Ukuhlinzwa Kweplastiki Ukubuyisela Ukulinganisa
I-TRAM i-TRAM (i-transverse rectus abdominus myocutaneous) inqubo ye-tissue flap esebenzisa imisipha, amafutha nesikhumba esiswini sakho ukuze udale isilonda sesifuba esisha ngemuva kwe- mastectomy . Le nqubo ithatha igama layo kusukela emzimbeni we-rectus abdominus muscle yakho. Kunezindlela ezimbili zokwenza i-TRAM flap - njenge-flap ye-tishu yamahhala (evaliwe), futhi njenge-pedicle (ehlanganisiwe ne-tunneled) ye-tissue flap. Isifuba sakho esakhiwe kabusha ngeke sibonakale sizwe ngendlela efanayo nesifuba sakho semvelo, futhi uzodinga ukuhlinzekwa okungeziwe ukudala ingono kanye ne-areola.
Ukwakhiwa kabusha kwe-TRAM Flap
Ngesikhathi sokuvuselela kabusha kwe-TRAM, isikhumba, amafutha, nesisipha kuzosuswa kusuka emathunjini kuze kube esifubeni sakho, futhi zisetshenziselwa ukwakha isigundane sebele. Iningi labesifazane banezicubu ezanele endaweni yabo yesisu ukuze benze isifuba esisha. Kodwa uma kungekho izicubu ezanele, ukufakelwa okuncane kungabekwa ukugcwalisa ubukhulu besifuba esisha. Izindlela ezimbili zisetshenziselwa ukuhambisa izicubu zakho kusuka kwesisu sakho esifubeni sakho - i-flap yamahhala ne-pedicle flap.
Izindlela zamahhala nama-Pedicle Flap
- I-Pedicle Flap - Le ndlela ayidingi ukusika isikhumba, amafutha, imithwalo yegazi, kanye nemisipha mahhala endaweni yayo esiswini sakho. I-pedicle flap izodluliselwa emhubheni ngaphansi kwesikhumba sakho kuze kube sesikhumulweni sakho.
- I-Flap yamahhala - Udokotela wakho ohlinzayo uzosika ingxenye yesikhumba, amafutha, imithwalo yegazi, kanye nemisipha mahhala endaweni yayo esiswini sakho. Lesi sigaba sizosuswa endaweni yakho esifubeni bese sixhunyaniswa nokunikezwa kwegazi usebenzisa i-microsurgery (efana nenqubo ye- DIEP ). Lokhu kuzothatha isikhathi esiningi kunendlela yokwenza i-pedicle flap, kodwa odokotela abaningi abahlinzayo bazizwa ukuthi kudala ukuma kwesifuba esingokwemvelo.
Izinzuzo ze-TRAM Flap
Isifuba esakhiwe kabusha se-TRAM sizozwa kakhulu njengesifuba esingokwemvelo kunoma ubani othinta wena: Kuzofudumala futhi kuthole ngoba kuyoba nokusabalalisa okuhle namafutha okwanele ukugcoba nokuhamba njengesifuba sakho sokuqala. Ngoba imisipha yamathumbu namanoni afakwa esitheni sakho esisha, uzoba nesisu, okwenza kube nesisu esiswini.
Izinkinga ze-TRAM Flap
Isifuba sakho esisha ngeke sibe nesisindo esikhulu ngoba izinzwa ezazisesiswini sakho sokuqala zisusiwe. Inqubo ye-flap ye-TRAM idinga isikhathi esengeziwe ekuhlinzekeni nasekutholeni kunokufakela ukubekwa. Ezinye izingozi zihlobene ne-TRAM flap - i-hernia yesisu nesisu esiswini (ngoba imisipha esekela isisu isuswe). Inqubo ye-flap ye-TRAM inesilinganiso se-5% sokuhluleka lapho kwenzeka khona i-flap ingafa, futhi izosuswa ngokuphelele. I-pedicle flap, engakaze ixhumeke ekunikezeni igazi layo, cishe ayikwazi ukuhluleka.
