Uthini Isikhumba Sithengisa?
Ukufakelwa kwesikhumba ukufaka isikhumba esiphephile endaweni lapho isikhumba sonakalisiwe, silahlekile, noma sisuswe ngokuhlinzwa. Isikhumba esinempilo sivuna kusuka kusiza somnikelo (esibizwa nangokuthi indawo yomthombo) futhi sitshaliselwa kusayithi lomamukeli.
Obani Abadinga Isikhumba Sesikhumba?
Ukuqoqa isikhumba kwenziwa ukuze kuhlinzekelwe isivinini sokuzivikela nokugqugquzela ukuphulukiswa kwamagundane avulekile.
Ukulimala kungase kube ngenxa yokuhlukumezeka noma ukutheleleka, ukushisa, izilonda ze-varicose (varicose) , izilonda ezicindezelayo (i-bedsores), noma izilonda zesifo sikashukela ezingaphuluki ngendlela yokwelashwa okuvamile. Zivame futhi zenziwe njengengxenye yokuvuselelwa kwesifuba se-post-mastectomy nezinye ukuhlinzwa ukuze kususwe amangqamuzana anomdlavuza.
Uvelaphi Isikhumba?
I-graft yekhanda ephumelele kunazo zonke yilabo abasebenzisa isikhumba somguli. Ivunwa kusuka kwenye indawo yomzimba futhi ibizwa ngokuthi i-autograft. I-graft yekhanda nayo ingaphumelela uma ivunwa kusuka emaceleni afana nesiguli.
Uma umnikeli ohlukile engeyona i-twin efanayo, kunethuba elinamandla lomzimba owenqaba isikhumba esisha. Umzimba ubona njengomzimba ovela ngaphandle futhi uwuhlasela ngesistimu yomzimba. Kodwa-ke, ngisho noma isikhumba somnikeli sinqatshiwe, ukuhlanganiswa kungaphumelela ngokunikeza umzimba wesiguli isikhathi esanele nokuvikela ukukhulisa isikhumba esisha yedwa.
Imithombo yokufakelwa eminye isetshenziselwa ukusetshenziselwa okwesikhashana kuze kube yilapho isikhumba somlenze sikhula. Lezi zindlela zihlanganisa:
- Isikhumba esithathwe ku-cadaver (esibizwa nge-Allograft)
- Isikhumba esithathwe esilwaneni (esibizwa nge-Xenograft)
- Izicubu zomzimba
Njengoba i-autograft noma i-graft efakwe emawele amabili, udokotela wakho ohlinzayo uyoqapha lapho kunokwenzeka khona ukuvuna isikhumba somnikeli esivela engxenyeni yomzimba evame ukumbozwa izingubo.
Bazozama ukufanisa umbala wesikhumba nokuthungwa ngokuseduze ngangokunokwenzeka phakathi kwamasayithi nabamukeli. Ithanga langaphakathi namathanga ngamasayithi e-donor avame kakhulu. Ingalo engenhla, ingaphambili, emuva, nesisu kungenzeka isetshenziswe.
Izindlela Zokuqamba Ngesikhumba
Kunezinhlobo ezintathu eziyinhloko zezingcweti zesikhumba:
I-graft-thickness graft iyisimo esivame ukusetshenziswa kakhulu sokufakelwa kwesikhumba. Isusa kuphela i-epidermis (ungqimba ophezulu wesikhumba) kanye nengxenye ye-dermis (ungqimba ophakathi wesikhumba). Lokhu kuvumela ukuthi indawo yomthombo iphole ngokushesha. Kodwa-ke, lolu hlobo lokuhlanganiswa luyinkimbinkimbi futhi lungashiya isayithi lomnikeli nge-pigmentation engavamile (elula).
I-graft-thickness egcwele isusa i-epidermis, i-dermis, ne-hypodermis (ungqimba ophansi wesikhumba) ngokugcwele. Ngokuzenzekelayo, umphumela uvame ukuhamba kangcono, yingakho ama-graft esebenzayo ngokuvamile avunyelwe ubuso.
Ukusetshenziswa kwe-graft full thickness kuncane kakhulu. Zingafakwa kuphela ezindaweni zomzimba ezinemithambo yegazi ephawulekayo ukuqinisekisa ukusinda kwe-graft.
Ukuhlanganiswa okuhlanganisiwe kungabandakanya ukukhishwa kwesikhumba, amafutha, imisipha kanye ne-cartilage. Lezi zithombe ezivame ukusetshenziselwa ezindaweni ezidinga ukuvuselelwa kwezintathu ezintathu, njengempumu.
