M sutures:-daban da kuma hanyoyin da blending

A ta aiki, likitoci amfani sutures, akwai daban-daban na su, wannan shi ne daya daga cikin na kowa hanyoyin amfani da shiga nazarin halittu tsokoki: ganuwar da kayan ciki, da rauni gefuna, da sauransu. Sun kuma taimaka wa dakatar da zub da jini, domin bile, duk godiya a zabi da hakkin dinki.

A cikin 'yan shekarun nan, da babban manufa na halittar wani irin hadin gwiwa da aka dauke su mutunta kowane gefe na ciwo, ko da kuwa da irin. A kabu ya kamata a yi amfani da haka cewa akwai daidai dace da rauni gefuna, da kuma kowane daga cikin yadudduka na ciki sashin jiki, wanda na bukatar suturing. Yau wadannan ka'idoji suna hade a cikin lokaci "daidaici".

Dangane da kayan aiki da ake amfani da su haifar da wata kabu, kazalika da yi art, wanda zai iya bambanta iri biyu: manual da kuma inji sutures. Ga mai rufi Weld manual hanya yin amfani da na al'ada da kuma traumatic allura, allura da kambun, hanzaki da sauran kayan aikin. Domin da crosslinking za a iya zaba a roba absorbable dinki ko nazarin halittu asalin, karfe waya ko wasu kayan.

The inji hatimi ne amfani da wani musamman na'urar inda yin amfani da karfe staples.

A lokacin stitching da raunuka da kuma samuwar anastomoses likita yiwu stitches a jere - jere da yadudduka - biyu, ko ma hudu layuka. Tare da cewa da seams ake shiga tare da rauni gefuna, saboda haka su ma sosai dakatar da jini. Amma abin ne daban-daban na dinki kayan yau?

Nau'in m sutures

Kamar yadda muka ce, da seams na iya zama duka manual da inji, amma akwai da dama da azuzuwan da su division:

• su ne nodes, kazalika da ci gaba da dabara na aikace-aikace.
• idan rabonsu a cikin tsari - mai sauki, nodal, dimbin yawa ko P Z, jaka kirtani, da wani 8-dimbin yawa.
• a cikin ayyuka da za a iya raba hemostatic da aka ci da gumi.
• da yawan layuka - daga daya da kuma har zuwa hudu.
• wa'adin lokacin gano a cikin masana'anta - m, kuma a nutsa cikin wani hali na farko, a wani lokaci bayan da stitches an cire, da kuma a karo na biyu idan ya kasance a cikin jiki har abada.

Har ila yau daraja ambata shi ne cewa m sutures, su ra'ayoyi rarrabu, dangane da kayan amfani: za su iya zama absorbable idan amfani catgut - wani jinsin, kuma Amar Dexon - shi ne roba. Shiga cikin jiki lumen - wannan irin kabu overlaps da m gabobin. Constant - Waɗannan su ne iri na gidajen abinci da cewa ba su cire, suka kasance a cikin jiki har abada, kuma suna kewaye da wani connective nama kwantena.

Raw Materials for suturing

Dinki abu ya hada da daban-daban kayayyakin amfani na jijiyoyin bugun gini ligation, da ake ji m sutures. Iri abu don suturing nama da kuma fata a kowace shekara ƙwarai bambanta dangane da yadda tiyata ci gaba. Wannan kawai likitoci ba su yi amfani to connect da nama da kayan ciki da fata:

• dabbobi masu shayarwa agara.
• kifi fata;
• samu daga berayen wutsiyoyi thread.
• jijiyoyi dabbobi.
• Gashi dauka daga manes na dawakai.
• cibiyarki igiyar kawai haife mutumin.
• tube na tasoshin.
• hemp ko kwakwa zaruruwa.
• roba itace.

Amma godiya ga zamani aukuwa, sun zama yanzu m roba zaruruwa. Akwai lokuta inda karfe ƙila za a yi amfani da.

Ga wani dinki a haɗe wasu bukatun:

• high ƙarfi.
• m surface.
• elasticity.
• matsakaici elongation.
• babban matakin zamewa na kyallen takarda.

Amma daya daga cikin muhimmanci sharudda cewa amfani da dinki abu ne jituwa tare da mutum nama. A halin yanzu da aka sani da kayayyakin amfani ga gidajen abinci, da antigenic dũkiyarsu da kuma reactogenic. Cikakkar siffofin wadannan halaye ba ya wanzu, amma mai tsanani daga gare su, ya kamata a rage girmanta.

