Kuvhiya shinda rokuremekedza, ukobvu, saizi

Chero avhareji nzira munhu mumwe kana mumwe muupenyu hwavo kanenge kamwe atarisana zvakakomba makuvaro kana kushandiswa. Muzviitiko zvacho zvose, kukuvara vanachiremba sutured kuti mhanyisa apore. The zvomusejari yakasiyana shinda kubva rakajairika?

Pandaida stitches

Deep mavanga uye maronda, abdominal kuvhiyiwa, mamwe makuvaro - vanhu vakawanda zvakadaro watarisana chokuti tinofanira kusona jira kwavo nani uye dzichimhanya chingamubatsira. Kwenguva refu dambudziko iri, pamwe chete zvinobudirira kurwadziwa yaiva huru chipingamupinyi kune pakuzadzisa kuvhiyiwa.

Munhau kwave akawanda yakareba kumuka kwokuderera nechirango. Somuenzaniso, muRoma yekare pokuvhiyiwa ruzivo kumboitika kukura, pamwe chikoro nerimwe ndouya aikwanisa aiva chiremba uyo akabata varwi ronda pashure kundikana zvesimba. KuMiddle Ages somushonga yose yaita kubva nyasha, uye ruzivo vose vekare kukanganwika, kumutsiridzwa muna Renaissance uye ano.

Usamborega haritsvaki mu kuporesa maronda, nekuti munhoroondo yevanhu kuramba kuitwa hondo, uye munguva yorugare chena kuvhiya shinda akatiponesa upenyu zhinji. Sei kuuya pamusoro?

nyaya

Science ane zvakakwana yokuwanda zvinoratidza kuti mashandiro wokutanga, kusanganisira kwazvo kunzwisisa, akaita kare kusati kwatombova dzinokosha zvishandiso uye ruzivo womunhu anatomi rakadzika.

Wokutanga Kushandiswa suture rakanyorwawo kwakaitika makore 2000 asati munhambo yedu. Kushandisa mutsvuku uye tsono mu maronda kwave inorondedzerwa Chinese bhuku iri mushonga. Mumazuva iwayo, ganda vaisona horsehair, mhuka runda, donje faibha, matanda uye nezvimwe zvirimwa. Muna 175 BC, Galen akatanga kutaurwa catgut, izvo zvakagadzirwa connective zvinyama zvipfuwo. Kuna XX remakore, akanga anoita chete suture. Zvisinei, muna 1924, akanga akazogadzira acho, rakanga yakazonzi zvinhu zvenaironi. Iye anonzi wokutanga chakaita zvokugadzirwa shinda, yakakodzera stitching maronda. Papera chinguva wakaonekwa polyester uye zvinhu zvenaironi, izvo zvinenge pakarepo yakatanga kushandiswa pakuvhiya. Pakati ichi remakore zvakanzi yagadzirwa polypropylene uye 70 - chakaita zvokugadzirwa absorbable fibers.

Panguva iyoyo sezvo siyana kuvhiya shinda uye tsono huchibva metamorphosis. Kana vasina havana wakasiyana zvatinosiita inokosha, vakanga reusable uye pachavo vakavhiringidzwa rinenge Ndokuzofungisisa ivo wakawana ano curved chimiro, vave yakasvinuka kumeso. Contemporary kuraswa atraumatic tsono dzavo pamusoro microroughness akazadzwa silicone.

Modern suture

The Kuvhiya of XXI remakore akashandisa tambo akasiyana mavambo uye zvivako. Vanogona kuva zvose zvakasikwa uye chakaita zvokugadzirwa. Kunewo vaya dzimwe nguva avhiyiwa pachavo kutsunga, kana kudiwa kwavari. Uchibatsirwa wavo, kazhinji sutured dzimwe nhengo dzomukati, apo nokuti kwokunze tichiita ingashandiswa, izvo zvaida kuti kubvisa paya. Chisarudzo chokupedzisira anotorwa chiremba, zvichienderana siyana zvikonzero, hunhu ronda uye murwere ezvinhu. Anokoshesawo kukura zvomusejari sutures, kusarudza zvakakodzera ukobvu kutsigira rinenge asi kwete kuvakuvadza kamwe zvakare.

zvinodiwa

Pane zvinhu zvinoverengeka zvivako kuti ave ano zvokuvhiyiwa shinda. Izvi zvinodiwa suture vakanga akagadzira muna 1965. Zvisinei, vachiri kushanda nhasi:

• Easy mbereko;
• hypoallergenic;
• pasi mutengo;
• inertness;
• simba;
• nemishonga zvirwere;
• resorbability;
• pakawanda chero tishu;
• Kubvuma sanduko, kudekara noruoko, hapana ndangariro filament;
• kushaya zvemagetsi basa;
• nzvimbo rakavimbika.

