Kuyini Ukwakhiwa Kabusha Kwamabele Ngokuhlinzwa Kwe-Flap? Inhloso, Inqubo & Nemiphumela

Ukwakhiwa kabusha kwamabele ngokuhlinzwa kwe-flap kuyinqubo eyakha kabusha ibele lakho usebenzisa izicubu zakho ezivela kwenye ingxenye yomzimba wakho. Cabanga ngakho njengokuhambisa izicubu ezinempilo ezindaweni ezinjengesisu sakho, emhlane, noma ethangeni ukuze wakhe isimo sebhele elisha elibukeka futhi lizizwe lingokwemvelo kunezithako zodwa.

Le ndlela inikeza isixazululo esingapheli ngoba isebenzisa izicubu zakho eziphilayo. Ibele elakhiwe kabusha liguga nawe futhi livame ukunikeza ukuzwa okuthambile, okungokwemvelo uma kuqhathaniswa nezithako zokwenziwa.

Kuyini ukwakhiwa kabusha kwamabele ngokuhlinzwa kwe-flap?

Ukuhlinzwa kwe-flap kudlulisela izicubu ezinempilo, amafutha, isikhumba, futhi ngezinye izikhathi imisipha evela kwenye ingxenye yomzimba wakho ukuze yakhe kabusha ibele lakho. Udokotela ohlinzayo uhambisa ngokucophelela lezi zicubu ngenkathi egcina ukuhlinzekwa kwegazi lazo kungashintshi noma elixhuma kabusha emithanjeni yegazi endaweni yesifuba sakho.

Kunezinhlobo ezimbili eziyinhloko zezinqubo ze-flap. Ama-flap e-Pedicled ahlala exhumeke ekuhlinzekweni kwawo kwegazi lokuqala futhi athunyelwa ngaphansi kwesikhumba sakho endaweni yamabele. Ama-flap amahhala asuswa ngokuphelele bese exhunywa kabusha emithanjeni yegazi emisha kusetshenziswa izindlela ze-microsurgery.

Izindawo ezivame kakhulu zabanikeli zihlanganisa isisu sakho, umhlane, izinqe, namathanga. Udokotela wakho ohlinzayo uzokhetha indawo engcono kakhulu ngokusekelwe ohlotsheni lomzimba wakho, ukuhlinzwa kwangaphambilini, nezintandokazi zakho.

Kungani kwenziwa ukwakhiwa kabusha kwamabele ngokuhlinzwa kwe-flap?

Lokhu kuhlinzwa kusiza ukubuyisela isimo sebhele lakho ngemva kwe-mastectomy noma ukulimala okukhulu kwamabele. Abesifazane abaningi bakhetha ukwakhiwa kabusha kwe-flap ngoba kwakha ibele elizizwa njengezicubu zabo zemvelo futhi elingahlala impilo yonke ngaphandle kokushintshwa.

Ungase ucabangele le nketho uma ufuna ukugwema ukulungiswa kwesikhathi eside okuhambisana nezithako. Ngokungafani nezithako zamabele, ezingase zidinge ukushintshwa njalo eminyakeni engu-10-15, ukwakhiwa kabusha kwe-flap ngokuvamile kunikeza isixazululo esingapheli.

Abanye besifazane bakhetha nokuhlinzwa nge-flap lapho ukwakhiwa kabusha okusekelwe ekufakweni kungafaneleki ngenxa yokwelashwa ngemisebe, isikhumba esincanyana, noma izinkinga zangaphambilini. Le nqubo ingenziwa ngokushesha ngesikhathi sokuhlinzwa kwakho i-mastectomy noma ihlehliswe kuze kube izinyanga noma iminyaka emva kwalokho.

Iyini inqubo yokwakhiwa kabusha kwamabele ngokuhlinzwa nge-flap?

Ukuhlinzwa kuvamile ukuthatha amahora angu-4-8 futhi kwenziwa ngaphansi kwe-anesthesia ejwayelekile. Udokotela ohlinzayo uzosebenza kuzo zombili izindawo lapho kuthathwa khona izicubu kanye nendawo lapho idada lakho elisha lenziwa khona.

Nakhu okwenzekayo ngokuvamile ngesikhathi senqubo:

1. Udokotela ohlinzayo uphawula indawo yomnikeli futhi uhlela ngokucophelela ukususwa kwezicubu
2. Izicubu ze-flap zivunwa ngenkathi kugcinwa imithambo yegazi nemizwa uma kungenzeka
3. Ngezindiza zamahhala, izicubu zithuthwa esifubeni sakho futhi imithambo yegazi ixhunywa kabusha kusetshenziswa i-microsurgery
4. Izicubu zibunjwa futhi zibekwe ukuze zakhe idada lakho elisha
5. Zombili izindawo zokunikela kanye nendawo yamabele zivalwa ngama-sutures
6. Amanzi abekwa ukuvimbela ukwakheka koketshezi ngesikhathi sokuphulukisa

Ubunzima buxhomeke ohlotsheni lwe-flap onalo. Ama-DIEP flaps avela esiswini sakho ajwayelekile kakhulu futhi agcina imisipha yakho yesisu, ngenkathi ama-latissimus dorsi flaps avela emhlane wakho avame ukuhlanganiswa nokufakwa okuncane.

