Ukwakhiwa kabusha kwesifuba: I-DIEP Flap

-Delile

• Ngubani umuntu ozobhalisela ukwakhiwa kabusha kwe-DIEP flap?
• Kufanele ngithole nini ukwakhiwa kabusha kwe-DIEP flap?
• Kwenzekani ngesikhathi sokwakhiwa kabusha kwe-DIEP flap?
• Ziyini izinzuzo zokwakhiwa kabusha kwe-DIEP flap?
• Ilondoloza ubuqotho bemisipha
• Isebenzisa izicubu zakho
• Yiziphi izinkinga ezihambisana nokuhlinzwa kwe-DIEP flap?
• Kwenzekani ngemuva kokwakhiwa kabusha kwe-DIEP flap?
• Unganquma kanjani ukuthi kufanele ube nokwakhiwa kabusha kwesifuba

Kuyini ukwakhiwa kabusha kwe-DIEP flap?

I-flap perforator ye-epigastric artery perforator (i-DIEP) ejulile iyinqubo eyenziwe ukuvuselela kabusha isifuba usebenzisa izicubu zakho ngemuva kwe-mastectomy. I-mastectomy ukuhlinzwa ukususa isifuba, okuvame ukwenziwa njengengxenye yokwelashwa komdlavuza webele. Udokotela ohlinzayo angenza umsebenzi wokwakha kabusha ngesikhathi noma ngemuva kwe-mastectomy.

Kunezindlela ezimbili zokwenza ukwakhiwa kabusha kwamabele. Enye indlela ukusebenzisa izicubu zemvelo ezithathwe kolunye uhlangothi lomzimba. Lokhu kwaziwa njengokwakhiwa kabusha kwe-autologous. Enye indlela ukusebenzisa okufakelwa ebeleni.

Kunezinhlobo ezimbili ezinkulu zokuhlinzwa okwakhiwa kabusha kwamabele okuzenzela. Babizwa ngokuthi i-DIEP flap ne-TRAM flap. I-flam ye-TRAM isebenzisa imisipha, isikhumba, namafutha kusuka esiswini sakho esingezansi ukwakha isifuba esisha. I-DIEP flap iyindlela entsha, ehlanjululwe kakhudlwana esebenzisa isikhumba, amafutha, nemithambo yegazi ethathwe esiswini sakho. IDIEP imelela “umthambo wemithambo we-epigastric ophansi ojulile.” Ngokungafani ne-TRAM flap, i-DIEP flap igcina imisipha yesisu futhi ikuvumela ukuthi ugcine amandla nokusebenza kwemisipha esiswini sakho. Lokhu futhi kuholela ekululameni okubuhlungu nokushesha.

Nakhu okudingeka ukwazi mayelana nokuthi ukwakhiwa kabusha kusebenza kanjani, izinzuzo nezingozi, nokuthi yini ongayilindela uma ukhetha i-DIEP flap.

Ngubani umuntu ozobhalisela ukwakhiwa kabusha kwe-DIEP flap?

Umuntu ofanelekayo we-DIEP flap ngumuntu onezicubu ezanele zesisu ezingakhuluphele futhi ezingabhemi. Uma uke wahlinzwa isisu esedlule, ungahle ungabi yilungele ukwakhiwa kabusha kwe-DIEP.

Lezi zinto zingakubeka engcupheni enkulu yezinkinga ngemuva kokwakhiwa kabusha kwe-DIEP. Wena nodokotela wakho ningaxoxa ngezindlela ezingenzeka uma ungeyena umuntu ofuna ukuvuselelwa kabusha kwe-DIEP.

Kufanele ngithole nini ukwakhiwa kabusha kwe-DIEP flap?

Uma ulungele ukungena kwi-DIEP flap, ungahle ube nokuhlinzwa kabusha kwebele ngesikhathi se-mastectomy yakho noma izinyanga kuye eminyakeni eminingi kamuva.

Bayanda abesifazane abakhetha ukuhlinzwa amabele ngokushesha. Kwezinye izimo uzodinga i-expander expander ukuze uvule isikhala sezicubu ezintsha. I-expander expander iyindlela yokwelashwa noma ithuluzi elifakwa ukukhulisa izicubu ezizungezile, lisiza ukulungisa indawo yokuhlinzwa okuqhubekayo. Izokwandiswa kancane kancane ukwelula imisipha nesikhumba sebele ukudala isikhala sezicubu ezivuselelayo.

Uma udinga ukusebenzisa izikhulisi zezicubu ngaphambi kokuhlinzwa kabusha, isigaba sokwakhiwa kabusha sizobambezeleka. Udokotela wakho ohlinzayo uzobeka i-expander expander ngesikhathi se-mastectomy.

