kuba ingumtya omnye ogudileyo, ayinazintanda zokubeka iibhaktheriya, ithoba kakhulu Umngcipheko wokosuleleka.
Ngokwahlukileyo koko, a umthungo ophothiweyo (okanye i-multifilament sutures) yenziwe ngemicu emincinane eliqela ephothiweyo, njengentambo encinane. Umthungo wesilika kwaye Vicryl yimizekelo eqhelekileyo. I ukuphotha yenza i umthungo bhetyebhetye kakhulu kwaye kulula ukuphatha ukwenzela i Ugqirha wonyango. Idala ukungqubana okugqwesileyo, okuthetha ukuba inakho ukhuseleko oluhle lweqhina-I iqhina ihlala ibotshelelwe ngokuqinileyo. Nangona kunjalo, i ukuphotha inokusebenza njengentambo, enokutsala ulwelo kunye neebhaktheriya enxebeni, yiyo loo nto i-monofilament idla ngokukhethwa kumanxeba angcolisekileyo. Ukhetho phakathi i-monofilament kwaye a umthungo ophothiweyo ihlala ihla kurhwebo phakathi kokuphatha lula kunye nomngcipheko wosulelo.
Ukwahlula Okukhulu: Ukufunxwa kunye ne-Non-Absorbable Sutures
Mhlawumbi ulwahlulo olubaluleke kakhulu kwi umthungo Iintlobo kukuba ngaba umzimba uyakuwophula. Iisutures ezifunxayo zenzelwe ukuba ziqhekeke ngaphakathi emzimbeni ngokuhamba kwexesha. Ngokuyintloko isetyenziswe ngaphakathi kuba inyama ethambileyo lungisa apho ungenakho ukubuyela emva ukuze uzisuse. Izinto ezifana ikati (impahla yendalo) okanye eyenziweyo ipoliglecapone kwaye polydioxanone zenzelwe ukwehlisa umgangatho nge-hydrolysis okanye i-enzymatic digestion. Ezi zinto zidla ngokubizwa ngokuba zizigulana imithungo enyibilikayo.
Ngokuchaseneyo, engafunxwanga iisutures zihlala emzimbeni ngokusisigxina okanye de zisuswe ngokwasemzimbeni. Inayiloni, polyproplene, kwaye i-silk suture iwela kolu didi. Ayinakufunxwa iisutures zisetyenziswa ngokuqhelekileyo ukuvalwa kwesikhumba apho i umthungo inokususwa xa inxeba liphola, okanye kwizihlunu zangaphakathi ezifuna inkxaso yexesha elide, njengaku sentliziyo utyando okanye umthambo ukulungisa. I umthungo isebenza njengesiseko senkxaso esisigxina. Ukukhetha phakathi iisutures ezifunxayo nezingenakufunxa kuxhomekeke ngokupheleleyo kwi indawo yenxeba kwaye ixesha elingakanani izicubu idinga inkxaso ukuze ibuyise amandla ayo.
Ukuntywila nzulu kwizinto zeNdalo kunye ne-Synthetic Suture Materials
Imbali ye umthungo inika umdla, isuka kwiintsinga zendalo ukuya kwiipolima eziphambili. Iisutures zenziwe ukusuka nokuba yendalo kunye neyokwenziwa imithombo. Ngokwendalo impahla yomthungo ibandakanya isilika, ilinen, kunye ikati (ithathwe kwi-submucosa yegusha okanye amathumbu enyama, etyebileyo icollagen). Ngelixa ikati ibingumgangatho weenkulungwane, izinto zendalo zihlala zixhokonxa phezulu ukusabela kwezicubu kuba umzimba uyazibona njengeeproteni zangaphandle.