Ungalungiselela kanjani ukwakhiwa kabusha kwamabele ngokuhlinzwa nge-flap?

Ukulungiselela kwakho kuzoqala emasontweni amaningana ngaphambi kokuhlinzwa ngemvume yezokwelapha nokulungiswa kwendlela yokuphila. Udokotela ohlinzayo uzofuna ukuqinisekisa ukuthi usesimweni esingcono kakhulu sempilo kule nqubo enkulu.

Kuzodingeka uyeke ukubhema okungenani amasonto angu-6-8 ngaphambi kokuhlinzwa, njengoba i-nicotine iphazamisa kakhulu ukuphulukisa futhi yandisa izinkinga. Uma uthatha ama-blood thinners, izithasiselo, noma imithi ethile, udokotela wakho uzokweluleka ukuthi uyeke nini.

Ukulungiselela ngokomzimba kufaka phakathi:

• Ukuthola umsebenzi waselabhorethri kanye nemvume yezokwelapha kudokotela wakho oyinhloko
• Ukuhlela usizo ekhaya ngesikhathi sokululama kwakho
• Ukulungisa indawo yakho yokuhlala ngezinto ozodinga ukuzifinyelela kalula
• Ukugcina izingubo ezixegayo, ezinethezekile ezivuleka ngaphambili
• Ukuhlela amasonto angu-2-4 ngaphandle komsebenzi, kuye ngomsebenzi wakho

Ithimba lakho labahlinzi lizohlinzeka ngemiyalelo enemininingwane mayelana nokudla, ukuphuza, kanye nezinhlelo zemithi ngosuku lokuhlinzwa. Ukuba nakho konke okulungiswe ngaphambili kusiza ukunciphisa ukucindezeleka futhi kusekele ukuphola okungcono.

Ungawafunda kanjani imiphumela yakho yokwakhiwa kabusha kwamabele?

Impumelelo ekwakhiweni kabusha kwe-flap ilinganiswa kokubili ukusinda kwesicubu esidluliselwe kanye nokwaneliseka kwakho ngokubukeka nokuzwa. Ezinsukwini ezimbalwa zokuqala ngemva kokuhlinzwa, ithimba lakho lezokwelapha lizogada ngokusondele ukugeleza kwegazi ukuze liqinisekise ukuthi i-flap ithola ukujikeleza okwanele.

Izimpawu zokuqala zokuphola okuhle zihlanganisa umbala wesikhumba obomvana, ofudumele kanye nezinga lokushisa lesikhumba elivamile endaweni yokwakhiwa kabusha. Udokotela ohlinzayo uzohlola lezi zimpawu ngesikhathi sokuvakasha okulandelayo futhi angase asebenzise amadivayisi akhethekile ukuqapha ukugeleza kwegazi.

Imiphumela yesikhathi eside ithuthuka phakathi nezinyanga eziyi-6-12 njengoba ukuvuvukala kwehla futhi isicubu sihlala endaweni yaso entsha. Ibele lakho elakhiwe kabusha lizoqhubeka nokushintsha futhi lithambe ngokuhamba kwesikhathi, ekugcineni lithuthukise ukubukeka nokuzwa kwemvelo.

Khumbula ukuthi ukulingana okuphelele akuhlali kungenzeka, futhi ungase udinge izinqubo ezengeziwe zokuthuthukisa ukuma noma ukufanisa elinye ibele lakho. Abesifazane abaningi bathola ukuthi imiphumela ifanele inqubo yokululama, kodwa kubalulekile ukuba nethemba elingokoqobo.

Ungakuthuthukisa kanjani ukululama kwakho kokwakhiwa kabusha kwamabele?

Ukwelashwa kwakho kugxila ekuvikeleni ukuhlinzekwa kwegazi elisha ku-flap yakho ngenkathi uvumela umzimba wakho ukuthi uphole zombili izindawo zokuhlinzwa. Iviki lokuqala libalulekile ekusindeni kwe-flap, ngakho-ke uzodinga ukulandela imikhawulo yomsebenzi ngokucophelela.

Ngesonto lokuqala lama-2-3, uzodinga ukugwema ukuphakamisa noma yini engaphezu kwamaphawundi angu-5-10 futhi unqabele ukunyakaza kwengalo. Udokotela ohlinzayo uzokwandisa kancane kancane amazinga akho omsebenzi njengoba ukuphola kuqhubeka.