I-Chemotherapy kanye nemisebe nakho kuzothinta isikhathi sokwakhiwa kabusha kwesifuba se-DIEP. Kuzofanele ulinde amasonto amane kuya kwayisithupha ngemuva kwamakhemikhali kanye nezinyanga eziyisithupha kuya kwezingu-12 ngemuva kwemisebe ukuze wakhe kabusha i-DIEP.

Kwenzekani ngesikhathi sokwakhiwa kabusha kwe-DIEP flap?

Ukwakhiwa kabusha kwe-DIEP flap kungukuhlinzwa okukhulu okwenzeka ngaphansi kwe-anesthesia ejwayelekile. Udokotela wakho ohlinzayo uzoqala ngokwenza imbobo esiswini sakho esingezansi. Ngemuva kwalokho, bazokhulula futhi basuse isikhumba, amanoni, nemithambo yegazi esiswini sakho.

Udokotela ohlinzayo uzodlulisela i-flap esusiwe esifubeni sakho ukudala isiduli sesifuba. Uma ngabe wakha kabusha ibele elilodwa kuphela, udokotela ohlinzayo uzozama ukufanisa ubukhulu nokuma kwesinye isifuba sakho eduze ngangokunokwenzeka. Udokotela wakho ohlinzayo uzobe esexhuma ukunikezwa kwegazi le-flap nemithambo yegazi emincane engemva kwethambo lesifuba noma ngaphansi kwengalo.Kwezinye izimo kungafiseleka ukuthi kuphakanyiswe ibele noma kuncishiswe ibele elihlukile ukusiza ukuqinisekisa ukulingana kwebele.

Ngemuva kokuthi udokotela wakho ohlinzayo abumbe isicubu esifubeni esisha futhi asixhume ekunikezelweni kwegazi, bazovala imisiko ebeleni lakho elisha nasesiswini ngemithungo. Ukwakhiwa kabusha kwe-DIEP kungathatha isikhathi esingamahora ayisishiyagalombili kuya kwayi-12 ukuqeda. Ubude besikhathi buxhomeke ekutheni udokotela wakho ohlinzayo wakha kabusha ngasikhathi sinye njenge-mastectomy noma ngokuhlinzwa okuhlukile. Kuya futhi ngokuthi uyahlinzwa yini esifubeni esisodwa noma zombili.

Ziyini izinzuzo zokwakhiwa kabusha kwe-DIEP flap?

Ilondoloza ubuqotho bemisipha

Ezinye izindlela zokwakha kabusha amabele ezisusa izicubu zomzimba esiswini sakho, njenge-flam ye-TRAM, zandisa ubungozi bama-bulges esiswini kanye ne-hernia. I-hernia kulapho isitho sidlulela engxenyeni ebuthakathaka yemisipha noma izicubu okufanele zisigcine sisendaweni.

Ukuhlinzwa kwe-DIEP flap, noma kunjalo, akuvamile ukubandakanya imisipha. Lokhu kungaholela esikhathini esifushane sokutakula kanye nobuhlungu obuncane ngemuva kokuhlinzwa. Ngoba imisipha yesisu ayisetshenziswanga ngeke ulahlekelwe amandla esisu nobuqotho bemisipha. Usengozini ephansi kakhulu yokuthuthukisa i-hernia.

Isebenzisa izicubu zakho

Isifuba sakho esakhiwe kabusha sizobukeka singokwemvelo ngokwengeziwe ngoba senziwe ngezicubu zakho. Ngeke futhi kudingeke ukhathazeke ngezingozi eziza nokufakelwa kokufakelwa.

Yiziphi izinkinga ezihambisana nokuhlinzwa kwe-DIEP flap?

Konke ukuhlinzwa kuza nengozi yokutheleleka, ukuphuma kwegazi, kanye nemiphumela emibi ye-anesthesia. Ukwakhiwa kabusha kwesifuba akunjalo. Uma ucabanga ngalokhu kuhlinzwa, kubalulekile ukuthi kwenziwe ngudokotela ohlinzayo onoqeqesho olunzulu kanye nesipiliyoni se-microsurgery.

Izigaxa: Ukwakhiwa kabusha kwesifuba se-DIEP kungaholela kwizigaxa zamafutha ebele. Lezi zigaxa zakhiwa izicubu ezibomvu ezaziwa nge-fat necrosis. Izicubu ezibomvu ziyakhula uma amanye amafutha asesifubeni engalitholi igazi elanele. Lezi zigaxa kungenzeka zingakhululeki futhi zingadinga ukususwa ngokuhlinzwa.

Ukwakhiwa kwamanzi: Kukhona nengozi yokuqhuma koketshezi noma kwegazi ngemuva kokuhlinzwa ebeleni elisha. Uma lokhu kwenzeka, umzimba ungamunca uketshezi ngokwemvelo. Ngezinye izikhathi, uketshezi kuzodingeka ukhishwe.

