Ukwakhiwa kwakhona kwesifuba: I-DIEP Flap

Umxholo

• Ngubani umgqatswa kulwakhiwo ngokutsha lweflap?
• Ndimele ndilufumane nini ulwakhiwo ngokutsha lweflap?
• Kwenzeka ntoni ngexesha lokwakhiwa kwakhona kweflap?
• Zithini izibonelelo zokwakhiwa ngokutsha kweflap?
• Igcina ingqibelelo yemisipha
• Sebenzisa ithishu yakho
• Zeziphi iingxaki ezinxulumene notyando lwe-DIEP flap?
• Kwenzeka ntoni emva kokwakhiwa kwakhona kweflap?
• Ungasithatha njani isigqibo sokuba kuya kufuneka uphinde ube nokwakhiwa kwakhona kwebele

Yintoni i-DIEP yokwakhiwa kwakhona kweflap?

Ubunzulu be-epigastric artery perforator (i-DIEP) yinkqubo eyenziweyo yokwenza uqhaqho lwesifuba usebenzisa izicubu zakho emva kwembumba. I-mastectomy ngotyando lokususa isifuba, esihlala senziwa njengenxalenye yonyango lomhlaza wamabele. Ugqirha unokwenza utyando lokwakha kwakhona ngexesha okanye emva kwemastectomy.

Zimbini iindlela zokwenza ukwakhiwa kwakhona kwebele. Enye indlela kukusebenzisa izicwili zendalo ezithathwe kwelinye ilungu lomzimba. Oku kwaziwa njengokwakhiwa ngokutsha kwe-autologous. Enye indlela kukusebenzisa izinto ezifakwe ebeleni.

Zimbini iintlobo eziphambili zoqhaqho lokuvuselelwa kwamabele okuzenzekelayo. Babizwa ngokuba yi-DIEP flap kunye ne-TRAM flap. I-TRAM flap isebenzisa imisipha, ulusu kunye namafutha kwisisu sakho esezantsi ukwakha isifuba esitsha. I-DIEP flap yindlela entsha, ecokisekileyo esebenzisa ulusu, amanqatha, kunye nemithambo yegazi ethathwe esiswini sakho. I-DIEP imele “isitshabalalisi semithambo esingaphantsi.” Ngokungafaniyo ne-TRAM flap, i-DIEP flap igcina izihlunu zesisu kwaye ikuvumela ukuba ugcine amandla kunye nokusebenza kwemisipha esiswini sakho. Oku kukhokelela ekuphulukaneni kabuhlungu kunye nokukhawuleza.

Nantsi into ekufuneka uyazi malunga nendlela yokwakha kwakhona esebenza ngayo, izibonelelo zayo kunye nemingcipheko, kunye nento onokuyilindela ukuba ukhetha i-DIEP flap.

Ngubani umgqatswa kulwakhiwo ngokutsha lweflap?

Umgqatswa ofanelekileyo kwi-DIEP flap ngumntu onesisu esaneleyo esiswini esingatyebanga kwaye esingatshayiyo. Ukuba ukhe wenza utyando lwangaphambili lwesisu, awunakuba ngumgqatswa wokwakhiwa kwakhona kwe-DIEP.

Ezi zinto zinokukubeka emngciphekweni omkhulu wokufumana iingxaki emva kokwakhiwa kwakhona kwe-DIEP. Wena kunye nogqirha wakho unokuxoxa ngeendlela ezinokubakho ukuba awunguye umgqatswa wokwakhiwa ngokutsha kwe-DIEP.

Ndimele ndilufumane nini ulwakhiwo ngokutsha lweflap?

Ukuba ungumgqatswa we-DIEP flap, unokuphinda ube notyando lwebele ngexesha le-mastectomy yakho okanye iinyanga ukuya kwiminyaka emininzi kamva.

Baninzi ngakumbi abantu basetyhini abakhetha ukuba benze utyando lokwakha ngokutsha amabele kwangoko. Ngamanye amaxesha uyakufuna i-expander expander yokwenza indawo kwithishu entsha. Isihlunu esandisayo yindlela yonyango okanye isixhobo esifakelwe ukwandisa izicwili ezingqonge, ukunceda ekulungiseleleni indawo ukuze iphinde iqhubeke. Iya kwandiswa ngokuthe chu ukolula izihlunu kunye nolusu lwebele ukwenza igumbi lezicubu ezivuselelayo.

Ukuba ufuna ukusebenzisa izandiso zethishu ngaphambi kotyando lokwakha ngokutsha, inqanaba lokwakha ngokutsha liya kulibaziseka. Ugqirha wakho uya kubeka i-expander expander ngexesha le-mastectomy.

