Ukuhlinzwa Kwepulasitiki Ukubuyiselwa Kwama-Brem Symmetry
I-IGAP flap (i-inferior gluteal artery perforator) yindlela evulekile ye-tissue flap esebenzisa amafutha nesikhumba kusuka esitokisini sakho esingaphansi ukuze udale isilonda sesifuba esisha ngemuva kwe- mastectomy . Ayikho imisipha yakho ekhanyayo iyokwekwa noma idluliselwe ukuvuselelwa kwe-IGAP. Le nqubo ibizwa ngokuthi i-perforator ye-gluteal engaphansi kwe-buttock yakho engezansi. Isifuba sakho esakhiwe kabusha ngeke sibe nokubonakala okufanayo nokuzwela njengesifuba sakho semvelo, futhi uzodinga ukuhlinzwa okungeziwe ukudala ingono entsha kanye ne-areola .
Izindlela ze-IGAP ne-SGAP Flap
Ukuvuselelwa kwebele ye-IGAP kufana kakhulu nenqubo ye-SGAP, futhi ihluke ngendlela eyodwa kuphela: i-IGAP isebenzisa izicubu ezithathwe esitokisini sakho esingaphansi , i-SGAP isebenzisa izicubu ezisuka kumuntu wakho ophezulu . Zombili ziyi-reconstruct free flap zokusebenzisa i-microsurgery ukuxhuma kabusha i-artery kusuka ku-tissue flap endaweni yakho esifubeni ukuze udale isilonda sesifuba.
Abaningi besifazane banezicubu ezanele emadodeni abo ukuze benze isifuba esisha, kodwa uma kungekho izicubu ezanele, ukufakelwa okuncane kungasuswa ngemuva kwesibhamu sakho ukuze usize ukugcwalisa ubukhulu besifuba sakho esisha. Ukukhishwa kwesikhumba namafutha kusuka esitokisini sakho kufana nenqubo yokuphakama kwezimpahla kodwa kufaka umthambo kanye ne-vein ezoletha igazi emathisini afakwe.
Awuyena ozofaka isicelo se-IGAP uma:
- Uke waba nesibhamu esincane esincane se-buttock namafutha asusiwe
- uye waba ne-liposuction e-buttock yakho engezansi
- uyabhema - uketshezi lwakho lwama-buttock luzothatha isikhathi eside ukuphulukisa, futhi izicubu zakho ezinamafutha ziyakwazi ukukhula zibe izicubu ezinzima
Izinzuzo Nokungalungi
Izinzuzo
- ukukhetha okuhle uma ungenayo i-fat fat fat
- ukhetho oluhle kunoma ubani onesikhumba esanele namanoni esithombeni esingaphansi
- akukho misuli inqunywe noma ishukunywe, isheshe ukuphumula isikhathi
- ukuphakama kwamakhemikhali kubangelwa isikhumba se-gluteal nokususwa kwamafutha
- isilinganiso esingaphansi kwezingu-2%
I-Cons
- Iziphumo ezimbili, ngenxa yezingosi ezimbili zokuhlinzwa
- uma i-IGAP yakho ihluleka, i-flap ye-tishu ingafa futhi izosuswa ngokuphelele
- uma ukuvuselelwa kwakho kwehluleka, kufanele ulinde izinyanga ezingu-6 kuya kwezingu-12 ukuze uzame futhi
Okumele Ukulindele Ngesikhathi
Uzobe unedation noma i-anesthesia ejwayelekile ngesikhathi sakho se-mastectomy nokuvuselelwa. Udokotela wakho ohlinzayo we-plastic uzokusebenzisa uphawu lokukhumba ukuze uhlele ngokucophelela ukuchotshozwa okuzokwenza isikhumba sakho sikhumba. I-ellipse izokwehliswa ngaphesheya kwe-buttock yakho ephansi. Uma une-mastectomy nokuvuselelwa ngesikhathi esifanayo (ukuvuselelwa okusheshayo), udokotela wakho ohlinzayo uzosusa isifuba sakho, uvikele isikhumba esiningi njengoba kuyobe iphephile ukugcina.
Ukuhambisa amafutha, isikhumba, kanye negazi
Ukusebenzisa ukukhishwa kwesikhumba, udokotela wakho ohlinzayo uzokwenza ukuchotshozwa emthonjeni wakho ophansi, futhi uphakamise uhlaka lwesikhumba namanoni. Ngaphambi kokunqamula lesi sikhumba somzimba, uzosesha i-perforator engaphansi kwe-gluteal ne-vein ezokwenza ukuthi igazi lithembeke esifubeni sakho esisha. Lezi zingxube zegazi zizohanjiswa ngokucophelela kanye ne-flap yakho ye-tissue.
