Nzira sutures: mhando uye nzira ndokusanganisa

In basa rayo, vanachiremba vanovhiya vanoshandisa sutures, kune marudzi akasiyana navo, ichi ndicho chimwe chezvinhu zvakafanana dzakashandiswa zvokubatanidza zvoutachiona munyama: madziro zvomukati, vanga micheto, uye vamwe. Vanobatsirawo kumisa kubuda kweropa, nokuti bile, kuvonga zvose kusarudza zvakarurama suture.

Mumakore achangopfuura, chikuru nheyo kwezvisikwa upi mhando rwakashodoka anoonekwa kuti kuremekedza mumwe kumucheto ronda, zvisinei kwayo mhando. The musono anofanira kutevedzerwa kuitira kuti pane zviri chaizvo vachiwirirana ronda micheto, uye mumwe nomumwe akaturikidzana ari womukati nhengo, chinoda suturing. Nhasi nheyo idzi ikashandiswa mu rokuti "zvakarurama".

Zvichienderana iro chishandiso rinoshandiswa kusika munhu musono, uyewo kuita uri, mumwe anogona kusiyanisa nezvemarudzi maviri: Chinyorwa uye nomuviri sutures. Nokuti kuifukidza weld Chinyorwa netsika vachishandisa kwakajairika uye dzechimwe tsono, tsono yokuisira, tweezers nezvimwe zvokushandisa. Nokuti crosslinking inogona akasarudza chakaita zvokugadzirwa absorbable suture kana zvipenyu mavambo, simbi waya kana zvimwe zvinhu.

Chisimbiso zvemaziso rinoshandisirwa ne zano rinokosha apo kushandisa simbi zvinodyiwa.

Panguva stitching kuti maronda uye paumbwe anastomoses chiremba angabvuma stitches mumutsetse - musara uye akaturikidzana - mbiri, kana kunyange mina. Pamwe nokuti vazvo zvabatanidzwa pamwe muchikuvadza micheto, saka vari kwazvo zvakanaka kumisa ropa. Asi zvii rakasiyana-siyana suture zvinhu nhasi?

Kupatsanura pakati zvomusejari sutures

Sezvatakamboreva, ivo vazvo kunogona Chinyorwa uye zvemaziso, asi pane makirasi wandei weboka dzavo:

• vava nodes, uyewo kuramba unyanzvi kuti chikumbiro chavo;
• kana mugove wavo chimiro - nyore, nodal, akaumbwa kana P Z, chikwama tambo, ane 8-zvakaumbwa;
• ayo functionality inogona kukamurwa hemostatic uye Volt;
• maererano nokuwanda mitsara - kubva mumwe uye kusvikira mana;
• kupedza kuwana mukati Mucheka - bvisika uye achinyatsotaurira kana rokutanga, imwe nguva pashure stitches vanobviswa, uye kana yechipiri vanoramba mumuviri zvachose.

Uyewo munokosha kutaura ndechokuti zvomusejari sutures, maonero avo vakakamurwa, zvichienderana zvinhu akashandiswa: vanogona kuva absorbable kana akashandisa catgut - munhu rudzi uye Vikram Dexon - iri chakaita zvokugadzirwa. Chinopinda kupinda mumuviri lumen - kubva musono mhando iyi overlaps negomba zvomukati. Constant - Ndivo mhando mapfundo kuti hadzina kubviswa, vanoramba vari muviri nokusingaperi, uye vari takapoteredzwa connective tishu Kamudzira.

Raw zvokuvakisa suturing

Suture zvinhu zvinosanganisira zvinhu zvakasiyana-siyana zvinoshandiswa vascular ligation, tikashandisa zvomusejari sutures. Types mashoko suturing rinenge uye ganda dzaisiyana ose gore zvikuru zvichienderana sei kuvhiyiwa yakatanga. Kuti chete vanachiremba vanovhiya havana kushandisa kubatanidza zvinyama zviri zvomukati uye ganda:

• mhuka mudzira;
• ganda rehove;
• vakawana kubva makonzo miswe shinda;
• tsinga yemhuka;
• Hair kubva manes yemabhiza;
• achiine rukuvhute tambo achangozvarwa murume;
• micheka yakatsemurwa midziyo;
• hemp kana kokonati fibers;
• rabha muti.

