Yintoni I-Skin Skin Graft Ithengisa?
Uluhlu lwesikhumba lusetyenziso lwesikhumba sempilweni kwindawo apho ulusu lonakaliswe khona, lulahlekile, okanye lukhutshwe ngugqirha. Isikhumba esinempilo sivuna kwisayithi yomnikeli (esabizwa ngokuba ngumthombo wendawo) kwaye utshintshelwe kwisayithi yomamkeli.
Ngubani ofuna i-Graft Graft?
Ukuqulunqa isikhumba kwenziwa ukwenzela ukubonelela umqobo wokukhusela nokukhuthaza ukuphulukiswa kwamanxeba avulekileyo.
Ingozi inokuvela kwixinzelelo okanye isifo, ukutshisa, i- venic (varicose) izilonda , izilonda zogonyamelo (i-bedsores), okanye izilonda zesifo sikashukela ezingaphilanga ngonyango oluqhelekileyo. Kananjalo bavame ukuqhutshwa njengenxalenye yokuvuselelwa kwebele emva kwe-post-mastectomy kunye nezinye iindlela zokuhlinzwa ukuze zisuse amaseli anomhlaza.
Uphi Ikhumba Elivela Kulo?
Iibrafti eziphambili kakhulu zesikhumba ziqhelekileyo ezo zizisebenzisa isikhumba somzi. Kuvunwa kwenye indawo yomzimba kwaye kuthiwa yi-autograft. Iibrafu zesikhumba zingaphumelela xa zivunwa kwi-twin efanayo yesigulane.
Xa umnikeli ohlukeneyo engekho iwele elifanayo, kukho ithuba elinamandla lomzimba elinqabe isikhumba esitsha. Umzimba ubona njengowomzimba ongaphandle wamanye amazwe kwaye uhlaselele nge-immune system. Nangona kunjalo, nangona ukuba isikhumba somnikeli sinqatshelwe, ukuhlanganiswa kungaphumelela ngokunika umzimba isiguli ixesha elaneleyo kunye nokukhusela ukukhulisa isikhumba esitsha sisodwa.
Eminye imithombo yohlengahlengiso isetyenziselwa ukusetyenziswa kwexeshana kuze kube yilapho isikhumba somguli sikhula. Ezi ndlela ziquka:
- Isikhumba esithathwe kwi-cadaver (ebizwa ngokuba ngu-Allograft)
- Isikhumba esithathwe kwisilwanyana (esibizwa ngeXenograft)
- Iimpawu zesistim
Nge-autograft okanye i-graft ethathwe kwi-twins, ugqirha wakho uya kuzinyameka xa kunokwenzeka ukuvuna isikhumba somnikeli kwisinye somzimba esiqhelekileyo esityathwe yimpahla.
Baya kuzama ukufanisa umbala wesikhumba kunye nokuthungwa ngokukhawuleza kunokwenzeka phakathi kwabanikeli kunye neendawo zokufumana. Umlenze wangaphakathi kunye neentambo zizona ndawo zixhaphakileyo. Ingalo engaphezulu, iphambili, umva, nesisu zisenokusetyenziswa kwakhona.
Iingcingo zeGraft Techniques
Kukho iintlobo ezintathu eziphambili zeengcambu zesikhumba:
Uluhlu lwe-split-thickness lusetyenziso oluqhelekileyo olusetyenziswa ngokuqhelekileyo. Iyakususa kuphela i-epidermis (uluhlu oluphezulu lwesikhumba) kunye nenxalenye yederm (uluhlu oluphakathi lwesikhumba). Oku kuvumela ukuba indawo yomthombo iphilise ngokukhawuleza. Nangona kunjalo, olu hlobo lohlulo lubucayi kwaye luya kushiya indawo yomnikeli ongenqabile (ukukhanya) ukugqithisa.
Ulwahlulo olugcweleyo lususa i-epidermis, i-dermis, kunye ne-hypodermis (ubuncinci besikhumba) ngokubanzi. Ngokuziqhenya, isiphumo sisoloko singcono, oko kutheni i-graft-graft egcweleyo ixhaswa ngobuso.
Ukusetyenziswa kobugcisa obugcweleyo buncinane. Ziyakwazi kuphela ukufakwa kwiindawo zomzimba ezineempawu ezinkulu zegazi ukuqinisekisa ukugcinwa komnquba.
Ukuhlanganiswa okuhlanganisiweyo kunokubandakanya ukususwa kwesikhumba, i-fat, i-muscle ne-cartilage. Ezi ngqungquthela ziqhelekileyo zisetyenziswe kwiindawo ezifuna ukuhlaziywa kwamathathu, njengempumlo.