Namhlanje, izinto zokwenziwa zikhethwa ngokubanzi. Ukwenziwa iisutures, ezifana nylon, polyester, kwaye polypropylene sutures, zenzelwe ukuqikelelwa. Babangela ubuncinci ukusabela kwezicubu kwaye ube namazinga okufunxa angaguqukiyo okanye amandla asisigxina. Ukwenziwa iinketho ezifana ipoliglecapone nikeza isiqalo esiphezulu amandla okuqina kwaye udlule izicubu ngokulula. Ngelixa a Ugqirha wonyango isenokusetyenziswa i-silk suture ngokuphathwa kwayo okugqwesileyo kunye iqhina ukhuseleko, umkhwa kumayeza anamhlanje utyekele kakhulu kuwo eyenziweyo iinketho zokuqinisekisa i umthungo yenza kanye njengoko kulindelekile ngaphandle kokubangela ukudumba okungeyomfuneko okanye ukudumba kwezicubu.
Ukuqonda amandla okuqina kunye noKhuseleko lwamaqhina
Iimpawu ezimbini ezibonakalayo zichaza ukuthembeka kwe-a umthungo: amandla okuqina kwaye iqhina lokhuseleko. Amandla okuqina libhekisa kubungakanani bobunzima okanye tsala umthungo inokumelana phambi kokuba iqhawuke. Phezulu amandla okuqina ibalulekile ekubambeni kunye izihlunu eziphantsi koxinzelelo, njenge esiswini ukuvalwa kodonga okanye indawo edibeneyo eguqukayo. Ukuba i umthungo ikhefu, inxeba liyavuleka, nto leyo ekhokelela kwiingxaki. Polypropylene kwaye polyester baziwa ngokugcina amandla abo ekuhambeni kwexesha.
Nangona kunjalo, eyomeleleyo umthungo ayinamsebenzi ukuba iqhina ukutyibilika. Ukhuseleko lweqhina bubuchule be impahla yomthungo ukubamba a iqhina ngaphandle kokuphazamiseka. Iintsimbi eziphothiweyo nikela ngokubanzi ukhuseleko olubalaseleyo lweqhina ngenxa yokuba ukuphotha inikeza ukukhuhlana. I-Monofilament sutures, ukuba mtyibilizi, kusenokuba mtyibilizi yaye kusenokwenzeka ukhuseleko amaqhina amahlwempu ukuba ayibotshwanga ngokujula okongeziweyo (iilophu). A Ugqirha wonyango kufuneka zilungelelanise ezi zinto. Umzekelo, nylon yomelele kodwa ifuna inyameko ubuchule bokusebenzisa ukuqinisekisa i iqhina uhlala ekhuselekile. Ukuba i iqhina iyasilela, i ukuvalwa iyasilela.
Ukukhetha inaliti eLungileyo kunye noMsonto woMsebenzi
A umthungo ayifane isetyenziswe ngaphandle kwe-a inaliti. Enyanisweni, kule mihla I-Sterle Suture ngenaliti ukupakishwa, i umthungo is swaged (incanyathiselwe) ngqo kwi inaliti. I inaliti kufuneka ikhethwe ngononophelo njengomsonto. Iinaliti ziza kwiimilo ezahlukahlukeneyo (ezigobileyo okanye ezithe nkqo) kunye namanqaku (afakwe kwi-tapered for soft izicubu, ukusika ulusu olunzima).
I ububanzi be-suture ikwabalulekile. Iisayizi zeSuture zichazwa ngu U.S.P. (United States Pharmacopeia) imigangatho, edla ngokuchazwa ngamanani afana no-2-0, 3-0, okanye 4-0. Okukhona lilikhulu inani eliphambi konothi, kokukhona lincipha kakhulu umthungo. A 6-0 umthungo ilungile kakhulu, isetyenziselwa zokuthambisa utyando ebusweni okanye isifo samehlo iinkqubo zokunciphisa i isikhafu. A 1-0 okanye 2-0 umthungo ingqindilili kwaye inzima, isetyenziselwa iindawo ezinoxinzelelo oluphezulu njenge esiswini ifascia. Ukusebenzisa ubukhulu umthungo kwindawo ethambileyo ukuqhawuka kungadala umonzakalo ngokungeyomfuneko, ngelixa kusetyenziswa obhityileyo umthungo kwisihlunu esinzima kunokukhokelela ekwaphukeni. I inaliti kwaye umthungo kufuneka isebenze ngokuhambelana ne izicubu.
