Iintlobo ze-Flaps kunye nendlela ezisetyenziselwa ngayo kwiNkqubo zoPhuculo zoKhenketho
I-flap isicande seetyhubhu esasanyathiselwe emzimbeni ngumthambo omkhulu kunye nesisu okanye kwisiseko sayo. Esi siqwenga seethambo kunye nokunikezelwa kwegazi okuxhotyoshelweyo kusetyenziselwa ukuhlinzwa ngokutsha ngokufakwa kwisayithi yomamkeli (indawo eyalimala apho i-flap okanye ukufakwa kwefayile ifakwe). Ngamanye amaxesha, i-flap iqulethwe yesikhumba kunye nezicubu ezinamafutha kuphela, kodwa i-flap ingabandakanya i-muscle kwisiza somnikeli (indawo apho i-flap iphakanyiswa khona).
Ngubani Ongadinga Ukunyangwa Kwe-Flap?
Ukuba ulahlekelwe yinyama yokulahleka phezu kwayo nayiphi na indawo yomzimba wakho, unokuba ngumviwa wokutyunjwa. Olu hlobo lotyando lweplastiki olwenziwa ngokutsha lusetyenziswa ngokutsha ukulungisa iimpembelelo ezishiywe emva kokulimala kabuhlungu okanye umonakalo . Iindlela zokugqithisa ziyakwazi ukuvelisa iziphumo ezintle ekubuyiseni ubuso phambi komhlaza wesikhumba.
Iintlobo zeFlaps
Kukho ezininzi iintlobo zeenkupho njengoko kukho iintlobo zokulimala ezingadinga ukusetyenziswa kwe-flap. I-Flaps ivela kwiindawo ezahlukeneyo kwaye isetyenziswe ngezindlela ezininzi ezahlukahlukeneyo ukuphumeza umphumo ofunwayo. Nangona kunjalo, amaqhosha asetyenziselwa ukuhlinzwa ngokutsha kweplastiki angaphulwa phantsi kwiindidi ezibini eziphambili.
Ummandla wendawo (i-Pedicled) I-Flap: Iishukela zikhululekile kwaye zijikelezwe ngenye indlela ukusuka kwindawo esondeleyo ukuze zifake i-defect, kodwa zihlala zihambelana nomzimba kwisiseko sayo kwaye zineemithwalo yegazi ezingena kwi-flap kwi-site yomnikeli.
Uhlobo lwe-flap movement olufunekayo lufuna ukuba yeyiphi na iindidi ezine eziphambili zentsimbi zangasese ezisetyenziswayo.
Iintlobo ezine eziphambili zeengqungquthela zendawo ziquka ukuqhubela phambili kwintsimbi (ihamba ngokuthe ngqo ngaphandle kokunyakaza), i- flap rotp (ijikeleza ngeenxa yokuphambanisa ukuba ibekwe kwisiphako esiseduze), isalathiso sokutshintsha (ihamba ngokukhawuleza ngokumalunga ne-pivot ingongoma ibekwe kwisiphako esisondeleyo) kunye ne- flap yolwimi .
I-flap yokubhaliweyo iyahluke kwabanye kuba ijikeleza ngeenxa yecala lokumisela libekwe kwindawo esondeleyo (kodwa engekho esecaleni). Isiphumo kukuba isahlulo seflepsi sidlula ngaphezulu okanye ngaphantsi kwecandelo lesicu esilungileyo, senza uhlobo lwe "bhuloho yesikhumba." Olu hlobo lwesiphakamiso lujoliswe ukuba lucwecwe (lwahlukileyo) ukusuka kwisiza somnikeli kwinkqubo elandelayo.
I-Flap yamahhala: Izishubhu ezisuka kwenye indawo yomzimba ziyahlanjululwa kwaye zitshintshelwe kwisayithi yomamkeli kwaye ukunikezelwa kwegazi kuxoxwa ngokugqithiseleyo kwimithambo yegazi ecaleni kwesilonda.
