Zosintha zowuma

Kukonzanso kwa mabala ndiko opaleshoni kuti ichepetse kapena kuchepetsa kuwonekera kwa zipsera. Imabwezeretsanso magwiridwe antchito, ndikukonzanso kusintha kwa khungu (kusalongosoka) komwe kumachitika chifukwa chovulala, chilonda, kuchira koyipa, kapena opaleshoni yam'mbuyomu.

Mitundu yotupa yamatenda ngati khungu limachiritsa pambuyo povulala (monga ngozi) kapena opaleshoni.

Kuchuluka kwa zipsera komwe kumadalira:

• Kukula, kuya, ndi malo a bala
• Zaka zanu
• Makhalidwe akhungu, monga mtundu (utoto)

Kutengera kukula kwa opaleshoniyi, kusintha kwa mabala kumatha kuchitika mukadzuka (dzanzi dzanzi), kugona (pansi), kapena kugona tulo mopanda kuwawa (anesthesia).

Nthawi yoti kuunikiranso zipsera sikuchitikapo nthawi zonse. Zipsera zimachepa ndipo zimayamba kuzindikirika akamakalamba. Mutha kudikirira kuti muchitidwe opaleshoni mpaka chilonda chiwoneke. Izi zitha kukhala miyezi ingapo kapena chaka chatha chilondacho chitachira. Kwa zipsera zina, ndibwino kuchitidwa opareshoni patatha masiku 60 mpaka 90 chilonda chikakhwima. Chipsera chilichonse chimasiyana.

Pali njira zingapo zokulitsira mawonekedwe a zipsera:

• Bala lingathe kuchotsedwa kwathunthu ndipo bala latsopanolo lidatsekedwa mosamala kwambiri.
• Kuchepetsa kutikita minofu ndi kupsinjika, monga zingwe za silicone.
• Dermabrasion imaphatikizapo kuchotsa zigawo zakumtunda za khungu ndi burashi yapadera ya waya yotchedwa burr kapena kufooka. Khungu latsopano limamera kudera lino. Dermabrasion itha kugwiritsidwa ntchito kuchepetsa khungu kapena kuchepetsa kusakhazikika.
• Laser itha kugwiritsidwa ntchito kufewetsera pamwamba pa bala, ndikuthandizira kukula kwatsopano kwa kolajeni mkati mwa chilondacho.
• Kuvulala kwakukulu (monga kuwotcha) kumatha kuyambitsa khungu lalikulu ndipo kumatha kupanga zipsera za hypertrophic. Mitunduyi imatha kuletsa kuyenda kwa minofu, mafupa ndi tendon (contracture). Kuchita opaleshoni kumachotsa minofu yowonjezerapo. Zitha kuphatikizira kudula pang'ono (mbali ziwiri) mbali zonse ziwiri za malowo, zomwe zimapanga zikopa zopangidwa ndi V (Z-plasty). Chotsatira chake ndi chilonda chopyapyala, chosawonekera kwenikweni, chifukwa Z-plasty imatha kuyambitsanso chilondacho kuti chizitsatira kwambiri khungu lachikopa ndikutulutsa zolimba pachilondacho, koma chimatalikitsa chilonda panthawiyi.
• Kulumikiza khungu kumaphatikizapo kutenga khungu lochepa kwambiri mbali ina ya thupi ndikuliika pamalo ovulalawo. Kuchita opaleshoni ya khungu kumaphatikizapo kusuntha khungu lonse, mafuta, misempha, mitsempha ya magazi, ndi minofu kuchokera ku gawo labwino la thupi kupita kumalo ovulalawo. Njirazi zimagwiritsidwa ntchito pakakhala khungu lalikulu lomwe latayika pachivulazo choyambirira, pomwe bala laling'ono silichira, komanso pomwe nkhawa yayikulu ikuyenda bwino m'malo mowoneka bwino.
• Kukula kwa minofu kumagwiritsidwa ntchito pokonzanso mawere. Amagwiritsidwanso ntchito pakhungu lomwe lawonongeka chifukwa cha zovuta za kubadwa ndi kuvulala. Buluni ya silicone imayikidwa pansi pa khungu ndipo pang'onopang'ono imadzazidwa ndi madzi amchere. Izi zimatambasula khungu, lomwe limakula pakapita nthawi.