Yana da muhimmanci ga dinki tsayayya sterilization, da kuma kiyaye shi kamar yadda idan dai zai yiwu, a lokaci guda ta babban halaye dole kasance asali. Dinki iya kunshi da daya ko fiye zaruruwa wanda ake juna da karkatacciyar, saka ko braiding, kuma su surface ya santsi, suka mai rufi da kakin zuma, silicone ko Teflon.

A halin yanzu, aikin tiyata da aka yi amfani da absorbable da kuma wadanda ba absorbable dinki abu iri. Nau'in m sutures, mafi yawansu shi shafi yin amfani da absorbable filaments - catgut, wanda aka sanya daga Tunica muscularis tumaki kananan hanji, kazalika don ƙirƙirar da shi za a iya yin amfani da submucosal Layer. Yau akwai 13 catgut masu girma dabam da cewa sãɓã, a cikinsa a diamita.

A ƙarfi daga cikin Weld abu ne ya karu tare da size. Alal misali, da ƙarfin trehnulevogo jinsunan ne game da 1400 g, amma girman da shida - 11500 na da irin wannan absorbable thread iya zama tsakanin 7 da kuma 30 days.

Daga cikin wadanda ba absorbable dinki a tiyata ta amfani da yarns siliki, auduga, flax, horsehair.

iri stitches

Lokacin da dinki da fata likita dole ne ya yi la'akari da yadda warai yanka ko tsage rauni, ta har da kuma yadda ta gefuna m. Har ila yau daukan la'akari da wuri da suka ji rauni. A mafi m tiyata da za a dauke a matsayin m sutures, photo labarin zai nuna abin da suka yi kama da:

• m subcutaneous.
• subcutaneous nodules.
• cutaneous nodular.
• m Multi-jere, shafi cikin fata.
• m, a daya jere, shafi cikin fata.

Wannan zai taimaka fahimta daidai da abin da hanyoyin da m sutures amfani a cikin crosslinking na cikin matsanancin ciwo.

Cigaba da intradermal irin

Ya kwanan amfani da mafi akai-akai, samar da mafi kyau kwaskwarima sakamakon. Its main amfani ne da kyau kwarai karbuwa daga cikin rauni gefuna, m kwaskwarima sakamako da kuma kadan rushewa daga microcirculation, idan aka kwatanta da sauran iri gidajen abinci. Da zare don stitching aka gudanar a dermis Layer jirgin sama a layi daya a cikinta. Duk da haka, domin sauki ja da zare ne mafi alhẽri ya dauki monofilament abu.

Da zarar za'ayi da farko m magani da raunuka, iri stitches za a iya zaba daban-daban, amma sau da yawa likitoci fi son absorbable sutures: Biosyns, monokrilu, polysorbate, Dexon da sauransu. Kuma daga filaments wanda ba narke, su ne manufa monofilament polyamide ko propylene.

katse dinka

Wannan shi ne wani daya daga cikin rare iri na waje kabu. Tare da halittarsa, da fata ne canza mafi kyau sabon allura. Idan ka yi amfani da shi, da sokin kama wani alwatika wanda tushe ne ya mika wa rauni. Wannan nau'i na huda iya dogara rike da dinki. Da allura da aka saka a cikin epithelial Layer kamar yadda kusa da rauni baki, da fatar na 4 mm, sa'an nan kwashe a kan QFontDatabase a subcutaneous nama yayin da dan kadan motsi daga cikin baki, har zuwa yiwu.

Da zarar cimma wannan matakin tare da gefen da rauni, da allura da aka juya su wajen midline da ake allura a cikin mafi zurfi ma'ana da rauni. Da allura a cikin wannan harka kara a tsananin tsakaitã masana'anta rauni a daya hannun, kawai a cikin wannan harka, da kabu samun wannan yawan yadudduka.

Takamaiman kuma a tsaye katifa dinki

Nau'in daga m stitches da kullin aka zaba ta hanyar Likita dangane da tsananin daga cikin rauni, idan akwai kadan wahala a gwama rauni gefuna, shi ne shawarar yin amfani da wata katifa dinki a cikin nau'i na da haruffa P, mikawa horizontally. Idan amfani nodal primary m dinki mai zurfi rauni, a cikin wannan hali, za ka iya barin saura kogo. Yana iya tattara abin da raba da rauni da take kaiwa zuwa fester. Wannan za a iya kauce masa idan dinki a benaye da dama. Wannan hanya na suturing ne yiwu duka biyu a cibiya da kuma ci gaba da irin.