Izingozi nezinkinga ze-Grafts Grafts
Izingozi kanye nezinkinga ezingase zibe khona ze-graft zesikhumba zifaka:
- ukuphuma
- i-hematoma
- ukutheleleka
- ukulahlwa / ukulahlekelwa / ukufa kwe-graft
- imiphumela engabonakali yemiphumela yobuhle, njengokukhwabanisa, ukwephulwa kwesikhumba okungahambi kahle noma ukuguqulwa komzimba
- ukulahlekelwa noma ukuncipha kwesikhumba
- ukuzwela okukhulu; ubuhlungu obungapheli (okungavamile)
- izinkinga ze-anesthesia
Ukucubungula kwangaphambili
I-graft yekhanda ithwala izingozi ezincane ezinganeni ezincane noma ezingaphezu kweminyaka engama-60. Ababhemayo nalabo abanezifo ezingapheli nabo basengozini enkulu. Izingozi ziyanda kubantu abathwala imithi ethile njengezidakamizwa eziphakeme zegazi , imisipha yokuphumula, ne-insulin.
Indlela I-Graft Yesikhumba Eyenziwa Ngayo
- Inxeba isandulelwe ukuhlinzwa. Inxeba ihlanzwa futhi ilinganiswe. Khona-ke, iphethini ilandelwa ukudluliselwa kwisayithi lomnikelo.
- I-anesthesia ilawulwa. Kuye ngobukhulu, ubunzima, nendawo yelonda, kanye nohlobo lokufakelwa, inqubo ingadinga i- anesthesia yendawo , i-anesthesia yesifunda, i- sedation iv , i- anesthesia jikelele , noma inhlanganisela yalokhu.
- Isikhumba somnikeli sivunwa futhi silungisiwe. Isikhumba singasuswa nge-scalpel noma ngosizo lomshini okhethekile wokuvuna okuthiwa i-dermatome. Ukuhlanganiswa kungabuye kube "ukuhlushwa," inqubo lapho kuhlanganiswa okuningi okulawulwa khona ku-graft. Le nqubo ivumela uketshezi ukuthi kuphume kusuka ezicubu ezingaphansi futhi isikhumba somnikeli sibhekane nendawo enkulu kakhulu.
- Isayithi lomnikeli livaliwe. Nge-thickness noma ukuhlanganiswa okuhlanganisiwe, lokhu kwenziwa nge- sutures . Nge-greft-thickness graft, ama-sutures awadingeki kusayithi lomnikelo.
- Ukuhlanganiswa kufakwa kusayithi lomamukeli. Ngesinye isikhathi, i-graft ihlanganiswe nezicubu ezizungezile nge-sutures noma okuyisisekelo.
- I-bandage yokucindezelwa isetshenziselwa isayithi lomamukeli we-graft. I-apparatus ekhethekile yokugcoba okuthiwa i- VAC isilonda ingase ibekwe phezu kwendawo yokuqala kwezinsuku ezintathu kuya kwezingu-5 ukulawula amanzi futhi ukwandise amathuba okuba nesilondolozi sokusinda.
- Ukuphulukisa kuqala. Ekuqaleni, i-graft isebenzisa i-oksijeni nezakhi ezisuka kumathisimusi kwisayithi lomamukeli ukuze ziphile. Izitsha ezintsha zegazi ziqala ukukhula ngaphakathi kwamahora angu-36 okuqala, zilandelwa ngamaseli wesikhumba amasha aqala ukukhula kusukela ekufakeni ukuhlanganisa ukumboza indawo yomamukeli ngesikhumba esisha.
- Ukunakekelwa kwe-Post-Op: Kokubili amasayithi omnikeli nabamukeli kufanele agcinwe enomso futhi avikelwe kahle. Udokotela wakho uzokufundisa ngendlela efanele yokusebenzisa imithi nokubopha.
Imithombo:
> Rao K, et al. I-Thickness Skin Graft Cover ephelele yezingqinamba ezingezansi ezilandelayo. I-Dermatology Online Journal. 2008; 14 (2): 4
> Landau AG, i-Hudson DA, i-Adams K, i-Geldenhuys S, i-Pienaar C. i-Full-Thickness Skin Grafts: Ukwandisa ukuGraft Thatha Ukugqoka Ukucindezela Okungalungile Ukulungiselela I-Graft Bed. Ama-Annal of Surgery Plastic. 2008; 60 (6): 661-6.