khoom

Kev loj hlob ntawmtxheej txheem zooyuav tsum muaj kev paub thiab kev nkag siab txog cov kev xav tau ntawm kev siv tshuabsuturing.

Thaum noj cov ntaub so ntswg tom, rab koob yuav tsum tau thawb los ntawm kev siv cov adab teg, yog tias nws nyuaj dhau los ntawm cov ntaub so ntswg, ib rab koob tsis raug yuav raug xaiv, los yog rab koob yuav blunt.

Lub zog ntawm lubcov ntaub ntawv sutureyuav tsum tau khaws cia thoob plaws kom tsis txhob slack sutures, thiab qhov deb ntawm cov sutures yuav tsum sib npaug.

Kev siv ib qho tshwj xeeb suture qauvTej zaum yuav txawv nyob ntawm qhov chaw raug sutured, qhov ntev ntawm qhov incision, qhov nro ntawm txoj kab suture, thiab qhov tshwj xeeb xav tau raukev, inversion,los yogEversionntawm cov ntaub so ntswg.

Suture qauvtuaj yeem ua tau dav categorized licuam ​​tshuam los yog txuas ntxiv.

A. Cov qauv cuam tshuam

Interrupted suturesyog siv los txo qhov nro, lossis nyob rau hauv qhov chaw uas yuav tsum tau muaj zog ntxiv.Lawv tsis yog kev khwv nyiaj txiag li ibnruam sutureas aknotyuav tsum tau khi tom qab txhua qhov kev tso kawm suture, siv ntau cov khoom siv suture ntau.Yog tias ib qho ntawm cov sutures ua tsis tiav, qhov no yuav tsis cuam tshuam rau lwm cov sutures muab tso rau hauv qhov txhab.

• Lub sij hawm siv.
• Ntau cov ntaub ntawv suture.
• Nyob ntawm tus nqi ntxiv ntawmcov ntaub ntawv suturehauv cov ntaub so ntswg.
• Muaj peev xwm tswj taulub zog thiab cov ntaub so ntswg txoj hauj lwmyog hais tias ib feem ntawm txoj kab suture poob los yog kua muag.
• Muab qhov tseeb dua rau ntug apposition.
• Tsawg qhov caws pliavtsim nyob rau hauv lub qhov txhab kho

B. Cov qauv tsis tu ncua

Cov qauv txuas ntxiv yog cov qauv nrawm tshaj plaws ntawm cov qauv suture, siv rau thaj tsam ntawm qhov tsis sib xws xws li kaw lub cev kab noj hniav, cov leeg nqaij, cov ntaub so ntswg adipose, thiab tawv nqaij, thiab muaj kev lag luam ntau dua li cov qauv cuam tshuam.

Yog tias rub nruj heev, txawm li cas los xij, lub qhov txhab tuaj yeem pucker.Yog hais tias ib feem ntawm lub qhov txhab tawg vim tsis ua hauj lwm ntawm lub nruam suture, tus so ntawm lub qhov txhab yuav raug cuam tshuam thiab rov qhib raws nws qhov ntev.

• Siv sijhawm tsawg dua.
• Tsawg tus nqi ntawmcov ntaub ntawv suture.
• Tsawg cov ntaub ntawv suture hauv cov ntaub so ntswg.
• Tsis muaj peev xwm tswj tau, yog tias ib lub pob caus plam, plam lossis rhuav tshem tag nrhosuture kab ua loosened.
• Nyuajkom tau txais qhov tseeb ntug rau ntug apposition.
• Ntau caws pliavcov ntaub so ntswg tsim.

C. Cov Qauv Kev Cai

1. Yooj yim Interrupted Suture

• Noj ib qho tomsymmetricallyat ibsib npauglos ntawm ob sab ntawm lub qhov txhab thiab rub kom nruj.
• Aknotmuab tso rau, thiab cov khoom siv suture yog trimmed ua ntej rov ua txoj kev kom txog thaum lub qhov txhab raug kaw.
• Hom suture no muaj txiaj ntsig zoo rau kev kaw ntawm linea alba thaum lub sijhawm phais plab lossis lwm qhov chaw uas xav tau lub zog ntau dua.
• Yooj yim rau kev thov.
• ruaj ntseganatomical kaw.
• Tso cai hloov ntawmsuture nro.

Kev siv

• Daim tawv nqaij, cov ntaub so ntswg subcutaneous, fascia, hlab ntsha, paj hlwb, plab hnyuv thiab zis.

2. Yooj yim cuam tshuam Intradermal Suture

• Upside down yooj yim cuam tshuam rau 'faus lub pob'.
• Cov no tau muab tso rau hauv ib qho yooj yim cuam tshuam tus qauv hauv qab ntawm daim tawv nqaij thiab qhov tom ntawm lub suture pw ntsug rau qhov incision.
• Lawv siv lostshem tawm qhov chaw tuagthiab rautxo qhov nrontawm daim tawv nqaij sutures.
• Lawv muaj txiaj ntsig los txo cov neeg mob cuam tshuam thiab rautshem tawm qhov xav tau kev tshem tawm suturehauv thaj chaw rhiab heev.
• Cov qauv no yuav tsum tau siv ua ke nrog lub pob faus (s).
• Absorbable suturecov khoom yuav tsum tau siv.