Kuma sau da yawa amfani kabu Donatti (a tsaye katifa dinki). A ta farko aiwatar ne da za'ayi ta hanyar da huda 2 cm daga rauni gefuna. Vykoli ne a gefen kuma a lokaci guda nesa. Lokacin dauke da fitar da gaba huda da vykoli nesa daga rauni baki ne riga 0.5 cm. A yarns kisa kawai bayan duk seams an hõre haka zai yiwu zuwa sauƙaƙe magudi a cikin zurfin da rauni. Amfani da kabu Donati ya sa ya yiwu a dinka da rauni tare da manyan diastasis.

Domin samun kwaskwarima, idan wani aiki dole ne a hankali ya yi farko m magani da raunuka, iri stitches aka zaba daidai. Idan bai kula da tufafinsa wasan da rauni gefuna, sakamakon zai kai ga tsanani scarring. Idan muka yi amfani da} arfin tuwo a lokacin da tightening na farko kumburi, shi zai zama mummuna mai gangara sanduna, wadda ake located tare da dukan tsawon na tabo.

Amma ga tying kullin, duk da siliki zaren daura biyu nodes, da kuma roba da kuma catgut - uku.

Nau'in daga m sutures da kuma hanyoyin da su aikace-aikace

Lokacin da ake ji wani irin kabu, kuma su da yawa amfani a tiyata, yana da muhimmanci tsananin bi don tsayar da dabara. Yadda daidai amfani knotted dinki?

Tare da allura a kan allura riƙewa farko soke baki a nesa 1 cm, rike da forceps. All vkoly gudanar daura da juna. Da allura da aka yarda da wani sashe kai tsaye ta hanyar duka biyu gefuna, amma bi da bi za a iya za'ayi, sai bayan daya, sa'an nan a cikin wani. Bayan kammala yarn karshen suna rike da forceps da allura da aka cire, da kuma thread ake dangantawa, cikinsa da gefuna da rauni ya kamata a taƙaice zuwa juna kamar yadda a hankali kamar yadda zai yiwu. Saboda haka yin wani sauran seams, kuma muddin rauni ba gaba daya sewn up. Kowane hadin gwiwa dole ne a nesa na 1-2 cm daga juna. A wasu lokuta, da nodes za a iya daura sama, a lokacin da duk seams an hõre.

Yadda ƙulla da kulli

A mafi yawan lokuta, likitoci amfani da sauki naúrar for dauri da dinki. Kuma yin shi haka: bayan da dinki da aka Threaded cikin gefen rauni, da iyakar kusa da juna da kuma kunnen doki kulli, da kuma sama da shi ne wani.

Likita ta kulli za a iya sanya a cikin wani hanya: kamar yadda wani thread Threaded a cikin rauni, daya bangaren dauki a daya karshen da sauran bayan da wasu suka kawo kusa da juna cikin rauni gefuna, yin biyu kulli, da kuma riga a kan shi sauki. Da zare iyakar aka yanke a nesa na 1 cm daga cikin taron.

Yadda za a dinka rauni, yin amfani da wani karfe sashi

Nau'in daga m sutures da kuma hanyoyin da su aikace-aikace na iya zama daban-daban, wanda aka ƙaddara a rauni site sarrafawa. Daya wani zaɓi iya zama giciye-dake tsakanin ta wajen karfe staples.

Staples ne farantin karfe wanda fadin shi ne da dama mm, da kuma tsawon - game da santimita, amma zai iya zama more. Dukansu iyakar daga gare aka gabatar a cikin nau'i na zobba, kuma suna cikin ruwa, wanda ke shiga nama da kuma ba slide kashe hooks.

Don shafi Brace mĩki ya bi gefuna kama da musamman hanzaki, kawo su tare, acikin sarƙa da kyau, saboda haka rike da daya hannun, akwai buƙatar ka kai wani sashi hanzaki. Bayan haka, tambaya ta a kan kabu line, squeezing da iyakar, sa kokarin. A sakamakon wannan magudi sashi ne lankwasa da kuma maida hankali da gefuna da rauni. Ya kamata gabatar da wani nesa na 1 cm daga juna.

Cire staples, kazalika da gidajen abinci, bayan 7-8 kwanaki na danniyan. A saboda wannan dalili mai ƙugiya da kuma musamman biyu daga hanzaki. Bayan kau da sashi za a iya hada kai, haifuwa da kuma amfani ga suturing raunuka sake.

