Chinangwa:
Chifukidzo chekuvaka rusvingo chinodikanwa kana pane chiremera mu thoracic kana muchifuva. Chikonzero chinonyanya kukosha chechifukidzo chemasvingo masimba ane utachiona kana husina kugadzikana kupera kwemazuva ekupedzisira. Kupera kwemazuva mashoma ndeye nzira yekuvhiya iyo yakatsvaira yakagadzirwa pamwe chete nesternum (inozivikanwawo seyamufupa), mushure mokunge sternum yakakamurwa kana kuputsika.
Iyi nzira inopa kusvika pamwoyo nemapapu ekuvhiya.
Etiology:
Chest wall defect is divided into two general categories: acquired and congenital .
Akawanikwa:
- Trauma
- Tumor
- Kurwara
- Radiation
Congenital:
- Poland Syndrome
- Pectus Excavatum
- Pectus Carinatum
Zvinangwa:
Zvinangwa zvekuvakazve ndezvekuti:
- Bvisa zvisingabatsiri, zvakagadziriswa mavara kubva mudanda rechifuva
- Dzorera kugadzikana uye kugadzikana kumadziro echifuva
- Bvisa imwe nzvimbo yakafa (nzvimbo yakafa ndiyo nzvimbo isina chinhu inoguma mushure mekubvisa chikamu chemapapu kana mapapu ose)
- Ipa ruzivo rwakasimba rwemasvingo echifuva
- Ita mazano ekutenderera
Anatomy:
Rusvingo rwebhokisi rine zvikamu zvitatu:
- Utanhi rekunze: Mishonga yakadzika, iyo inosanganisira ganda, subcutaneous fat, uye muscle
- Central layer: Skeleton, iyo inosanganisira mbabvu, maronda, uye sternum
- Inner layer: Pleural space, iyo nzvimbo (cavity) pakati pemasaga nemapapu
Rimwe, maviri, kana zvikamu zvitatu zvinogona kunge zvichifanira kuvakwa zvichienderana nechinokanganisa.
Iyo nzira yekugadzirisa inotanga nehutachiona hwakadzika uye inopfuurira kune yakanyanyisa - mumiririro wechirungu, ipapo skeletal framework, uye pakupedzisira zvinyoro zvishoma.
Uyezve, rudzi rwekuvakazve huchaitwa huchaenderana nenzvimbo yechipfuva pamadziro echifuva.
Kuvandudzwa kweInner Layer:
- Chinangwa chekugadzirisa mukati memukati, iyo inozivikanwawo separietal cavity, ndechokuwana mhepo isina simba isina simba.
- Izvi zvinoitwa nekuzadza nzvimbo yakafa kuti irege kuzadzwa nemvura uye / kana pus.
- Nzvimbo yakafa yakazadzwa nekushanda kwemafupa (iyo inozivikanwawo seyiyo inowanika) munzvimbo yechipfuva kana kushandisa omentum :
- Latissimus dorsi flap
- Serratus anterior flap
- Pectoralis main flap
- Rectus abdominis flap
- Omental flap
Kugadziriswa kweMiddle Layer:
- Iyo skeletal layer inofungidzirwa sechepakati
- Izvi zvinotarisirwa kuchengetedza nhengo dzinokosha (moyo, mapapu, nezvimwewo) uye kubudisa kuporesa kwakakwana
- Kana zvibhakera zvina kana zvinopfuura zvakagadziriswa zvabviswa kana chirema chiri chikuru kupinda masentimita mashanu, skeletal layer inofanira kuvakwazve
- Kugadziriswa kunoitwa nevanotevera:
Kugadzirwa kweAlloplastic:
- Tsitsi dzakasimbiswa ne methyl methacrylate
- Bone grafts
Kugadziriswa kwemagetsi:
- Latissimus dorsi flap
- Serratus anterior flap
- Pectoralis main flap
- Rectus abdominis flap
- Omental flap
Kugadziriswa kweAuter Layer:
- Mucheka mutsvuku (ganda, zviduku zvinotapira) zvinonzi sekunze
- Chiremera chemafupa akanyorova chinogona kuva chikamu chemazana (pamusoro pechironda) kana kuti inogona kuva yakakwana hurefu (yakadzika ronda)
Chikamu chakasanganiswa mavanga anovakwazve ne:
- Split-thickness skin grafts kana
- Locoregional flaps
Kuzara mavara mavanga anovakwazve ne:
- Locoregional flaps
- Kusununguka kwakasununguka muzviitiko zvisingawanzoitiki
Sources:
Din AM, Evans GRD. Chest Wall Reconstruction. MuMcCarthy JG, Galiano RD, Boutros SG, eds. Current Therapy in Plastic Surgery. Philadelphia: Saunders Elsevier, 2006.
Janis JE. Chest Wall Reconstruction. MuJanis JE (ed). Zvinyorwa zvePlastiki Surgery. St. Louis: Quality Medical Publishing Inc., 2007.
Chang RR. Kugadziriswa Kwemagariro. Mune Thorne CHM, Beasely RW, Aston SJ, Bartlett SP, Gurtner GC, Spear S, eds. Grabb na Smith's Plastic Surgery, 6th ed. Philadelphia: Lippincott, 2007.
Pectus Carinatum Medline Plus.
Yakasvika musi waApril 2, 2011.
Pomerantz J, Hoffman W. Chest Wall Defects. MuKryger, ZB, Sisco M (eds.). Practical Plastic Surgery. Austin, Texas: Landes Bioscience, 2007.
http://www.microsurgeon.org/. Yakasvika musi waApril 2, 2011.