Mavuto omwe angawonetse kufunikira kowunikiranso khungu ndi awa:

• Keloid, yomwe ndi bala lachilendo lomwe limakhala lokulirapo komanso lautoto wosiyana ndi khungu lonse. Ma keloids amapitilira malire a chilondacho ndipo amatha kubwerera. Nthawi zambiri amapanga mawonekedwe akuda, owoneka ngati chotupa. Ma keloids amachotsedwa pamalo pomwe amakumana ndi minofu yabwinobwino.
• Chipsera chomwe chili pakona pamizere yolumikizana ndi khungu.
• Chipsera chomwe chimakhuthala.
• Chipsera chomwe chimayambitsa kupotoza zina kapena chimayambitsa mavuto poyenda kapena magwiridwe antchito.

Zowopsa za anesthesia ndi opaleshoni yonse ndi izi:

• Zomwe zimachitika ndi mankhwala
• Mavuto opumira
• Kukhetsa magazi, magazi kuundana, matenda

Zowopsa za opaleshoni yowonongeka ndi:

• Zowonongeka mobwerezabwereza
• Keloid mapangidwe (kapena kubwereza)
• Kupatukana (dehiscence) kwa bala

Kuwonetsera zipsera pamadzuwa ochuluka zitha kuyipangitsa kuti ikhale yamdima, zomwe zingasokoneze kukonzanso kwamtsogolo.

Pofuna kukonzanso keloid, kukakamizidwa kapena kuvala zotanuka kumatha kuikidwa pamalowo pambuyo pa opareshoniyo kuti keloid isabwerere.

Kwa mitundu ina yowunikiranso zipsera, kuvala mopepuka kumayikidwa. Zokopa nthawi zambiri zimachotsedwa pakatha masiku atatu kapena anayi kumaso, ndipo pakadutsa masiku 5 mpaka 7 pochekera mbali zina za thupi.

Mukabwerera kuzinthu zachilendo ndipo ntchito imadalira mtundu, digiri, ndi malo opangira opaleshoniyi. Anthu ambiri amatha kuyambiranso ntchito zawo atangopitidwa kumene. Dokotala wanu angakuuzeni kuti mupewe zinthu zomwe zingatambasulidwe ndipo zitha kukulitsa chilonda chatsopano.

Ngati mukumira kwakanthawi kolumikizana, mungafunike chithandizo chamankhwala mukatha opaleshoni.

Ikani mafuta oteteza ku dzuwa kuti kuwala kwa dzuwa kusachititse khungu lanu kuti lisachoke.

Kukonzanso kwa keloid; Kukonzanso kwa hypertrophic scar; Kukonza mabala; Z-zokongoletsa

• Keloid pamwamba khutu
• Keloid - mtundu
• Keloid - pamapazi
• Chilonda cha keloid
• Kusintha kowopsa - mndandanda

Hu MS, Zielins ER, Longaker MT, Lorenz HP. Kupewa mabala, chithandizo, ndikukonzanso. Mu: Gurtner GC, Neligan PC, eds. Opaleshoni ya Pulasitiki, Voliyumu 1: Mfundo. Wolemba 4. Philadelphia, PA: Elsevier; 2018: mutu 14.

(Adasankhidwa) Leitenberger JJ, Isenhath SN, Swanson NA, Lee KK. Zosintha zowuma. Mu: Robinson JK, Hanke CW, Siegel DM, Fratila A, Bhatia AC, Rohrer TE, olemba. Opaleshoni ya Khungu: Procedural Dermatology. Wachitatu ed. Philadelphia, PA: Elsevier; 2015: mutu 21.