Iingozi kunye neengxaki zePrafts Grafts
Izingozi kunye neengxaki ezinokubakho kwesikhumba kubandakanya:
- kuphuma
- hematoma
- sulelo
- ukulahlwa / ukulahlekelwa / ukufa kwegraft
- iziphumo ezingabonakaliyo zeempawu zobuchule, ezifana nokutshatyalaliswa, ukungafaki kwesikhumba okanye ukungabonakali
- ukulahleka okanye ukunciphisa kwintlungu
- ukwandiswa kwemvakalelo; ubuhlungu obungapheliyo (ngokungafaneki)
- iingozi ze-anesthesia
Ukuqwalasela kwangaphambili
Iibrafti zesikhumba zithwala ingozi kwiintsana eziselula okanye abantu abangaphezu kweminyaka engama-60. Ababhemayo kunye nalabo abanezifo ezingapheliyo basengozini enkulu. Ubungozi buya kubantu abathatha amachiza athile afana ne- high blood pressure drugs , i-muscle relaxants, kunye ne-insulin.
Indlela i-Graft Graft eyenziwe ngayo
- Inxeba isetyenziselwa ukuhlinzwa. Isilonda sihlambulukile kwaye silinganiswe. Emva koko, umzekelo ulandelwa ukuthunyelwa kwisiza somnikeli.
- I-Anesthesia ilawulwa. Ngokuxhomekeka kubukhulu, ubunzima, kunye nendawo yesilonda, kunye nohlobo lokuxhoma, inkqubo inokufuna i- anesthesia yendawo, i-anesthesia yendawo, i- sedation ye-iv , i- anesthesia jikelele , okanye ukudibana kwezi zinto.
- Isikhumba somni sivunwa kwaye silungiselelwe. Ulusu luyakususwa nge-scalpel okanye ngoncedo lomshishini okhethekileyo ovuna ngokuthi i-dermatome. Igraft ingabuye ibe "i-meshed," inqubo apho ukufakwa kwezinto ezininzi ezilawulwayo kufakwa kwi-graft. Le nqubo ivumela ukuba amanzi aphule avela kwimizimba engaphantsi kwaye isikhumba somnikeli sisasaze kwiindawo ezinkulu.
- Isayithi lomnikeli livalwe. Ngobuninzi obunamandla okanye udidi lokuhlanganiswa, oku kwenziwa nge- sutures . Nge-graft-thickness graft, i-sutures ayifuni kwisayithi lomnikeli.
- Uluhlu lubekwe kwisayithi yomamkeli. Ngesinye indawo, i-graft ixhomekeke kuma-tissue azungezile nge-sutures okanye kwi-staples.
- I-bandage yoxinzelelo isetyenziselwa kwisayithi yommkeli womgcini. Isixhobo esicacileyo sokucoca esibizwa ngokuthi i- VAC isilonda sinokubekwa phezu kwendawo yokuqala kwiintsuku ezintathu ukuya kwezi-5 ukulawula umjelo kunye nokwandisa amathuba omnquba wokusinda.
- Ukuphilisa kuqala. Ekuqaleni, i-graft isebenzisa i-oksijeni kunye nezondlo ezivela kwisitishi kwindawo yokufumana iindawo zokuhlala. Imitsha emitsha yegazi iqala ukukhula ngaphakathi kweeyure ezingama-36 zokuqala, ilandelwa ngamaseli ephulo omtsha aqala ukukhula ukusuka kwi-graft ukufihla indawo yommkeli ngesikhumba esitsha.
- Ukunakekelwa kwePost-Op: Bobabini abaxhasi kunye nabamkeli beendawo kufuneka bagcinwe ngobumanzi kwaye bavikeleke kakuhle. Ugqirha wakho uya kukufundisa ngokusetyenziswa okufanelekileyo kweyeza kunye nokubambisa.
Imithombo:
> Rao K, et al. Ukukhupha okupheleleyo kwesikhumba se-Graft Cover Cover for Lower Limb Defects Ukulandela ukuxutywa kwezilonda ezinqabileyo. Dermatology Journal Online. 2008; 14 (2): 4
> Landau AG, i-Hudson DA, i-Adams K, i-Geldenhuys S, i-Pienaar C. i-Full-Thickness ye-Graft Grafts: Ukukhuphula i-graft Ukuthatha iingubo zokunyusa ukunyanzela ukulungisa i-Graft Bed. Iingxelo zePlastic Surgery. 2008; 60 (6): 661-6.