Ukuhlinzwa kwePlastiki ukubuyisela iSmmetmetry
I-TRAM i-TRAM (i-rectus rectus abdominus myocutaneous) yindlela yokwenza i-tissue flap inkqubo esebenzisa imisipha, inqatha kunye nesikhumba esiswini sakho ukudala isilonda esitsha sesifuba emva kwe- mastectomy . Le nkqubo ithatha igama layo kwi-rectus rectus abdominus muscle kwisisu sakho. Kukho iindlela ezimbini zokwenza i-TRAM i-flap - njenge-free (efihliweyo) i-flap, kunye ne-pedicle (iqhotyoshelwe kunye ne-tunnel). Isifuba sakho esilungiswayo asiyi kukhangela kwaye sivakale ngokufana nesifuba sakho semvelo, kwaye uya kufuna udweliso olongezelelweyo ukudala ingono kunye ne-areola.
I-TRAM Flap Reconstruction
Ngexesha lokwakha kabusha i-TRAM, isikhumba, i-fat, kunye ne-muscle ziya kutshintshwa ukusuka kwisisu sakho ukuya esifubeni sakho, kwaye zisetyenziselwa ukwenza isilonda sesifuba. Uninzi lwabafazi banamathokwane okwaneleyo kwindawo yabo yesisu ukuze benze isifuba esitsha. Kodwa ukuba akukho zicubu ezaneleyo, ukufakwa okuncinci kunokufakwa kwindawo yokuzalisa ubuninzi besifuba esitsha. Izindlela ezimbini zisetyenziselwa ukuhambisa isisu sakho kwisisu sakho kwisifuba sakho-i-flap ezamahala and pedicle flap.
Izindlela zeHlap Free and Pedicle Flap
- I-Pedicle Flap - Le ndlela ayifuni ukusika i-flap yesikhumba, i-fat, imithana yegazi kunye ne-muscle mahala kwindawo yayo kwisisu sakho. I-pedicle flap iya kutshintshwa ngaphantsi kwesikhumba phantsi kwesikhumba sakho ukuya kwindawo yakho esifubeni.
- I-Flap Free - Ugqirha wakho uya kugawula icandelo lesikhumba, i-fat, imithana yegazi, kunye ne-muscle mahala kwindawo yalo kwisisu sakho. Eli candelo liya kuthunyelwa kwindawo yakho yesifuba kwaye uxhumeke kwi-blood supply yakho usebenzisa i-microsurgery (efana ne- DIEP flap procedure). Oku kuya kuthatha ixesha elide kuneenkqubo ze-pedicle flap, kodwa abaninzi oogqirha baziva ukuba kudala ubuninzi bemvelo yesifuba.
Izinzuzo ze-TRAM Flap
Isifuba se-TRAM esilungiswayo siya kuvakalelwa kakhulu njengengxube yendalo kumntu ochaphazelayo: Kuya kufudumala kwaye ithambile kuba iya kubakho ukujikeleza kakuhle kunye namafutha aneleyo ukutshiza kwaye ihambe njengengxama yakho yasekuqaleni. Ngenxa yokuba izicathulo zomzimba kunye neoli zifakwe kwisifuba sakho esitsha, uya kuba ne-tummy tuck, okubangele isisu esisisigxina.
Iingxaki ze-TRAM Flap
Isifuba sakho esitsha asiyi kuba nemvakalelo eninzi ngenxa yokuba isisindo esasisesiswini sakho sokuqala sisusiwe. Inkqubo ye-flap ye-TRAM idinga ixesha elongezelelweyo ekusebenzeni nasekuphumeni ngaphandle kokufaka ukubekwa. Ezinye izingozi zidibene ne-TRAM flap - i-hernia yesisu kunye nesisu esiswini (kuba isiscle esisekela isisu isuswe). Inkqubo ye-TRAM ye-flap inomlinganiselo we-5% wokungaphumeleli apho i-flap ingafa, kwaye iya kufuneka isuswe ngokupheleleyo. I-pedicle flap, engazange ikhutshwe kwi-blood supply yayo, akunakwenzeka ukuba iphumelele.