I-Chemotherapy kunye ne-radiation ziya kuchaphazela ixesha lokwakhiwa kwakhona kwesifuba se-DIEP. Kuya kufuneka ulinde iiveki ezine ukuya kwezintandathu emva kwekhemotherapy kunye neenyanga ezintandathu ukuya kwezili-12 emva kwemitha ukuze uphinde wakhe i-DIEP.

Kwenzeka ntoni ngexesha lokwakhiwa kwakhona kweflap?

Ukwakhiwa kwakhona kwe-DIEP flap yinto enkulu eyenziwa phantsi kwe-anesthesia jikelele. Ugqirha wakho wotyando uya kuqala ngokwenza isicatshulwa kwisisu sakho esezantsi. Emva koko, baya kukhulula kwaye basuse isikhumba, amanqatha kunye nemithambo yegazi esiswini sakho.

Ugqirha uya kugqithisa i-flap esuswe esifubeni sakho ukuze enze isilonda sebele. Ukuba unokwakhiwa kwakhona kwisifuba esinye kuphela, ugqirha uya kuzama ukuthelekisa ubungakanani kunye nokumila kwesinye isifuba ngokusondeleyo. Ugqirha wakho uya kuthi axhume ukunikezelwa kwegazi le-flap kwimithambo yegazi encinci ngasemva kwethambo lesifuba okanye phantsi kwengalo. Ngamanye amaxesha kuyanqweneleka ukuphakanyiswa kwebele okanye ukuncitshiswa kwebele elisecaleni ukunceda ukuqinisekisa ulingano lwamabele.

Emva kokuba ugqirha wakho otyumbayo ebumba izicwili esifubeni esitsha aze adibanise nokunikezelwa kwegazi, baya kuvala ukusikwa kwebele lakho elitsha kunye nesisu ngemithungo. Ukwakhiwa kwakhona kwe-DIEP kungathatha ixesha elide ukuya kwiiyure ezili-12 ukugqiba. Ubude bexesha buxhomekeke ekubeni ugqirha wakho uyakha kwakhona ngaxeshanye njenge-mastectomy okanye kamva kutyando olwahlukileyo. Kuxhomekeke ekubeni uyenziwa utyando kwibele elinye okanye zombini.

Zithini izibonelelo zokwakhiwa ngokutsha kweflap?

Igcina ingqibelelo yemisipha

Ezinye iindlela zokwakha kwakhona amabele ezisusa izicubu zomzimba kwisisu sakho, njenge-TRAM flap, ukwandisa umngcipheko weesisu esiswini kunye ne-hernia. I-hernia kuxa ilungu lityhala kwindawo ebuthathaka yemisipha okanye yethishu ekufanele ukuba ihlale endaweni yayo.

Utyando lwe-DIEP flap, nangona kunjalo, aluhlali lubandakanya umsipha. Oku kunokubangela ixesha elifutshane lokubuyisela kunye nentlungu engaphantsi emva kotyando. Ngenxa yokuba izihlunu zesisu zingasetyenziswanga awuyi kuphulukana namandla esisu kunye nokunyaniseka kwemisipha. Ukwanomngcipheko ophantsi kakhulu wokuphuhlisa i-hernia.

Sebenzisa ithishu yakho

Isifuba sakho esakhiwe ngokutsha siya kujongeka ngokwendalo kuba senziwe kwinyama yakho. Kananjalo akuyi kudinga ukuba nexhala malunga nomngcipheko oza nezinto zokufakelwa.

Zeziphi iingxaki ezinxulumene notyando lwe-DIEP flap?

Lonke utyando luza nomngcipheko wosulelo, ukopha, kunye neziphumo ebezingalindelekanga zeanesthesia. Ukwakhiwa kwakhona kwebele akukho ngaphandle. Ukuba ucinga ngolu tyando, kubalulekile ukuba lwenziwe ngugqirha wotyando onoqeqesho olubanzi kunye namava kwi-microsurgery.

Amaqhuma: Ukwakhiwa kwakhona kwesifuba se-DIEP kungakhokelela kumanqatha amabele. La maqhuma enziwe ngezicwili ezibomvu ezaziwa ngokuba yi-fat necrosis. Izihlunu ezibomvu ziyakhula ukuba amanye amanqatha ebeleni awafumani gazi laneleyo. Ezi ziqhuma zinokungonwabi kwaye kungafuneka zisuswe ngotyando.

Ulwakhiwo lwamanzi: Kukho umngcipheko wokuba ulwelo okanye igazi liqokeleleke emva kotyando kwibele elitsha. Ukuba oku kuyenzeka, umzimba ngokwendalo unokufunxa ulwelo. Ngamanye amaxesha, umbane kuya kufuneka ukhutshwe.

Ukuphulukana nemvakalelo: Isifuba esitsha asisayi kuba nemvakalelo eqhelekileyo. Abanye abantu basetyhini banokuphinda babenemvakalelo ngokuhamba kwexesha, kodwa uninzi alwenzi njalo.