Iingozi ze-Flap kunye neengxaki
Iingxaki ezinokwenzeka ukususela kwi-flap ukuhlinzwa zibandakanya ubungozi obuninzi bokuphepha njengo:
- sulelo
- ukungabikho komzimba kunye / okanye ukukhutshwa kwesikhumba
- ukuphuma kwegazi okanye i- hematoma
- isikhumba okanye i-fat necrosis (ukufa kwesisu)
- ukuphulukiswa kwesilonda okanye ukuhlukana
- iifutha zegazi
- iingozi ze-anesthesia
- i-thrombosis enzulu
- iingxaki zomzimba kunye neepulmoni
- i-edema eqhubekayo (ukuvuvukala) okanye ukuqokelela kwamanzi
- intlungu eqhubekayo
- utshintsho kwisesigxina okanye unesigxina / ukulahleka kwentlungu
- iziphumo ezingenelisekiso zeziphumo zobuchule ezifuna ukuhlinzwa ngokutsha
- ukuphazamiseka okanye ukuphazamiseka kwe-expander
Biza udokotela wakho ogqithiseleyo ngokukhawuleza ukuba unentlungu yesifuba, ukuphefumula okufutshane, iintliziyo ezingavamile, ukuphuma kwegazi.
Kutheni Usebenzisa i-Flap Esikhundleni seGraft Graft ?
Ngenxa yokuba iiflegi zinegazi, zixhomekeke ngakumbi kunamabala ekhanda kwaye zivame ukuvelisa iziphumo ezingcono kumbono wezonyongiso kuba zinokunikela umgca ongcono ngetoni yesikhumba kunye nokubunjwa. Izikhumba zesikhumba nazo zikhethwa kakuhle xa izicubu "zininzi" zifunekayo ukuzalisa iziphene. Nangona kunjalo, kwiimeko apho kukho iindawo ezinkulu zokulahleka kwamathambo, ukusetyenziswa kwe-graft yolusu kunokufuneka.
Kutheni Usebenzisa I-Flap Esikhundleni Sokwandiswa Kwetyhu ?
Nangona ukwandiswa kwezicubu kunokuvelisa iziphumo eziphezulu ngokubhekiselele kumbala wesikhumba, ukubunjwa, kunye nokuvakalelwa, kunemiphumo.
Ukwandiswa kweTisue kufuna rhoqo, ubuncinane, iinkqubo ezimbini zokugqirha, kunye nokuhambela ngokuphindaphindiweyo ugqirha wakho ukuqhubela phambili ukukhupha i-expander. Okwangoku, i-expander ishiywe endaweni, ukudala into enokuthi iimeko ezininzi zingabonakali phantsi kwesikhumba apho i-expander ifakwa khona. Nangona kunjalo, kwimeko yokuvuselelwa kwebele , le vesi eyongezelelweyo ingaba yinqweneleka.
Jonga ngaphambi nangemva kwezithombe zokwakha emva komhlaza wesikhumba usebenzisa i-flap techniques .
Imithombo:
Iinqununu ezisisiseko zePlaps Flaps; UFisher J., uGeorgeide GS, iGeorgeide NG, uRiefkohl R, iBarwick WJ; Umbhalo wePlastiki, iMailillofacial, kunye noKuChungechunge lweZakhiwo. Umqulu 1, edition 2, ngo-1992, iphepha 29-40.
Udliwano-ndlebe neBhodi eqinisekisiweyo yePlastiki yobunjineli kunye noViwoyilo oQulunqisayo, uAndrew Jacono, MD, eNew York, NY.
I-Skincercer Skin kunye ne-Surgeon yakho yePlastiki, Iphepha leNgcaciso yeMonde, uMbutho waseMerika wezilwanyana zePlastiki.
I-Skin Flaps; Tschoi M, Hoy FA, Granick MS; Iikliniki zePlastiki yokuhlinzwa; 2005; UTshazimpuzi; Umqulu 32 (2), p261-273.