Awuyena Umviwa Ukuba:
- ungaphezu komzimba okanye ukhuluphele - unobungozi obukhulu besisu esiswini emva kwe-TRAM, kuba kunesifo esincinci ukuxhasa ubunzima bakho besisu
- Unqabile - awuyi kuba neelwimi ezisiswini esiswini
- utshaya - isanti sakho esiswini siya kuthatha ixesha elide ukuphulukisa, kwaye izicubu zakho ezinamafutha ziyakwazi ukukhula zibe ziisundu
Ukubuyiswa kwesisu ngoku okanye emva koko
Ukwakhiwa kwesisu kunokwenziwa ngexesha le- mastectomy okanye emva kwonyango. Ukuba udinga unyango lwe-radiation kwindawo engaphantsi kwesifuba okanye esifubeni, kufuneka ulibazise. Nangona kunjalo, kuyafaneleka ukulinda: Ukuba nenkqubo eyenziwe ngaphambi kokuba unyango luzalise kakhulu umda we-radiation of therapy of your treatment.
Ukuba ucinga ngokuphinda uhlaziywe, yinto efanelekileyo yokuthetha nomgulane wakho wegulana phambi kokuba ube ne-mastectomy. Oku kukunika ithuba lokuba nemilinganiselo kunye nemifanekiso ethathwe ngamabele akho angokwemvelo , ngoko isifuba sakho esilungiswayo singaphinda sivuselelwe ngokuchanekileyo ngokunokwenzeka. Igqirha lakho logqirha liya kukunika uluhlu lwezinketho, kwaye lunokukunceda ulondoloze ulusu kwaye ukhusele izikhala ezingadingekile ukuba uthe wadibana naye ngaphambili.
Yintoni enokuyilindela Ngethuba le-TRAM Flap Breast Reconstruction
Ngeke uphapheme ngexesha lakho le-mastectomy okanye u-reconstruction, ngoko uya kuba ne- sedation okanye i- anesthesia jikelele . Thetha ugqirha wakho kunye ne-anesthesiologist malunga nento eya kusebenza ngayo. Ukuba uye wahlinzwa phambi kwengxaki kunye neenkathazo nge-anesthesia, cela ukuba unokuthi ulandelelwe isicupunu. Ukuba une-mastectomy kunye nokuhlaziywa ngexesha elifanayo (ukuvuselelwa ngokukhawuleza), ugqirha wakho ogqithisileyo uya kuqala ukususa isifuba sakho, ekhuphe isikhumba esikhulu njengoko uya kukhuseleka ukugcina.
Ukulungele ukulungiswa kwesisu se-TRAM Flap
Umgqirha wakho weplastiki uya kusebenzisa ummakishi wesikhumba ukuze acwangcise ngokucophelela isicatshulwa esiza kubumba isikhumba sakho. I-ellipse ecacileyo iya kutsalwa kwisisu sakho, phezu kwe-rectus isisu sakho esiswini. Le ellipse iya kuba yesikhumba se-skin evala ingqalelo kwisifuba sakho esakhiwa ngokutsha. Xa ukufakwa kwefowuni kuvaliwe, kuya kuba ngumgca owela i-tummy yakho kwi-hip ukuya kwi-hip.
Ukuhambisa umsila kunye neSikhumba
Xa ukhankanya ulusu, ugqirha wakho weplastiki uza kwenza uhlalutyo, kwaye uphakamise isikhumba kunye ne-muscle flap. I-tunnel iya kudalwa ngaphantsi kwesikhumba sakho ukuze i-flap ishintshwe. Le ngqungquthela yamathambo iya kudlula kwi-tunnel ukuya kwi-mastectomy yakho incision. Phawula ukuba lo mzekeliso ubonisa ukugqithisa kwamahhala - ulusu, i-fat, imithana yegazi kunye ne-muscle liyekile.