Asi nemhaka zviitiko ano, zvino wazova chakaita zvokugadzirwa fibers. Pane zviitiko apo simbi ringashandiswawo.

Nokuti chero suture dzakabatanidzwa zvimwe zvinodiwa:

• mukuru simba;
• wakatsetseka penyika;
• elasticity;
• mwero elongation;
• yakakwirira pamwero pitikoti pakati munyama.

Asi mumwe zvinodiwa zvinokosha kuti anoshanda kune suture zvinhu inowirirana tishu kwevanhu. Pari anozivikanwa zambara majoini, vane antigenic zvivako uye reactogenic. Mhedziso siyana maitiro aya hakuwaniki, asi kukomba kwavo zvinofanira kushoma.

Zvinokoshawo kuti suture akaramba mbereko, uye akaramba kwenguva refu sezvinobvira, panguva imwe chete zvayo chikuru maitiro anofanira kuramba yepakutanga. Suture anogona kuva mumwe kana kupfuura fibers ayo interconnected kubudikidza nokuvhiringidza, knitting kana kwokuruka, uye pamusoro wavo akatedza, izvo zvinenge zvakazara wakisi, silicone kana teflon.

Pari, Kuvhiya rinoshandiswa absorbable uye non-absorbable suture zvinhu mhando. Kupatsanura pakati zvomusejari sutures vakawanda kunosanganisira kushandisa absorbable filaments - catgut, yakaitwa kubva tunica muscularis gwai duku ura, uyewo kuti kusika inogona kushandisa submucosal rukoko. Nhasi kune 13 catgut hukuru zvakasiyana pachavo vari dhayamita.

Simba weld zvinhu ichiwedzerwa pamwe saizi. Somuenzaniso, ndiye simba trehnulevogo kwemarudzi anenge 1400 g, asi kukura wechitanhatu - 11500 kwaiita absorbable neshinda kunogona kuva pakati 7 uye 30 mazuva.

Of asiri absorbable suture mu kuvhiyiwa vachishandisa pemavara pamusoro nesirika, donje, neshinda, horsehair.

marudzi stitches

Kana suture ganda chiremba anofanira kufunga sei chaizvo kuchekwa kana chakabvamburanyiwa ronda, ayo papi uye sei yayo kumicheto akaputsa. Uyewo inorangarira nzvimbo akuvara. The inonyanya kufarirwa kuvhiyiwa kuonekwa sezvo zvomusejari sutures, Photo Nyaya icharatidza nezvavanoona:

• enderera subcutaneous;
• subcutaneous nodules;
• cutaneous nodular;
• kuramba multi-musara, rakaiswa mukati ganda;
• kuramba mumwe musara, ndikarangarira mukati ganda.

Izvi zvichakubatsira kunzwisisa chaizvo nzira zvomusejari sutures yaiwanzoshandiswa ari crosslinking ronda wokunze.

Chinogara chichingoitwa intradermal mhando

Ake ichangobva kushandiswa kakawanda, ichipa zvakanakisisa zvizorwa mugumisiro. chikuru mukana Its ndiro kwazvo kwadzakabva of muchikuvadza micheto, chakanakisisa zvizorwa kushanda uye usingashandi nokuvhiringidzirwa microcirculation, kana ichienzaniswa nedzimwe mhando mapfundo. The shinda nokuti stitching chiri kuitwa dermis rukoko Ndege kufanana nazvo. Zvisinei, nokuti nyore kudhonza neshinda nani kutora monofilament zvinhu.