Awuyena Umbuzo Uma:
- ukhuluphele kakhulu noma ukhuluphele - usengozini enkulu ye- hernia yesisu emva kwe-TRAM, ngoba kunesisipha esincane ukusekela isisindo sakho se-tummy
- unomzimba omncane kakhulu - awunaso izicubu ezanele zesisu
- uyabhema - isihlungu sakho esiswini sithatha isikhathi eside ukuphulukisa, futhi izicubu zakho ezinamafutha zikwazi ukukhula zibe izicubu ezinzima
Ukuvuselelwa Kwebele Kamuva Manje noma Kamuva
Ukwakhiwa kwesisu kungenziwa ngesikhathi sokugula noma ngemuva kokwelashwa. Uma udinga ukwelashwa kwama-radiation endaweni engaphansi kwegazi noma esifubeni, kufanele ubambezele. Kodwa-ke, kufanelekile ukulinda: Ukuba nenqubo eyenziwe ngaphambi kokuba ukwelashwa kuqedile kakhulu kunqanda ikhono lochwepheshe be-radiation ukukuphatha ngendlela efanele.
Uma ucabanga ngomsebenzi wokwakha kabusha, kuwumqondo omuhle ukukhuluma nodokotela wakho wokuhlinza ngaphambi kokuba unesifo sokushaya umzimba. Lokhu kukunika ithuba lokuba nezilinganiso nezithombe ezithathwe ngamabele akho angokwemvelo , ngakho isifuba sakho esakhiwe kabusha singabuyiselwa kabusha ngokunembile ngangokunokwenzeka. Udokotela wakho ohlinzayo we-plastic uzokunikeza uhla lwezinketho, futhi angasiza ukugcina isikhumba nokuvimbela izibazi ezingadingekile uma uxoxisana naye kusengaphambili.
Yini Ongayilindela Ngesikhathi I-TRAM Flap Breast Reconstruction
Ngeke uphapheme ngesikhathi se-mastectomy yakho noma kabusha, ngakho-ke uzoba nesilation esiswini noma i- anesthesia ejwayelekile . Khuluma nodokotela wakho wokuhlinza nomuntu onesi-anesthesiologist mayelana nokuthi yini ezosebenza kangcono kuwe. Uma uke wahlinzwa ngenkinga ngaphambili nangenkinga nge-anesthesia, buza ukuthi ungakwazi yini ukulandelwa isicashu. Uma une-mastectomy kanye nokuvuselelwa ngesikhathi esifanayo (ukuvuselelwa ngokushesha), udokotela wakho ohlinzayo uzosusa kuqala isifuba sakho, uvikele isikhumba esiningi njengoba uzophepha ukugcina.
Ukulungela ukulungiswa kwebele le-TRAM Flap
Udokotela wakho ohlinzayo we-plastic uzokusebenzisa uphawu lokukhumba ukuze uhlele ngokucophelela ukuchotshozwa okuzokwenza isikhumba sakho sikhumba. I-ellipse ekhonjisiwe iyokweluleka esiswini sakho, phezu kwe-rectus abdominus muscle yakho. Le ellipse iyoba isikhumba sesikhumba esivala ukufakwa kwesifuba sakho esakhiwe kabusha. Uma ukufakwa kwe-flap kuvaliwe, kuyoba umugqa owela umama wakho kusuka ku-hip ukuya ku-hip.
Ukuhambisa ama-muscle ne-Skin
Emaketheni esikhumba, udokotela wakho ohlinzayo we-plastiki uzokwenza ukuchotshozwa, futhi akhuphukise isikhumba nesifipha semisipha. Umhubhe uzokwenziwa ngaphansi kwesikhumba sakho ukuze i-flap ingasuswa. Lesi sikhumba senyama siyodabula umhubhe ukuya ekucutsheni kwakho kwe-mastectomy. Phawula ukuthi lo mfanekiso ubonisa ukugqashula kwamahhala - isikhumba, amafutha, imithwalo yegazi kanye nemisipha sekunqunywe.
