Chiganda Chine Ganda Chipi?
Ganda rinosungirirwa ndiyo inotsiva ganda rakanaka pane imwe nzvimbo iyo ganda rakakuvadzwa, rakarasika, kana kuti rakagadzirwa chirwere. Ganda rakaputika rinokohwa kubva kunzvimbo yavanopa (iyo inonziwo nzvimbo yekuchengetedza nzvimbo) uye inoendeswa kunzvimbo yekugamuchira.
Ndiani Anoda Ganda Refu?
Ganda rinowirirana rinowanikwa kuti ripe chidziviriro chinodzivirira uye kukurudzira kuporesa mavanga akazaruka.
Ikukuvara kunogona kuva kubva mukushungurudzika kana kutapukirwa, kupisa, venous (varicose) ulcers , zvinokonzerwa nemakumbo (bedsores), kana chironda cheshuga chinosaporesa nekurapa. Vanowanzoitwa sechikamu chemashure-mastectomy uyezve mamwe mavhivhi kuti abvise masero ane kenza.
Iko Ipi Ganda Rinobva Kubva?
Iyo yakabudirira zvikuru yeganda graft ndiyo inowanzoshandisa iyo ganda romurwere pachake. Inokohwa kubva kune imwe nzvimbo yemuviri uye inonzi autograft. Ganda grafts inogonawo kubudirira kana yakabvunzwa kubva kune rimwe divi remurwere.
Apo mupi wega akasiyana nemapatya akafanana, pane mukana wakasimba wemuviri unoramba ganda idzva. Muviri unoiona sechirongwa chekune imwe nyika inopinda uye ichichirwisa kuburikidza nehutachiona hwemuviri. Zvisinei, kunyange kana ganda rinopa rubatsiro rakarambwa, kubatanidzwa kunogona kubudirira nekupa muviri wevarwere nguva yakakwana nekuchengetedza kukura ganda idzva pachako.
Zvimwe zvinotangira zvinyorwa zvinongoreva chete kushandiswa kwenguva pfupi kusvikira ganda romurwere pachake richikura. Izvi zvinosanganisira:
- Ganda rakatorwa kubva kune cadaver (inonzi Allograft)
- Ganda rinotorwa kubva kumhuka (inonzi Xenograft)
- Synthetic tissue
Uine autograft kana kuti kubatanidzwa kunotorwa kubva kumapatya, chiremba wako anovhiya achatarisira chero nguva zvichikwanisa kukohwa ganda ravanopa kubva kune chikamu chemuviri kazhinji akavharwa nenguvo.
Vachaedzawo kutarisa ganda rekugadzira nekugadzirwa sepamusoro pekukwanisika pakati pemunhu anopa uye anogamuchira nzvimbo. Iko mukati mahudyu uye mabheti ndiyo nzvimbo dzinowanzopa zvipo. Ruoko rwepamusoro, forearm, back, uye mimba rinogona kushandiswawo zvakare.
Nzira dzeGraft Graft
Kune matatu mitatu mikuru yeganda grafts:
Kupatsanurwa-kupenya kubatanidzwa ndiyo inonyanya kushandiswa rudzi rweganda. Inobvisa chete epidermis (yakakwirira yeganda) uye chikamu chedermis (pakati pepakati peganda). Izvi zvinobvumira nzvimbo yepo nzvimbo yekurapa nokukurumidza. Zvisinei, rudzi urwu rwekubatanidza rwakanyanya kuoma uye runogona kusiya nzvimbo inopa vapeji isina kukodzera (lighter) pigmentation.
Kuzara kwemafuro kunobvisa epidermis, dermis, uye hypodermis (pasi pepakati peganda) zvachose. Zvinyoronyoro, mugumisiro wacho unowanzova nani, ndicho chikonzero huzere-hutema graft inowanzokurudzirwa chiso.
Kushandiswa kwehuwandu-thickness grafts zvishoma zvishoma. Zvinogona kuiswa panzvimbo dzemuviri ane mishonga yakakosha yeropa kuti uchengetedze kuponeswa kwemaseri.
Bumbiro rakawanda rinogona kusanganisira kubviswa kweganda, mafuta, musimba, uye cartilage. Aya mabatiro anowanzoshandiswa munzvimbo dzinoda hutatu-humwezve hunovakazve, hwakadai semhino.