Kamwe akaita chikuru kuvhiya dambudziko maronda, mhando stitches zvinogona kusarudzwa zvakasiyana, asi kazhinji vanachiremba vanosarudza absorbable sutures: Biosyns, monokrilu, polysorbate, Dexon nevamwe. Uye kubva filaments zvisingakwanisi kuiparadza, vari akanaka monofilament polyamide kana polypropylene.

akambomiswa Musono

Uyu ndemumwewo yakakurumbira mhando Outdoor musono. With kwayo pakusikwa, ganda iri punctured yakanakisisa okurwadzisa tsono. Kana iwe kuishandisa, yokubayiwa sokunge netriangle ane nechimwe chinotungamirwa kurutivi ronda. chimiro ichi ponji anogona yakavimbika rokubata suture. The tsono akaiswa epithelial rukoko sezvo pedyo muchikuvadza kumucheto, achisiya of 4 neMM, uye ipapo vakatakura pamusoro oblique iri subcutaneous zvinyama apo zvishoma kutama kubva kumucheto, kure sezvinobvira.

Kamwe kubudirira chete pamwero neminondo ronda, tsono riri zvayaitenderera paguyo kurutivi midline uye vari jekiseni kupinda gobvu pfungwa ronda. The tsono muchiitiko ichi kunosvika machira zvakasimba zvakafanana, ichibata muchikuvadza Ukuwo, chete muchiitiko ichi, kuti musono anowana chete nhamba micheka.

Horizontal uye mira metiresi suture

Mhando zvomusejari stitches uye nokusunungura mapfundo vanosarudzwa nokuda chiremba zvichienderana kwokuomerwa ronda, kana paine tisinganetseki mu kuenzanisa ronda micheto, Zvinokurudzirwa kushandisa metiresi suture ari muchimiro tsamba P, kuvakoka yakatambarara. Kana rikashandiswa nodal chepuraimari kuvhiya suture ronda rakadzika, muchiitiko ichi, unogona kusiya residual mhango. Inogona unganidza chii Anopatsanura ronda uye rinoendesa akaora. Izvi zvingadziviswa kana suture iri pamapuriro dzakawanda. nzira iyi suturing zvinogoneka zvose panguva nomusimboti uye chinoramba mhando.

Uyewo kazhinji kuiswa musono Donatti (hunyambiri metiresi suture). In yayo yokutanga Implementation rinoitwa kuburikidza ponji 2 cm kubva muchikuvadza kumicheto. Vykoli ari divi uye panguva iyoyo kure. Kana tichiita inotevera ponji uye vykoli chinhambwe kubva muchikuvadza pamucheto atova 0.5 cm. The pemavara ungasunga chete pashure vazvo vose zvavakatemerwa saka zvinogoneka aivabatsira kuchinja ari kudzika ronda. Uchishandisa musono Donati runoita kuti kusona ronda huru diastasis.

Kuti vawane zvizorwa, kana chero oparesheni anofanira kunyatsoongorora akaita chikuru kuvhiya mabatiro maronda, mhando stitches vakasarudzwa nemazvo. Kana poromoka mutambo vanga micheto, mugumisiro kuchaita kuti zvikuru scarring. Kana tikashandisa kunyanya simba apo tightening racho raiva pedyo nebundu wokutanga, zvichava yakanyangara transverse zvipfigiso, dziri pamwe yose kureba vanga.

Kana rokusunga nokusunungura mapfundo, vose sirika shinda vasunge nodes maviri, uye chakaita zvokugadzirwa uye catgut - navatatu.

Mhando zvomusejari sutures uye nzira chikumbiro chavo

Kana kushandisa chero mhando musono, uye anoshandisa avo mazhinji vavhiyiwa, zvakakosha mukanyatsochengeta kuomerera kuita magadzirirwo. Sei Ashandiswa knotted suture?