Ukulahlekelwa umuzwa: Isifuba esisha ngeke sibe nokuzwa okujwayelekile. Abanye besifazane bangaphinde bathole imizwa ngokuhamba kwesikhathi, kepha abaningi abakutholi.

Izinkinga ezinikezwa ngegazi: Cishe umuntu oyedwa kwabayishumi abathola ukwakhiwa kabusha kwe-DIEP flap bazobhekana nezimpikiswano ezinenkinga yokuthola igazi elanele ezinsukwini ezimbili zokuqala ngemuva kokuhlinzwa. Lesi yisimo esiphuthumayo sezokwelapha futhi sizodinga ukuhlinzwa.

Ukwenqatshwa kwezicubu: Kubantu abayi-100 abane-DIEP flap, cishe abantu aba-3 kuye kwabangu-5 bazoba nokwaliwa okuphelele noma ukufa kwezicubu. Lokhu kubizwa nge-tissue necrosis, futhi kusho ukuthi yonke i-flap iyahluleka. Kulokhu, udokotela wakho uzoqhubekela phambili ngokususa izicubu ezifile. Uma lokhu kwenzeka kungenzeka ukuzama ukuhlinzwa futhi ngemuva kwezinyanga eziyisithupha kuya kwezingu-12.

Izibazi: Ukwakhiwa kabusha kwe-DIEP flap kuzodala nezibazi ezungeze amabele akho nenkinobho yesisu. Isibazi esiswini cishe sizoba ngaphansi komugqa wakho we-bikini, usuka esinqeni uye emathangeni. Kwesinye isikhathi lezi zibazi zingathuthukisa ama-keloid, noma izicubu ezibomvu ezikhule kakhulu.

Kwenzekani ngemuva kokwakhiwa kabusha kwe-DIEP flap?

Kuzodingeka uchithe izinsuku ezimbalwa esibhedlela ngemuva kwalokhu kuhlinzwa. Uzoba namashubhu athile esifubeni ukukhipha uketshezi. Udokotela wakho uzosusa ama-drain lapho inani loketshezi lincipha liye ezingeni elamukelekayo, imvamisa kungakapheli isonto noma amabili. Ungaqala kabusha imisebenzi ejwayelekile kungakapheli amasonto ayisithupha kuya kwayishumi nambili.

Ungase futhi uhlinzwe ukwengeza ingono noma i-areola esifubeni sakho esisha. Udokotela wakho ohlinzayo uzofuna ukuvumela ibele lakho elisha liphole ngaphambi kokwakha kabusha ingono ne-areola. Lokhu kuhlinzwa akunzima njengokuvuselelwa kwe-DIEP flap. Udokotela wakho angakha ingono ne-areola usebenzisa izicubu zomzimba wakho. Enye indlela ukuthi ube nengono kanye ne-areola ebhalwe emzimbeni webele lakho elisha. Kwezinye izimo, udokotela wakho ohlinzayo angenza i-mastectomy yokuvikela ingono. Kulokhu, ingono yakho ingagcinwa.

Ukuhlinzwa kwe-DIEP flap kungadala isimo esibizwa nge-contralateral breast ptosis, esaziwa nangokuthi isifuba esinciphayo. Ekuqaleni noma ngokuhamba kwesikhathi, ibele lakho loqobo lingacwila ngendlela ibele elakhiwe kabusha elingenzi ngalo. Lokhu kuzonikeza amabele akho isimo esilinganayo. Uma lokhu kukukhathaza, khuluma nodokotela wakho ngokulungisa lokhu. Lokhu kungenziwa ngasikhathi sinye nokwakhiwa kabusha kwakho kokuqala noma kamuva ngokunye ukuhlinzwa ebeleni elingelona umdlavuza.

Unganquma kanjani ukuthi kufanele ube nokwakhiwa kabusha kwesifuba

Ukunquma ukuthi ungakha kabusha isifuba ngemuva kwe-mastectomy kungukukhetha komuntu siqu. Yize kungadingekile kwezokwelapha, abanye besifazane bathola ukuthi ukuhlinzwa okwakhiwa kabusha kwamabele kuthuthukisa inhlalakahle yabo yengqondo kanye nekhwalithi yempilo.

Kunezinketho ezahlukahlukene zokwakha kabusha, futhi uhlobo ngalunye luza nezinzuzo nezingozi zalo. Izici ezahlukahlukene zizonquma ukuhlinzwa okulungele wena. Lezi zinto zifaka:

• okuthandwa nguwe
• ezinye izinkinga zezokwelapha
• isisindo sakho nenani lezicubu zesisu noma amafutha
• ukuhlinzwa kwangaphambilini kwesisu
• impilo yakho jikelele

Qiniseka ukuthi uxoxa ngobuhle nobubi bazo zonke izinketho zokuhlinzwa nezokuhlinzwa ngaphandle kwethimba lakho lezokwelapha ngaphambi kokwenza noma yiziphi izinqumo.