Ukuvala i-IGAP Flap Incision
Ukushiswa kwakho kwe-buttock kuzovaliwe futhi ukufakwa kwamanzi kungafakwa ukuze kukhuthazwe ukuphulukiswa nokuvimbela ukwakhiwa kwamanzi. Lokhu kuhlanganiswa ngeke kubonakale, ngoba kungenzeka kube phansi ngokwanele ukufihla emkhombeni wakho. Uzothola ukuphakanyiswa kwe-butt ngenxa yalesi sigaba senqubo.
Ukudala Isibeletho Sakho Esisha
I-flap yakho ye-tissue, ephelele ngemithambo yegazi, izothunyelwa endaweni yakho ye-mastectomy. Ukuze uqinisekise ukuthi izicubu ziyasinda endaweni yayo entsha, udokotela wakho ohlinzayo uzosebenzisa i-microsurgery ukufaka kabusha imithwalo yegazi emgqonyeni wezicubu emithanjeni yegazi esifubeni sakho. Isikhumba sakho namathishu amafutha abuye abuyele emgqeni wesifuba futhi aqhubekele endaweni. Ingqikithi yemvelo ye-buttock engezansi yenza ukuqhubeka kahle kwekhasi lesikhumba sakho sebele. Udokotela wakho ohlinzayo angasebenzisa amasu okumaketha emithanjeni yegazi, ukusiza abasebenzi basebhedlela ukuba baqaphe ukuphulukiswa kwabo njengoba usuphulukisa. Kufanele ulindele ukuthi ube nezikhukhula ezihlinzekwayo kulokhu kuhlanganiswa, futhi, ukusiza ngokuphulukisa.
Ukuvuselela kusukela ku-IGAP Flap Breast Reconstruction
Hlela ukugqoka izingubo ezingavamile, ezikhululekile kwamasonto ambalwa alandelayo. I-jeans ye-Tight phezu kwe-buttock incision nge-drain ngeke ikhululeke. Kumele uhlele ukuhlala esibhedlela izinsuku ezintathu noma ezine emva kwalokhu kuhlinzeka, futhi ulindele ukuthi unesihlengikazi sigcine inqubo yakho yokuphulukisa. Cishe ngesonto ngemuva kokuhlinzwa, uma i-buildup yakho ewuketshezi isinciphile kakhulu, ungase ukwazi ukukhipha izikhukhula zakho. Kuzodingeka uphumule amasonto amane kuya ayisithupha ngemva kwe-IGAP, ngakho qiniseka ukuthi othile uzoba khona ukushayela futhi akuphakamisele.
I-IGAP Flap ye-Double Mastectomy
Uma unesikhumba okwanele namafutha emabhokisini womabili ukudala amabele amabili amasha, ungaba nokwakha kabusha i-IGAP flap ngesikhathi esisodwa ngemuva kokuphindaphinda kabili . Uma usuvele unezicubu zomzimba ezisetshenziselwa ukuvuselelwa kwebele (i-SGAP flap) kumele ukhethe indlela ehlukile (DIEP, lat flap, noma ukufaka).
Ukucabangela okukhethekile
I-IGAP isebenzisa izicubu zomzimba ezinomdlavuza ofana nesifuba sesifuba sakho semvelo, odokotela abaningi base-plastic bacabanga ukuthi kubangelwa ukuvuselelwa kwesifuba esingcono kunenqubo ye-SGAP. I-IGAP flap yi-microsurgery, okudinga ukuqeqeshwa okubanzi, ikhono nesipiliyoni, ngaphezu kwezikhungo ezikhethekile esibhedlela sakho. I-sutures esetshenziselwa ukuxhuma kabusha imithwalo yegazi ingaba ububanzi obufanayo njengezintambo zezinwele zakho. Ithimba lakho lokuhlinzeka lizosebenzisa amathuluzi akhethekile ne-microscope ephakeme kakhulu ukwenza ingxenye ebaluleke kakhulu yale nqubo. Khetha udokotela ohlinzayo ngalesi sakhiwo ngokucophelela futhi ubuze imibuzo eningi uze uzizwe unesifiso ngesinqumo sakho.
> Imithombo:
> I-American Cancer Society. Ukwakhiwa Kwebele Isisu Ngemva Kwemastectomy. Izinhlobo ze-Breast Reconstruction. Kubuyekezwe: 09/06/2007.
> National Cancer Institute. Ukwelashwa Izinqumo Kwabesifazane abane-Cancer Stage Cancer Stage. Kuthunyelwe 10/22/2004.
> Ukuvuselelwa kwebele ne-gluteal artery perforator Iphutha likaJay W. Granzow, uJoshua L. Levine, u-Ernest S. Chiu, uRobert J. Allen Journal of Plastic, Reconstructive & Aesthetic Surgery - June 2006 (Umq. 59, Issue 6, Amakhasi 614-621 , I-DOI: 10.1016 / j.bjps.2006.01.005)