With tsono pamusoro tsono pedhi ichi pakutanga wakabaya pamucheto nechokure 1 masendimita, vakabata forceps. All vkoly wakaitwa pakatarisana mumwe. The tsono anobvumirwa kuita zvakananga kuburikidza vose micheto, asi zvinozoita kunogona kuitwa, shure mumwe, ipapo mumwe. Pashure pokupedza rwebhuruu kuguma vari wakabata forceps uye tsono yabviswa, uye neshinda kunobatanidzwa, sezvamakaropafadzwa micheto ronda vanofanira kupfupikiswa mumwe sezvo kunyatsotevera sezvinobvira. Saka kuita zororo vazvo uye sokuvapo ronda haina vasonanidza chose. vagari nomumwe anofanira kuva ari chinhambwe 1-2 masendimita nepedyo. Mune zvimwe zviitiko, nodes inogona kusungwa, kana vazvo vose rinorambidzwa.

How kusungirira fundo

Kazhinji, vanachiremba vanovhiya vanoshandisa nyore chairema nokuda nokusunga suture. Uye kuti izvozvo; mushure suture iri Threaded kupinda kumucheto ronda, kumugumo nepedyo uye sunga fundo, uye pamusoro payo ndomumwewo.

Chiremba wacho fundo zvinogona kuitwa mune imwe nzira: sezvo kurushinda Threaded kupinda ronda, mumwe chinhu tora mumwe mugumo uye mumwe pashure pomumwe uye vakauya pedyo pamwe ronda micheto, kuita fundo miviri, uye kare pamusoro payo nyore. The shinda Migumo dzinobviswa pane chinhambwe 1 masendimita paungano.

How kusonera ronda, uchishandisa simbi chikomboredzo

Mhando zvomusejari sutures uye nzira chikumbiro chavo angava akasiyana, zvakatemwa ari ronda nzvimbo localization. Imwe nzira kungava muchinjikwa Linking achishandisa simbi zvinodyiwa.

Oklahoma vari ndiro simbi ane upamhi iri dzakawanda neMM, uye kureba - pamusoro masendimita, asi anogona kuva. migumo Vose ayo dzinoturwa muchimiro maringi, uye vari mukati chipande, izvo kupinda munharaunda yacho zvinyama uye asingauyi Vaiisa kure zvikorekedzo.

Kushandisa vimba ronda anotevera micheto kukomba chaiwo tweezers, muuye nazvo pamwe chete, varibatanidze zvakanaka, saka tibatirire neruoko rumwe, unofanira kutora rimwe chikomboredzo tweezers. Pashure paizvozvo, shandisa pamusoro musono mutsetse, kudzvinya kumagumo, kuti kutamburira. Somugumisiro ichi evanhu chikomboredzo ndeyokubvisa uye anofukidza micheto ronda. Vanofanira kumanikidza chinhambwe 1 masendimita nepedyo.

Bvisa zvinodyiwa, uyewo majoini, pashure pemazuva 7-8 ose nokuiswa kwavo. Nokuti ichi chinangwa chiredzo uye rinokosha vachipiwa tweezers. Pashure kubviswa bracket the inogona dzichienderana, sterilized uye kushandiswa suturing maronda zvakare.

Mhando stitches mu cosmetology

Zvizorwa kuvhiya suture chinogona kuitwa chero aivapo sutures: nesirika, catgut, neshinda, nhete waya, Michel okusungisa kana horsehair. Pakati zvose izvi zvinhu, chete suture urwa, uye vamwe vose vasingadaro. The sutures dziri mumvura kana bvisika.

By ndokusanganisa unyanzvi mune cosmetology akashandisa kuramba uye knotty mapfundo, yokupedzisira uyewo unogona kukamurwa mberi mu marudzi akawanda: gungwa, vanhuwo zvavo vakadzi kana zvomusejari.

Munguva nodular mhando, pane imwe nani chikuru pamusoro kuramba: payo vakachengetwa ane ronda kumicheto. Asi kuramba musono zviri kudiwa nokuti aishanda nokukurumidza uye zvoupfumi sezvo mashoko anoshandiswa. In cosmetology, mhando izvi zvinogona kushandiswa:

• metiresi;
• kuramba musono Reverdy;
• enderera furrier;
• Mazano (mashiripiti);
• subcutaneous (American musono Halsted).