Modern, dzinongoitika uye chakaita zvokugadzirwa suture zvimwe kusangana dzakawanda izvi zvinodiwa. Most kazhinji kurapwa kunyange maronda zvakakura angaporeswa. Uye nokuda kuvhiyiwa uku kuti abudirire kuva kusvika musi kushanda vari kunze vose panguva micro vanochiva uye manipulations kunzwisisa pamwe inokosha zvakadaro nhengo somwoyo uye pfungwa, uye varwere kazhinji kudzorerazve pfupi nguva.

ukobvu

Chokwadi, chiuru makore mashomanana, kuvhiya shinda kwave kuchiita kuchinja uye hapana kuenzanisa havagoni kuenda chii vakamanikidzwa kushandisa apo vanachiremba.

Nhasi, vanachiremba vane siyana siyana suture zvinhu yakakodzera akasiyana-siyana munyama rose muviri. Most zvinonzwisisika nokuti munhuwo zvake maitiro ndiwo pakukora zvomusejari sutures. Zvinokanganisawo simba uye weld zvinorwadza uye maererano, vanga achiporesa nguva.

Pane tambo vanenge makumi maviri kuti rakasiyana chete ukobvu. Pakazoti tsika dzinosiyana 0.01 kusvika 0,9 millimeters. Saka, pakutanga ari munhevedzano tambo idzi wakawondereiko kudai mazuva ose kupfuura bvudzi munhu anenge 8 nguva!

mhando

Pakutanga govera mhando mbiri suture:

• monofilament suture shinda;
• multifilament, izvo zvaizoitawo vanogona chakakombama kana vakaruka.

Mumwe nomumwe kwemarudzi izvi obadaet pachake zvakanaka, zvainovhiringidzawo uye dzose. Saka monofilament ane mikana yakadai:

1. Kumeso. Maererano sechivako ichi mhando ndiyo shoma zvinorwadza, tichidzivisa zvakawanda ropa.
2. Shungu evanhu. Monofilament rinowanzoshandiswa intradermal sutures, nekuti hazvina inoomerera munyama uye hunogona kungoparara kubviswa kana zvakakodzera.
3. Kusavapo chibani maturo. Fani iyi iri yokuti anodzora zvakakodzera pamusoro fibers nomumwe vari yakaumbwa pakati Micro-voids, izvo vakazadzwa zviri ronda, kuwedzera mukana wokutapukirwa. Kana pasina ngozi monofilament yakadaro.
4. Inertness. Monofilament shinda riri kunyanya kugumbura ganda vachishandisa zvishoma mukana kukuvara kuzvimba.

Saka monofilametny suture zvinhu uye ane chinokosha chinetso. simba A zviduku. Zvinodiwa Kuti pemavara ano chii chinofanira kuva shoma nhamba nodes - Ivo kutsvinyira zvinyama uye anononoka kuporesa. Sezvo monofilament ane mvere pamusoro, kunoita akaoma zvakagadzirwa havasi zvakanaka chaizvo. Kana kushandisa ichi mhando zvinhu zvinofanira kushandiswa zvakawanda nodes kuti weld vanozvibata nani.

Kuvandudza ehupfumi ari filaments vari zvinenge zvakazara nziyo siyana kuti yekuzvidzivirira zvirwere, kuwedzera kumeso uye biocompatibility. Mukuwedzera, tinenge kushanda akaramba ari fibers itsva uye zvinhu, saka kuti kuvhiya haisi akamira.

Catgut uye cellulosic zvokuvakisa

Sezvambotaurwa, mashoko kuvhiya shinda, iro rinobva okuti mombe dumbu, akava mumwe wokutanga. Nhasi, mabikirwo yayo firimu iri zvikuru akakwana kupfuura kare, pane suture zvinhu pamwe Chrome kuifukidza, kuwedzera simba uye resorption nguva.