Nau'in na stitches a cosmetology

Cosmetic m dinki za a iya sanya ta wani daga cikin data kasance sutures: siliki, catgut, lilin thread, wani bakin ciki waya, Michel clamps ko horsehair. Daga cikin waɗannan duka kayan, kawai dinki dissolves, da kuma duk sauransu, ba. A sutures aka kura idon ko m.

By blending dabaru a cosmetology amfani a ci gaba da kuma knotty gidajen abinci, da karshen ma za a iya raba kara shiga da dama iri: tẽku, kuma sauran matan talakawa, ko m.

A nodular type, akwai daya babban amfani a kan m: shi tam riqe da rauni gefuna. Amma ci gaba da kabu ne a bukatar saboda shi ne amfani da sauri da kuma tattalin arziki a matsayin kayan amfani. A cosmetology, wadannan iri za a iya amfani da:

• katifa.
• m kabu Reverdy.
• m furrier.
• tela (sihiri).
• subcutaneous (American kabu Halsted).

A waɗannan lokuta, idan haƙuri yana da karfi da tashin hankali na kyallen takarda, likita zai iya amfani da wani farantin ko gubar farantin seams da kabu rollers, ta hanyar abin da shi ne zai yiwu don rufe manyan lahani kuma tam rike da masana'anta, a wuri guda.

A roba tiyata a matsayin likita iya, wani lokacin amfani da apodaktilny kabu. Its ainihi ta'allaka ne da cewa shi ne amfani da kuma daura kawai tare da wani musamman kayan aiki: da allura mariƙin, forceps, kuma Pean torsion.

Doki gashi - wannan shi ne mafi kyau dinki abu. Nau'in daga m sutures da nodes cewa wanzu a cosmetology, mai kyau don ƙirƙirar tare da shi. Ya sau da yawa amfani a ENT ayyukan, saboda kusan babu cutar, wadanda ba irritating da fata da kuma nama, da kuma a wurare da shi ba a blending suppuration da scarring. Doki gashi na roba, saboda haka sabanin siliki, shi ba zai yanke a cikin fata.

A amfani da sutures a Dentistry

Zahnärzte kuma amfani da daban-daban na stitches dakatar da zub da jini, ko a rufe gefen babban rauni. Duk wani nau'i na gidajen abinci a m Dentistry ne sosai kamar irin waɗanda muka rigaya aka bayyana, abin kawai da cewa akwai kananan bambance-bambance a cikin iri na kayan aikin. Dinki a cikin baka rami ne mafi sau da yawa amfani:

• da allura mariƙin.
• ophthalmic m forceps.
• bidentate kananan ƙugiya.
• ido almakashi.

Don gudanar da ayyukan a cikin baka rami na iya zama da wuya, da kuma kawai sana'a da kasuwanci za su iya yi wannan aiki yadda ya kamata, domin shi ne mai muhimmanci ba kawai high quality-farko lura da raunuka. Nau'in na stitches a Dentistry ne mai muhimmanci a zabi da hakkin, amma mafi yawan duk - yana da wani sauki katse dinka. Kuma ya hõre kamar haka:

1. Daidaito da ake bukata don soki garesu daga cikin rauni a wani isasshen nesa daga juna, da yarn su shimfiɗa kamar yadda zai yiwu, ya bar kawai karamin karshen - 1-2 cm.
2. The dogon karshen thread kuma da allura da aka gudanar a hagu, sa'an nan suka bukatar kunsa da allura mariƙin kewaye iri na agogo 2 sau.
3. Tare da taimakon wata allura mariƙin kama wani gajeren tip da kuma ja ta cikin madauki - wannan shi ne kashi na farko na taron jama'a, a hankali ƙara ja, sannu a hankali kawo tare da gefuna da rauni.
4. Har ila yau, rike da madauki, dole ne ka yi wannan magudi, kawai gungura counter-kewaye iri na agogo sau daya.
5. Dame kafa cikakken naúrar, tabbata a saka idanu da uniformity na yarn tashin hankali.
6. Shift naúrar tare da yanke line, yanke ƙarshen thread, cewa shi ne duk shirye su Weld.

Shi ne ma daraja tuna cewa daidai stitches da ake bukata daga tsakiyar rauni da kuma stitches yi ba ma sau da yawa don haka kamar yadda ba su damemu da jini wurare dabam dabam a cikin kyallen takarda. Don waraka tafi steadily, musamman a raunuka sakamakon rauni, ya zama dole ka shigar da dama kwanaki magudanun ruwa tsakanin seams.