Muzviitiko, kana murwere ane makakatanwa akasimba munyama, chiremba anogona kushandisa bwendefa kana kutungamirira mundiro vazvo uye musono rollers, kuburikidza izvo zvinoita kuvhara urema makuru uye vakachengetwa abate jira panzvimbo imwe.

Mupurasitiki Kuvhiya sezvo chiremba anogona dzimwe nguva kushandisa apodaktilny musono. Chaizvoizvo Its iri yokuti rinoshandisirwa kachira chete chinokosha chokushandisa: tsono anaro, forceps, uye Pean torsion.

Horse bvudzi - ichi ndicho chakanakisisa suture zvinhu. Mhando zvomusejari sutures uye nodes kuti zviripo cosmetology, zvakanaka kusika nayo. Kazhinji kushandiswa pfava kushandiswa, nekuti anenge asina utachiona, vasiri kugumbura ganda uye rinenge uye munzvimbo haisi ndokusanganisa suppuration uye scarring. Horse bvudzi kwakavharwa nenyama, saka kusiyana sirika, hazvizovi racherwa ganda.

Kushandiswa sutures mu dentistry

Vanachiremba vemazino kushandisawo mhando dzakasiyana-siyana stitches kumisa kubuda kweropa kana kuti chisimbiso nomuromo ronda guru. Mhando dzose majoini kuvhiya dentistry akanyatsojeka zvakafanana avo isu kare kurondedzerwa, chinhu bedzi pane misiyano diki iri mhando zvekushandisa. Suture ari nemumuromo mhango kakawanda kushandiswa:

• tsono anaro;
• ophthalmic zvomusejari forceps;
• bidentate diki haka;
• ziso chigero.

Kuita mabasa ari nemumuromo mhango kunogona kuva kwakaoma, uye chete nyanzvi pakati bhizimisi achakwanisa kuita basa iri zvakanaka, nekuti zvakakosha kwete chete yepamusoro chepuraimari mishonga maronda. Mhando stitches mu dentistry Zvinokoshawo kusarudza zvakarurama, asi kupfuura zvose - zviri nyore chakavhiringidza Musono. Zvino vakaisa sezvinotevera:

1. Kusachinja-chinja kunodiwa kubaya mativi ose ronda nechokure yakakwana kubva umwe, rwebhuruu kutambanudza yakawanda sezvingabvira, kusiya chete diki magumo - 1-2 cm.
2. The refu kuguma shinda netsono akasungwa ruoko rworuboshwe, ipapo vanofanira putira tsono anaro Kutenderera 2 nguva.
3. Achibatsirwa tsono pedhi akakunda pfupi yokutenda uye kudhonza kuburikidza loop - ndiwo chikamu gungano rokutanga, nokungwarira sungisa, zvishoma nezvishoma kuunza pamwe kumicheto ronda.
4. Uyewo, rwakabata loop, unofanira kuita zvakafanana kumonyanisa chete Mupumburu pakaunda-Kutenderera kamwe.
5. Sungisa zvakazara kuumbwa Unit, iva nechokwadi kuti kuongorora kufanana ari mutsvuku makakatanwa.
6. Kusuduruka dzaishandiswa pamwe akagerwa mutsetse, akagura kuguma shinda, wakagadzirira weld zvose.

Uyewo zviripo kuyeuka kuti zvakarurama stitches zvinodiwa kubva mid-ronda uye stitches regai Kakawanda kuitira kuti kunokanganisa ropa kuparadzirwa munyama. To kuporeswa akapfuurawo zvishoma nezvishoma, kunyanya maronda anokonzerwa kunotevera, zvakakodzera kuisa akawanda mazuva abudise pakati vazvo.