Ukudala Isibeletho Sakho Esisha
Isikhumba sesikhumba esiswini (namanje sinamathele emisipha) sizobekwa khona ukuze sigcwalise esikhumbeni esasilahlekile ngesikhathi se-mastectomy yakho. Uma une-flap pedicle, udokotela wakho ohlinzayo we-plastiki uzovala ukuchotshozwa kwesikhumba ukwenza isifuba esisha. Futhi uma une-flap yamahhala, udokotela wakho ohlinzayo uzosebenzisa i-microsurgery ukuxhuma kabusha izitsha zegazi kuqala, bese uvala ukucutshungulwa kwesikhumba.
Ukubuyisela kusuka ku-TRAM Flap Breast Reconstruction
Kungase kudingeke uhlale esibhedlela izinsuku ezingu-4 kuya kwezingu-7 lapho uqala ukuphulukiswa ekuhlinzekeni kokuvuselelwa kwebele. Uma unezikhukhula ezihlinzekwayo , uzofunda ukuthi ungaluthola kanjani futhi ugcine amarekhodi wevolumu yamanzi. Bika ubuhlungu uma unayo ukuze ilashwe. Ungabuyeli emuva emsebenzini - clela ngokuthatha kalula amaviki amathathu kuya kwangu-6 ukuze ululame. Qinisekisa ukuba nomuntu ozungezile ukukusiza ukukushayela futhi enze noma yikuphi ukuphakamisa. Futhi, qiniseka ukuthi uya kuma-aphoyintimenti wakho wokulandelela ukuze udokotela wakho ohlinzayo angabheka amehlo akho nokugqoka, futhi ususe izikhukhula zakho. Qaphela ukuthi lo mfanekiso ubonisa i-TRAM yokugcwalisa i-flap ne-napple reconstructed andola.
I-TRAM Flap ye-Double Mastectomy
I-flaam ye-TRAM ingasetshenziselwa ukuvuselelwa kwebele ngemva, noma, nge- mastectomy kabili . Kumele ube nezicubu ezanele zomzimba zamabele amabili. Isikhumba sakho sesikhumba sangasese sizohlukaniswa ngama-halves amabili, futhi sisetshenziselwe ukuvala ukukhwabanisa kwe-mastectomy ngayinye. Le nqubo ephindwe kabili ye-TRAM izothatha kabili isikhathi eside njenge-TRAM eyodwa, futhi isikhathi sokubuyisela sizophinde siphinde kabili. Ungase uzizwe ubuthakathaka futhi ube nobuhlungu emavikini ambalwa emva kwalokho.
Ukucabangela okukhethekile mayelana ne-TRAM Flap
- Ukuthengiswa okukodwa- udokotela wakho ohlinzayo angasusa izicubu zesisu ngesikhathi esisodwa kuphela. Uma udinga enye yokwakhiwa kwebele, kuzodingeka ukhethe indlela ehlukile.
- Ukwesaba kwe-Bikini - isihlungu sakho esiswini sizoba eside kakhulu. Uma ungagqoki i-bikinis noma kunjalo, akuyona inkinga. Kodwa uma ungafuni uhlamvu oluvela esikhwameni ukuze ufike emathunjini wakho, i-TRAM akuyona yona.
- Inkinobho yokuhamba - inkinobho yakho yesisu ingafinyelelwa noma ihanjiswe-isikhungo ngesikhathi se-TRAM. Udokotela wakho odokotela angakwazi ukudala inkaba entsha kuwe.
- Ubheka okuhle, uzizwa ulungile - isifuba sakho esisha sizozizwa njengento yangempela kumlingani wakho (okufudumele, okuguquguqukayo, ophansi) kodwa ngeke ube nokuzwa okufanayo kuwo kusukela ngebele lakho lokuqala. Amagundane asuliwe, ngakho-ke ukuzwa kwesifuba evamile kuzolahleka.
Imithombo
Thola Abahlinzayo Abahlinzeka NgamaPulasitiki / Ukuvuselela Endaweni Yakho
Imithombo:
I-American Cancer Society. Ukwakhiwa Kwebele Isisu Ngemva Kwemastectomy. Izinhlobo ze-Breast Reconstruction. Kubuyekezwe: 09/06/2007.
UDkt. Susan Love Research Foundation. Ukuvuselelwa kwebele. Kubuyekezwe: ngo-Ephreli 21, 2008.