Ukudala Isibeleko Esitsha
Isalathiso sesikhumba esisisu (esanyakanyanyiswe kwisistim) siya kubeka ukuze sigcwalise esikhumbeni esasilahlekile ngexesha lakho le-mastectomy. Ukuba unesipopu se-pedicle, ugqirha wakho wegulana uzakuvala ukuchaneka kwesikhumba ukwenza isifuba esitsha. Kwaye ukuba unesigqirha samahhala, ugqirha wakho uya kusebenzisa i-microsurgery ukuxhuma kwakhona imilambo yegazi kuqala, uze uvale ukuchithwa kwesikhumba.
Ukubuyisela kwi-TRAM Flap Breast Reconstruction
Unokudinga ukuhlala esibhedlele iintsuku ezi-4 ukuya kwezi-7 njengoko uqala ukuphulukiswa ukusuka ekuzalweni kwebele. Ukuba unomkhuhlane okhuphayo , uya kufunda ukukhupha loo nto kwaye ugcine iingxelo zomsindo wamanzi. Bika intlungu xa unayo nayiphi na into ukuze uphathwe. Musa ukubuyela ngqo emsebenzini - cwangciso malunga nokuthatha lula kwiiveki ezintathu ukuya kwezi-6 ukuze uphinde ufumane. Qiniseka ukuba nomntu ojikelezayo ukukunceda ukuqhuba kwaye wenze nayiphi na ukuphakamisa. Kwakhona, qiniseka ukuba uya kubaqeshwa bakho bokulandelelana ukuze ugqirha wakho angakwazi ukugcina iliso kwizinto ozibonayo kunye nokugqoka, kwaye ususe iimfudu zakho. Phawula ukuba lo mzekeliso ubonisa i-flame epheleleyo ye-TRAM kunye ne- inglone eyakhayo kunye ne-areola.
I-TRAM Flap ye-Double Mastectomy
I-flaam ye-TRAM ingasetyenziselwa ukuvuselelwa kwebele emva, okanye kunye, ne- double mastectomy . Kumele ube neesisisu ezaneleyo zesisu ngamabele amabini. Isalathisi sakho sekhanda siya kuhlulwa ngamacandelo amabini, kwaye isetyenziselwe ukuvala isicatshulwa ngasinye se-mastectomy. Le nkqubo ephindwe kabini ye-TRAM iya kuthatha kabini ixesha elide njenge-TRAM enye, kwaye ixesha lokubuyisela liya kuphinda liphindwe kabini. Unokuziva ubuthathaka kwaye ube nentlungu emva kweveki ezimbalwa emva koko.
Iingqalelo ezikhethekileyo malunga ne-TRAM Flap
- I-shot-shot shot - udokotela wakho ongagqirha angasusa isisu esiswini esisodwa kuphela. Ukuba ufuna enye yokwakhiwa kwebele, kuya kufuneka ukhethe indlela eyahlukileyo.
- Ubunzima beBikini - ubuhlungu bakho besisu kuya kuba bude. Ukuba awunxibe i-bikinis nantoni na, ayikho ingxaki. Kodwa ukuba awufuni isiqununu esivela kumlenze ukuze ufike kwi-tummy yakho, i-TRAM ayikho.
- Inkwenkwe yokuhamba - iqhosha lakho lomzimba lingasolula okanye lifuduswe ngaphandle kwesikhungo ngexesha le-TRAM. Ugqirha wakho unokukwazi ukudala inamba entsha kuwe.
- Uyabona kakuhle, uvakalelwa kakuhle - isifuba sakho esitsha siya kuziva ngathi yinto yangempela kumlingane wakho (ukufudumala, ukuguquguquka, ukuthambile) kodwa awuyi kuba neengcamango ezifanayo ukusuka kuyo. Amagulane anqunywe, ukuvakala kwengqondo ngokuqhelekileyo kuya kulahleka.
Imithombo
Fumana abaPhandili bePlastiki / iZakhiwo zoPhando kwiNgingqi yakho
Imithombo:
American Cancer Society. Ukubuyiswa kwesisu emva kweMastectomy. Iintlobo zeBreast Reconstruction. Ukuhlaziywa: 09/06/2007.
UDkt Susan Love Research Foundation. Ukwenziwa kwakhona kwesisu. Ukuhlaziywa: uEpreli 21, 2008.