Dzakasiyana-siyana zvomusejari sutures uye nzira kumanikidzira zvemukati vazvo

Kwete chete Hudyu vanofanira kumanikidza zvakanaka mukati zvinyama anofanira vasonanidza makachengeteka. Internal kuvhiya suture angava pakubhadhara anoverengeka uye mumwe nomumwe rakagadzirirwa stitching kwezvimwe zvikamu. Ngatimboonai neimwe mhando kuti nani kunzwisisa.

musono aponeurosis

Aponeurosis - nzvimbo umo splice tendinous nyama iyo vane yakakwirira simba uye elasticity. A klassiske nzvimbo aponeurosis ichaongororwa kuva avhareji mudumbu mutsetse - apo spliced rworudyi uye vasara peritoneum. Mudzira jira kuva internet mamiriro ndokusaka splicing yavo achitevedza fibers anowedzera siyana yavo pakati vanachiremba vanovhiya, izvi inonzi nokuitika jeko.

Nokuti kuti munyama izvi zvakawedzera nhare yavo muchinjikwa-Linking zvinokosha kushandisa imwe mhando mapfundo. It anonzi chakavimbika kupfuura kuramba pakubhiti Musono, izvo kunoita kushandisa chakaita zvokugadzirwa absorbable sutures. Kune vaya zvinosanganisira "Polisorb", "Biosyns" "Vicryl". Uchishandisa absorbable sutures kunogona ligature fistulas. Uyewo, kusika Joint kwakadaro rinogona kushandiswa non-absorbable shinda - "Lavsan". Uchibatsirwa wavo, unogona kudzivisa paumbwe hernias.

The musono pamusoro adipose zvinyama uye peritoneum

Mumakore achangopfuura, chaizvo kashoma sutured marudzi aya akamendwa nekuti ivo zvinopa wakanakisisa Fusion uye nokukurumidza kuporesa. Mukuwedzera, kusavapo vazvo hakuiti kanganisa ropa riyerere pa nzvimbo vanga inotungamirwa. Muzviitiko, kana pasina musono kuita, chiremba anogona kushandisa nayo kushandisa absorbable sutures - ". Kuroorwa sekristaro kuti"

vazvo intestinal

Nokuti stapling kuti mukaha nhengo vanoshandisa akawanda majoini:

• Single mutsara sero-tsandanyama-submucosal suture Pirogov, iyo ungano anoiswa pamusoro rokunze deko muviri.
• Mateshuka musono, ayo inoti ndechokuti nzvimbo panguva yayo zvisikwa anoramba mukati mumuviri, wayo mucosa.
• Single mutsara musono Gumby rinoshandiswa kana chiremba anoshanda ari ura guru, izvo ayo unyanzvi zvikuru zvakafanana musono Donati.

vazvo chiropa

Nokuti kuti muviri zvakakwana "crumbly" uye kakawanda kunyorova neropa uye bile, kuita pamusoro wayo pechiso musono akaoma kunyange nyanzvi chiremba. Kakawanda, muchiitiko ichi, chiremba unoisa kuramba musono pasina yakatokura kana kuramba metiresi suture.

Gallbladder kushandisa U-zvakaumbwa kana masere zvakaumbwa zvomusejari sutures.

Vazvo pamidziyo

Mhando zvomusejari sutures yaishandiswa traumatology, vane maitiro avo. Kana uchida kusona midziyo, muchiitiko ichi uyewo zvichibvira anobatsira kuramba musono pasina yakatokura, izvo zvinoita zvakavimbika chisimbiso. Kurishandisa zvinowanzoita kuti paumbwe "bunching", asi kudzivisa izvi chaizvoizvo muchikwanisa, kana ukashandisa chete-mutsara suture chikepe.

Nzira sutures mhando akashandiswa kunotevera oparesheni uye zvakafanana. Mumwe mhando ine zvainovhiringidzawo nezvazvakaipira, asi kana zvakarurama nzira nokuiswa kwavo uye sarudza zvakanaka sarudzo tambo, chero vadyi anogona kuita mabasa ayo uye hwakachengeteka ronda kana Musono muviri. Riini nokubviswa suture neimwe nyaya takatsunga nomumwe, asi kazhinji 8-10 maawa kare vari kubviswa.