Ngozi Nezvinetso zveChris Grafts
Ngozi uye zvinogona kuitika kune ganda rinosanganisira:
- kubuda ropa
- hematoma
- utachiona
- kurambwa / kurasikirwa / rufu rwekubatanidzwa
- kusagutsikana kwemashoko ekuongorora, zvakadai sekuvhara, kugadzirwa kweganda kusagadzikana kana kuputika
- kurasikirwa kana kuderedzwa mupfungwa yeganda
- kuwedzera kunzwisisika; chirwere chisingaperi (kazhinji)
- anesthesia ngozi
Kufungisisa Kwepamberi
Ganda grafts inotakura zvinetso zvevana vaduku kana avo vanopfuura makore makumi matanhatu. Vakasvuta nevaya vane zvirwere zvisingaperi vari pangozi yakanyanya. Njodzi dzinowedzera kuvanhu vanotora mimwe mishonga yakadai sepamusoro-blood yezvinodhaka zvinodhaka , musikana unozorodza, uye insulin.
Iyo Girafu Girafu Rakaita Sei?
- Ronda racho rinotorwa nokuda kwokuvhiyiwa. Ronda racho rinonatswa uye rinoyera. Zvadaro, chimiro chinongororwa nokuda kwekuendesa kune nzvimbo yavanopa.
- Anesthesia inoshandiswa. Zvichienderana nehukuru, hutsinye, uye nzvimbo yevanga, pamwe nehuwandu hwekubatanidza, nzira inogona kudiwa munharaunda yeanesthesia , inharaunda yeanesthesia, iv sedation , general anesthesia , kana kusanganiswa kweizvi.
- Ganda ravanopa rinokohwa uye rakagadzirirwa. Ganda racho rinogona kubviswa nekanyoro kana kuti kubatsirwa nemushonga unokosha wokukohwa unonzi dermatome. Mutsara unogonawo kuva "meshed," iyo nzira iyo mazano akawanda anotungamirirwa anowanikwa muburatiro. Iyi nzira inobvumira kusvibiswa kuputika kubva kune zvisikwa zvepasi uye ganda ravanopa kuti ripararire pane imwe nzvimbo huru.
- Nzvimbo yebatsiro inobva yavharwa. Uine huwandu hwakazara kana huwandu hwekubatanidza, izvi zvinoitwa ne sutures . Nekuparadzana-thickness graft, sutures haifaniri kunzvimbo yepaipa.
- Ikokubatanidza kunoiswa panzvimbo yekugamuchira. Kamwe pane imwe nzvimbo, iyo yakabatanidzwa yakanamatirwa kumatunhu akakomberedzwa ane sutures kana staples.
- Bhaniro rinosungirirwa rinoshandiswa pamusoro pemubatsiri wechipinda. Chimwe chinhu chakakosha chokugadzirisa chinonzi vanga VAC chinogona kuiswa pamusoro penharaunda yekutanga kwemazuva matatu kusvika ku5 kutonga mvura uye kuwedzera mikana yekubatanidza yekupona.
- Kuporesa kunotanga. Pakutanga, kubatanidzwa kunoshandisa oksijeni nemakemikari kubva mumatumbu kune nzvimbo yavanogamuchira kuti vararame. Mitsva yeropa itsva inotanga kukura mukati maawa makumi matatu ekutanga, inoteverwa nemasero matsva eganda anozotanga kukura kubva kumubatanidzwa kuti afukidze nzvimbo yeagamuchirwa nechave ganda.
- Post-Op Care: Vose vanopa zvipo uye nzvimbo dzinogamuchirwa vanofanira kuchengetwa zvine unyoro uye vakachengetedzwa zvakanaka. Chiremba wako achakurayiridza nezvekushandiswa kwakakodzera kwemishonga uye kubhakwa.
Sources:
> Rao K, et al. Kuvhara Kwakakwana Skin Graft Kuvhara Kwemaodzanyemba Kwemafupa Kutevera Kusarudzwa Kwezvipembenene Zvisina Mhemberero. Dermatology Online Journal. 2008; 14 (2): 4
> Landau AG, Hudson DA, Adams K, Geldenhuys S, Pienaar C. Full-Thickness Skin Grafts: Kuwedzera Girafu Kutora Kushandisa Kunetseka Kupfekedzwa Kugadzirira Gorofa. Annals of Plastic Surgery. 2008; 60 (6): 661-6.