Imiba enikezela ngegazi: Phantse umntu om-1 kwabali-10 abafumana ukwakhiwa kwakhona kwe-DIEP yokufumana i-flap yokwakha baya kufumana amaqhosha anemicimbi yokufumana igazi elaneleyo kwiintsuku ezimbini zokuqala emva kotyando. Le yimeko engxamisekileyo yezonyango kwaye iya kufuna utyando.

Ukwala izicubu: Ngaphandle kwe-100 yabantu abane-DIEP flap, malunga ne-3 ukuya kwe-5 yabantu baya kuphuhlisa ukwaliwa ngokupheleleyo okanye ukubhubha kwezicubu. Oku kubizwa ngokuba yi-necrosis yethishu, kwaye oko kuthetha ukuba yonke i-flap iyasilela. Kule meko, ugqirha wakho uya kuhamba phambili nokususa izicwili ezifile. Ukuba oku kuyenzeka kunokwenzeka ukuba uphinde uzame kwakhona emva kweenyanga ezintandathu ukuya kwezili-12.

Amabala: Ukwakhiwa kwakhona kwe-DIEP yeflegi kuya kubangela amanxeba ajikeleze amabele kunye nesisu sakho. Isilonda esiswini siya kuba ngaphantsi komgca wakho we-bikini, usuka kwi-hipbone uye kwi-hipbone. Ngamanye amaxesha ezi zikrakra zinokuphuhlisa i-keloids, okanye izicwili ezingaphezulu kakhulu.

Kwenzeka ntoni emva kokwakhiwa kwakhona kweflap?

Kuya kufuneka uchithe iintsuku ezimbalwa esibhedlele emva kolu tyando. Uya kuba neetyhubhu esifubeni sakho ukukhupha amanzi. Ugqirha wakho uya kususa ama-drains xa inani le-fluid lincipha ukuya kwinqanaba elamkelekileyo, ngokuqhelekileyo ngeveki okanye ezimbini.Unokwazi ukuqhubeka nemisebenzi yesiqhelo kwiiveki ezintandathu ukuya kwezilishumi elinambini.

Unakho ukwenza utyando ukongeza ingono okanye i-areola kwibele lakho elitsha. Ugqirha wakho uya kufuna ukuvumela isifuba sakho esitsha siphilise ngaphambi kokuba uphinde wakhe ingono kunye ne-areola. Olu tyando alunzima njenge-DIEP yokwakha kwakhona i-flap. Ugqirha wakho unokwenza ingono kunye ne-areola usebenzisa izicubu zomzimba wakho. Enye inketho kukuba ube nengono kunye ne-areola ene-tattoo kwibele lakho elitsha. Kwezinye iimeko, ugqirha wakho wotyando unokwenza ingono yokuthintela ingono. Kule meko, ingono yakho inokugcinwa.

Utyando lwe-DIEP flap lunokudala imeko ebizwa ngokuba yi-contralateral breast ptosis, ekwabizwa ngokuba sisifuba esixhomayo. Ekuqaleni okanye ngokuhamba kwexesha, ibele lakho lokuqala linokujinga ngendlela ibele elakhiwe ngokutsha elingenzi ngayo. Oku kuya kunika amabele akho imilo engalinganiyo. Ukuba oku kuyakukhathaza, thetha nogqirha wakho malunga nokulungisa oku. Oku kunokwenziwa ngaxeshanye nokwakhiwa kwakho okokuqala okanye kamva ngolunye utyando kwibele elingenamhlaza.

Ungasithatha njani isigqibo sokuba kuya kufuneka uphinde ube nokwakhiwa kwakhona kwebele

Ukuthatha isigqibo sokuba uza kuphinda uvuselele isifuba emva kwe-mastectomy lukhetho lwakho. Nangona kungeyomfuneko kwezonyango, abanye abantu basetyhini bafumanisa ukuba ukwenza utyando lokwakha amabele kuphucula impilo yabo yengqondo kunye nomgangatho wobomi.

Kukho iindlela ezahlukeneyo zokwakha ngokutsha, kwaye uhlobo ngalunye luza nezibonelelo zalo kunye nomngcipheko. Izinto ezahlukeneyo ziya kumisela utyando olulungele wena. Ezi zinto zibandakanya:

• ukhetho lomntu
• ezinye iingxaki zonyango
• ubunzima bakho kunye nenani lezihlunu zesisu okanye amanqatha
• utyando lwangaphambili lwesisu
• impilo yakho jikelele

Qiniseka ukuba uxoxa ngeenzuzo kunye nengxaki yazo zonke iindlela zotyando kunye nezinganyangwa kunye neqela lakho lonyango ngaphambi kokwenza izigqibo.