Izicelo eziKhethekileyo: Ukusuka ekuValweni kweSisu ukuya kuLungiso lweZithambiso
Iimfuno ezahlukeneyo zonyango iintlobo ezahlukeneyo ze-sutures. Kwi sentliziyo utyando, polypropylene sutures zidla ngokuba ngumgangatho wegolide ngenxa yokuba zi-non-thrombogenic (zingabangeli amahlwili) kwaye zihlala ngonaphakade. Kweye esiswini utyando, apho i-fascia idinga ukubamba ngokuchasene noxinzelelo lokuphefumla kunye nokunyakaza, okunamandla, kancinci ukufunxa iluphu okanye isigxina engafunxwanga umthungo uyafuneka.
Ngaphakathi zokuthambisa utyando, injongo kukushiya kancinci ukuba akukho mkhondo. Apha, isohlwayo i-monofilament njenge nylon okanye ipoliglecapone i ihlala isetyenziswa kuba idala ngaphantsi ukusabela kwezicubu kwaye ngaloo ndlela incinci isikhafu. Kuba mucosal izicubu, njengangaphakathi emlonyeni, zifunxa ngokukhawuleza amathumbu okanye Vicryl ikhethwa ukuze isigulana singabuyi ukususwa komthungo. I-Sutures ibekwe ngobuchule esekelwe kwixesha impiliso ethile izicubu. A umthambo kuthatha iinyanga ukuba iphile, ngoko ifuna ixesha elide umthungo. Ulusu uphilisa ngeentsuku, ngoko ke umthungo inokususwa ngokukhawuleza.
Ubuchwephesha be-Suture Techniques: Okuqhubekayo vs. Ukuphazamiseka
I impahla yomthungo sisiqingatha kuphela senxaki; i ubuchule bokuthunga uqeshwe yi Ugqirha wonyango sesinye isiqingatha. Zikho umthungo ezahlukeneyo iipateni. A umthungo oqhubekayo (i-running stitch) iyakhawuleza ukubeka kwaye isasaze uxinzelelo ngokulinganayo kulo lonke ukuvalwa kwenxeba. Isebenzisa iqhekeza elinye impahla yomthungo. Nangona kunjalo, ukuba umsonto omnye uyaqhekeka nangaliphi na ixesha, wonke ukuvalwa ingenziwa.
Kungenjalo, iphazanyiswe iisutures zibandakanya Imithungo yomntu ngamnye, ngamnye wabotshelelwa ngomthungo owahlukileyo iqhina. Ukuba enye umthungo ikhefu, abanye bahlala bekhuselekile, ukugcina i ukuvalwa. Le ndlela yobugcisa ithatha ixesha elide kodwa inika ukhuseleko olukhulu. I ubuchule bokusebenzisa kuxhomekeke kubude bokusikwa kunye nomngcipheko wosulelo. Umzekelo, phambi kwe- ithumba okanye usulelo, i-sutures ephazamisekileyo ikhuselekile kuba ivumela ukukhutshwa kwamanzi ukuba kuyimfuneko. I Ugqirha wonyango ikhetha ubuchule obulungele iimfuno zoomatshini ze izicubu kunye nokhuseleko lomguli.
Inkqubo ebalulekileyo yokususwa kweSuture
Kuba engafunxwanga sutures, inkqubo iphela nge ukususwa komthungo. Ukwazi ukuba nini susa imithungo bubugcisa. Ukuba ishiywe ixesha elide, i umthungo inokushiya "umzila kaloliwe" amanxeba okanye ifakwe kwi ukudumba kwezicubu. Ukuba lisuswe kwangethuba kakhulu, inxeba linokuthi livuleke (livuleke).