Ichi chichiri chinhu mukurumbira chaizvo mhando shinda, pasinei nokuti kushandiswa kwayo mune zvimwe zviitiko chakaenzana nhengo transplantation uye zvingakonzera rakakodzera masoja mhinduro. Asi catgut akakwana, kana musono inodikanwa refu, nekuti mazuva 10, anogona kuiparadza hafu, uye 2 Kwapera mwedzi kuparadzwa zvachose nokutevedzera nokugadzwa ake.

Cellulose fibers kuti poliniti inonzi oktselon uye katselon. Vanewo ane pfupi Absorção de Água, unoita kuti chinokosha urology, mupurasitiki uye chiremba kuvhiyiwa. Zvisinei, vane chinokosha zvinobatsira - kwete nekurambwa muviri sezvo dzimwe tishu.

Vamwe absorbable

Other kuvhiya shinda ane refu kubviswa nguva, izvo zvinobatsira vakawanda, thoracal uye oncology. Chakarebesa polidiaksanon inotsidza mumwoyo - kwayo zvizere Kutsakatika zvinoda 6-7 mwedzi.

Kunakisa chakaita zvokugadzirwa fibers ndechokuti pave zvikuru nokukurumidza uye akachena vanga kuporesa, yekuzvidzivirira chero matambudziko uye inflammations. Ndokusaka kubva phasing kubva catgut, kuwana nani analogues.

Sirika uye zvinhu zvenaironi

Vaviri Miti izvi - zvomusejari sutures, absorbable ekuedzwa. In tsika, izvi zvinoreva kuti kwavo kubviswa kubva muviri zvinotora makore anoverengeka. Silk yagara vaiona ndarama mureza, obaladaya pakawanda fomu. Zvisinei, nokuti kuti fibers ayo rwokuzvarwa mavambo, ivo vazvo vane kushandiswa kwayo kazhinji zvomoto uye inoda zvakawanda nezvayo. Asi iye kwakavharwa nenyama kwazvo, Zvinokosha zvakaisvonaka uye munyoro, uye ichi chakabereka rudo vanachiremba.

Zvinhu zvenaironi shinda zvakare kunowanzokonzera ane anogumbura mhinduro. Kunyange zvakadaro, izvozvo rinowanzoshandiswa suturing ari mudzira uye ophthalmology.

nonabsorbable

Kuvhiya shinda, izvo ngaibve kubviswa noruoko, uyewo kusiyana-siyana zvakakwana. Vamwe vavo vane yakanakisa evanhu ehupfumi, asi reactogenic. Mamwe inert mururame, asi zvakavaomera kushandisa uye kuva nesimba pasi. Kunyange zvakadaro, vanenge vose vari zvikuru kushandiswa zvese vakawanda uye unyanzvi kuvhiyiwa.

Kusiyanisa zvinotevera mapoka:

• Polyolefins - prolene, polypropylene. Pasinei chokwadi kuti majoini akadai anenge kumbobvira suppurate, operability ari murombo, uye ane kusungirira yakawanda nokusunungura mapfundo.
• Polyesters - zvinhu zvenaironi uye polyester. Ainyanya kushandiswa kutsigira kusvinwa nyama uye endoscopic kushandiswa.
• Fluoropolymers. Boka kupfuura akakwana - vane kumonyanisa zvivako zvakanaka uye zvakakwana simba. It hakurevi vakawanda nodes.

Steel uye titanium

Zvingaita sezvinoshamisa, asi simbi richiri kushandiswa pakuvhiya muchimiro shinda-kufanana waya uye chikomboredzo rinokosha muchina. A drawback chakakomba - zvinokuvadza kuti dzakapoteredza munyama. Kunyange zvakadaro, mune zvimwe zviitiko orthopedics uye mapfupa kuvhiyiwa kutsiva simbi havagoni kuva chinhu.

Saka pane zvakasiyana-siyana zvikuru sutures. Ivo anoshandiswa zvinangwa zvakasiyana, uye zvakakosha, chii pakupedzisira kuvhiya shinda anosarudzwa. The zita Chokwadi, hapana basa, asi chiremba nguva dzose inorangarira zvinhu zvakawanda pakusarudza zvakanakira murwere.