Iri-iri daga m sutures da kuma hanyoyin da tsawwala ciki seams

Ba wai kawai sassan waje ba sai a yi amfani dasu daidai, a cikin masana'anta ya kamata a kwashe shi. Tsarin ciki na ciki zai iya kasancewa da dama kuma kowannensu yana nufin ƙaddamar wasu sassan. Bari mu dubi kowane iri don fahimtar kome da kome.

Aponeurosis sashin

Aponeurosis ita ce wurin da ake yaduwa da takalma, wanda yake da karfi da kuma adadi. Matsayi mai kyau na aponeurosis shine tsakiyar tsakiyar ciki - inda yakamata da hagu na halayen spit. Tarkun kwaikwayo suna da tsarin fiber, wanda shine dalilin da ya sa zigon su tare da fiber na inganta haɓaka, tsakanin likitocin likitoci wannan sakamako ana kiransa sakamako.

Saboda gaskiyar cewa wadannan masana'antun suna da ƙarfin ƙaruwa, wajibi ne a yi amfani da wasu nau'i na sutura don yin dinki. Mafi yawan abin dogara shi ne ci gaba mai suture, wadda aka yi tare da taimakon rawanin shafawa. Wadannan sun hada da "Polysorb", "Biosin", "Vikril." Godiya ga yin amfani da zane-zane, yana yiwuwa ya hana kasancewar fistulas na liga. Har ila yau, don ƙirƙirar wannan sakon za ka iya yin amfani da zaren da ba a damuwa ba - "Lavsan". Tare da taimakonsu, za ku iya kaucewa samun ciwon hernias.

Seam kan nama da peritoneum

Kwanan nan, waɗannan nau'ikan takalma suna da wuya a ske su, domin su kansu suna samar da kyakkyawan gwaninta da kuma warkar da sauri. Bugu da ƙari, babu rabuwa ba ya tsangwama tare da jinin jini a shafin yanar gizon ƙwayar cuta. A waɗannan lokuta, idan baza ku iya yin ba tare da wani sutsi ba, likita zai iya sanya shi, ta hanyar amfani da zaren mai saurin - "Monocryl".

Stitches na hanji

Don ƙuƙwalwa na ɓoye marasa amfani da yawa ana amfani da su:

• Kwancen guda daya-mai rikitarwa-ƙwarƙwarar ƙuri'a Pirogov, wanda ƙirarsa yake a kan ƙananan kwasfa na kwayar.
• Ginin Mateshuk, wanda yake da mahimmanci ita ce gaskiyar cewa kulle lokacin da aka halicce shi ya kasance cikin jikin, a kan jikinsa na mucous.
• Ana amfani da jigon Gum guda daya lokacin da likita mai aiki tare da babban hanji, wanda a cikin fasaha ya kama kama da kogin Donatti.

Ƙungiyar hanta

Dangane da gaskiyar cewa wannan jikin ya isasshe "friable" kuma yalwaci da jini da bile, yana da matukar wuya a yi wani sutura a gefensa, har ma don likita mai sana'a. Mafi sau da yawa a wannan yanayin, likita ya sanya ci gaba da ba tare da fatar jiki ba ko kuma mai ci gaba da sutura.

A kan gallbladder, ana amfani da nau'ikan U-mai suna 8-shaped sutures.

Sanya kan tasoshin

Irin nauyin sutures da aka yi amfani da su a traumatology suna da nasarorin kansu. Idan kana buƙatar satar jiragen ruwa, to, a cikin wannan harka ci gaba da ba tare da kariya ba, wanda zai tabbatar da tabbaci, zai zama mafi kyau. Amfani da shi sau da yawa yakan jagoranci gawarwar "harmonica", amma zaka iya kauce wa wannan sakamako idan ka yi amfani da sakon layi guda-jere.

Sutures m, iri da suke amfani da su a traumatology da tiyata suna kama da juna. Kowace jinsin yana da nasarorin da ya dace da shi, amma idan ya dace ya kusanci jigilar su da zabi mafi kyawun sakon thread, sa'annan kowane sashin zai iya yin aikin da aka ba shi kuma ya tabbatar da ciwo ko kuma satar jikin. Lokacin da za a cire kayan da aka sanya a cikin kowane akwati ɗaya an ƙayyade ɗaya, amma an riga an cire su a ranar 8-10.