Kev siv

• Intradermal los yog subcuticular kaw.

3. Nthuav Cruciate (CrossMtus neeg saib xyuas)Suture

• Ib'X' puabyog tsim tshaj qhov txhab.
• Ib qho tom yog coj los ntawm ib sab, hla mus rau lwm qhov, ua ntej nce mus tom ntej8-10 mmces rov los ntawm qhov qub tom sab.
• Tom qab ntawd ib lub pob yog muab tso rau koom nrog cov suture xaus, hla lub qhov txhab.
• Rau qhov no suture yuavzoo tshaj plaws, ib square yuav tsum tau tsim nrog cov ces kaum ntawm lub suture.
• Qhov no suture yog siv raunyem nyem.
• Muaj zog thiab ceev duadua li yooj yim interrupted sutures, raws li ntau lub qhov txhab raug kaw nrog txhua suture tso.
• Tiv thaivEversion.

Kev siv

• Daim tawv nqaij.

4. Yooj Yim Nruam Suture

• Qhov chaw ib pib knot.
• Noj ib tug tom0.5-1 cmlos ntawm ob sab ntawm lub qhov txhab.
• Rub cov khoom siv suturenruj ces qhov txhab npoo yog appositional.
• Rov ua cov suture ib ncua deb ntawm thawj zaug;qhov tom yuav tsum pib ntawm tib sab txhua zaus raws li qhov qub tom kom txog thaum lub qhov txhab raug kaw lawm.
• Muab ib lub pob rau kev ruaj ntsegqhov txhab kaw.
• Ceev tshaj qhov cuam tshuam sutureqauv.
• Txhawb nqakev lag luam suture.
• Muab ib qho ntxivcua nrujlos yogkua nplaumfoob.
• Ntaunyuajkho qhov nro.
• Yuav ua tsis tau kiag liyog tias cov pob txha tsis muaj zog lossis tsis txaus.

Kev siv

• Daim tawv nqaij, cov ntaub so ntswg subcutaneous,fascia, gastrointestinal thiab urinary ib ntsuj av.

5. Nruam Intradermal Suture

• Lwm tuskev hloov khontawm ayooj yim nruamthiabhloov kho kab rov tav suture.
• Cov suture hla kab rov tav los ntawm cov khaubncaws sab nraud povtseg ntawm lub dermis, noj ib qho tom los ntawm kev sib hloov ntawm qhov txhab, thiab daim tawv nqaij raug rub kaw yam tsis muaj sutures pom.
• Qhov no yog ib qho suture uas tsis muaj zog yog li feem ntau yog siv nyob rau hauv cov cheeb tsam uas tsis tshua muaj nro, txawm li cas los, nyob rau hauv ib tug siab dua qhov txhab, daim tawv nqaij sutures yuav siv tau ntxiv.
• Intradermal suturesyog yooj yim dua rau tus neeg mob thiab pab tiv thaiv tus neeg mob cuam tshuam, lawv tsis txhob taug qab cov kab mob mus rau hauv lub qhov txhab thiab muaj qhov caws pliav tsawg heev.
• Txhawb kev lag luam suture.
• Muabdaim tawv nqaij zoo.
• Tsis muaj zog tshaj daim tawv nqaij sutures.
• Tsis muaj sutures tshem tawm.

Kev siv

• Intradermal los yog subcutaneous kaw.

6. Ford Interlocking Suture (Reverdin - Pam Plooj - Xauv Plooj)

• Akev hloov khontawm ib qho yooj yim nruam suture.
• Ruaj ntseg cov ntaub ntawv suture nrog ib tug knot.
• Ib qho tom los ntawm txhua sab ntawm lub qhov txhab.
• Ua ntej rub lub suture nruj, cov khoom yog threaded los ntawm lub voj tawm ib qho'L' zoo li tus suture.
• Rov ua dua kom txog thaumqhov txhab raug kaw.
• Cov no tsimzoo dua daim tawv nqaij appositiontshaj qhov yooj yim nruam suture.
• Kev tshem tawm nyuaj dua.

Kev siv

• Daim tawv nqaij

7. Gambie Suture

• Ahloov kho yooj yim cuam tshuam, tab sis nyuaj rau thov.
• Pab tswjmucosal eversion.
• Tsawg duaraug raukab mob 'wicking.
• Qhov no yog ibtshwj xeeb suturesiv los kho cov hnyuv.
• AHloov kho Gambieyog muab tso rau hauv tib txoj kev tab sis tsis nkag mus rau lub lumen ntawm txoj hnyuv.

Kev siv

• Lub plab anastomosis.