Ngokubanzi, imithungo ebusweni zisuswe ngeentsuku ezi-3-5 ukuthintela ukonakala. Sutures entloko okanye esiqwini zingahlala iintsuku ezisi-7 ukuya kwezili-10, ngelixa ezo zikumalungu okanye amalungu zingahlala iintsuku ezili-14. Inkqubo ifuna i-stele isikere kunye neeforce. I iqhina iphakanyisiwe, i umthungo inqunyulwe kufuphi nesikhumba, kwaye itsalwe. Kubalulekile ukuba ungaze utsale into engcolileyo ngaphandle kwendawo umthungo ngokucoca ngaphakathi kwenxeba. Ngokufanelekileyo ukususwa komthungo iqinisekisa ukugqiba okucocekileyo, kwezithambiso ukuya utyando.
Kutheni kufunwa imiba ye-Suture echanekileyo kwizibhedlele
Kubathengi abagcina iishelufu, ukuqonda Iindidi ezahlukeneyo ye imithungo ngumcimbi wokhuseleko lwesigulane kunye nokusebenza kakuhle kwebhajethi. Isibhedlele asikwazi ukusebenza ngaphandle koluhlu lwezinto ezahlukeneyo. Uyayidinga ikati kwiwadi ye-OBGYN, inzima nylon ye-ER ukuqhawuka ukulungiswa, kwaye kulungile i-monofilament ukwenzela utyando lweplastiki.
Iisutures zisetyenziswa phantse kuwo onke amasebe ezonyango. Iintlobo ezahlukeneyo ze-sutures Sombulula iingxaki ezahlukeneyo. Ukusebenzisa a umthungo ophothiweyo kwinxeba elosulelekileyo kunokukhokelela kwiingxaki, kanye njengokusebenzisa obuthathaka umthungo kwinxeba elinoxinzelelo oluphezulu linokubangela ukugqabhuka. Nokuba kunjalo yendalo kunye neyokwenziwa, okanye iisutures ezifunxayo nezingenakufunxa, ukuhambelana komgangatho ngundoqo. Siqinisekisa ukuba wonke umntu umthungo sivelisa, ukusuka kwi inaliti ubukhali kwi amandla okuqina womsonto, udibana nemigangatho engqongqo. Kuba xa a umthungo ibekwe, inomsebenzi omnye: ukubamba yonke into kunye de umzimba uziphilise ngokwawo.
Iqhosha lezitshixo
- Umahluko uchaziwe: A umthungo yimathiriyeli (umsonto); a umthungo yiluphu/indlela yobuchule eyenziwe yi Ugqirha wonyango.
- Iintlobo zeMathiriyeli: I-Monofilament sutures (njenge nylon) zigudile kwaye zinciphisa umngcipheko wosulelo; iintambo eziphothiweyo (njenge i-silk suture) nikeza ukuphatha kakuhle kwaye iqhina lokhuseleko.
- Ukufunxwa: Iisutures ezifunxayo (njenge ikati okanye Vicryl) zinyibilike kwaye zisetyenziswe ngaphakathi; engafunxwanga iisutures (njenge polyproplene) kufuneka asuswe okanye anike inkxaso esisigxina.
- Ukusabela kwezicubu: Izinto zokwenziwa ngokubanzi kubangela ngaphantsi ukusabela kwezicubu kunye namabala xa kuthelekiswa Iintsinga zendalo.
- Amandla: Amandla okuqina imisela ukuba i umthungo unokubamba inxeba phantsi koxinzelelo; iqhina lokhuseleko iqinisekisa ukuba ihlala ibotshelelwe.
- Umzobo: Ubungakanani obulandelayo U.S.P. imigangatho; amanani aphezulu (umzekelo, 6-0) athetha iisutures ezibhityileyo zomsebenzi ocekethekileyo, ngelixa amanani asezantsi (umzekelo, 1-0) ngawe-heavy-duty ukuvalwa.
Ixesha lokuposa: Jan-16-2026