Izindlela zokusekela ukuphola kwakho zihlanganisa:

• Ukuqhubeka unamanzi futhi udla ukudla okunomsoco ocebile ngamaprotheni
• Ukuthola ukuphumula okuningi nokulala ukuze kusekelwe ukulungiswa kwezicubu
• Ukuthatha imithi echazwe njengoba kuqondiswe ngayo ngenxa yezinhlungu nokuvimbela ukutheleleka
• Ukuya kuzo zonke izikhathi zokulandela ukuqapha
• Ukugqoka izingubo zokucindezela njengoba kunconywe
• Ukugwema i-nicotine notshwala obuningi ngesikhathi sokululama

Abantu abaningi bangabuyela emsebenzini wedeskini emasontweni ama-2-3, kodwa imisebenzi yomzimba nokuphakamisa okunzima kuvame ukukhawulelwa emasontweni ama-6-8. Udokotela ohlinzayo uzokuqondisa esigabeni ngasinye sokululama ngokusekelwe ekutheni uphola kahle kangakanani.

Obani abangabantu abahle kakhulu bokwakhiwa kabusha kwe-flap?

Abantu abahle kakhulu ngabesifazane abanempilo enhle ngokujwayelekile abanethishu eyanele yomnikeli etholakalayo ukuze idluliselwe. Udokotela ohlinzayo uzohlola uhlobo lomzimba wakho, umlando wezokwelapha, nendlela yokuphila ukuze anqume ukuthi uyalingana yini nale nqubo.

Ungase ube ngumuntu omuhle kakhulu uma unethishu yesisu eyanele ye-DIEP flap noma ithishu eyanele yangemuva ye-latissimus dorsi flap. Abangabhemi ngokuvamile banemiphumela engcono ngoba ukubhema kuphazamisa ukuhlinzekwa kwegazi okugcina ithishu ye-flap iphila.

Ezinye izici ezisekela impumelelo zihlanganisa:

• Ukulindela okungokoqobo mayelana nenqubo yokululama nemiphumela yokugcina
• Uhlelo oluhle lokusekela ngokomzwelo ngesikhathi sokuphola
• Ikhono lokuthatha isikhathi esanele emsebenzini nasemisebenzini yansuku zonke
• Azikho izimo ezinkulu zezokwelapha eziphazamisa ukuphola
• Ukuzibophezela ekulandeleni imiyalelo yangemva kokuhlinzwa ngokucophelela

Ubudala bodwa abuyona into ekhawulelayo, kodwa impilo yakho iyonke kanye nekhono lakho lokuphola kuyizinto ezibaluleke kakhulu okufanele zicatshangelwe. Udokotela ohlinzayo uzokusiza ukuthi uqonde ukuthi ukwakhiwa kabusha nge-flap kuyahambisana yini nemigomo yakho nezimo zakho.

Ziyini izinto eziyingozi zokuhluleka kokwakhiwa kabusha nge-flap?

Izinto eziningana zingakhuphula ingozi yakho yezinkinga, ukubhema kuyinto ebaluleke kakhulu. I-Nicotine inciphisa imithambo yegazi futhi ikhuphula kakhulu ithuba lokuhluleka kwe-flap, lapho izicubu ezithuthiwe zingasindi.

Izimo zezokwelapha ezithinta ukuphola nokugeleza kwegazi nazo zikhuphula ingozi yakho. Isifo sikashukela, izifo ze-autoimmune, nesifo senhliziyo konke kungathinta ikhono lomzimba wakho lokuphola kahle ngemuva kwalolu hlobo lokuhlinzwa oluyinkimbinkimbi.

Ezinye izinto eziyingozi zihlanganisa:

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• Ukwelashwa ngemisebe ngaphambilini endaweni yesifuba
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• Ukukhuluphala ngokweqile, okungakhuphula izingozi zokuhlinzwa nezokwelapha
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• Umlando wamagazi noma izifo zokopha
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• Ukuhlinzwa kwangaphambilini okungenzeka ukuthi konakalise izindawo ezingaba ngabanikeli
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• Ukulindela okungokoqobo mayelana nesikhathi sokululama nokubukeka kokugcina
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• Uhlelo lokusekela olulinganiselwe ngesikhathi sokululama okwandisiwe
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Udokotela wakho ohlinzayo uzobukeza ngokucophelela lezi zinto nawe futhi angase ancome ezinye izindlela uma izinga lakho lengozi liphezulu kakhulu. Izinto eziningi eziyingozi zingashintshwa ngaphambi kokuhlinzwa ukuze kuthuthukiswe amathuba akho okuphumelela.

Ingabe ukwakhiwa kabusha nge-flap kungcono kunokwakhiwa kabusha nge-implant?

Zombili izindlela zinezinzuzo ezihlukile, futhi ukukhetha

Ukwakhiwa kabusha nge-flap ngokuvamile kunikeza ukwaneliseka okungcono kwesikhathi eside ngoba izicubu ziguga nawe futhi zizizwa zisemvelo. Ngeke kudingeke ukhathazeke ngokufakwa esikhundleni se-implant noma izingozi zesikhathi eside ezihambisana nama-implant ebele.

Kodwa-ke, ukuhlinzwa kwe-flap kuhilela ukuhlinzwa okuyinkimbinkimbi, isikhathi eside sokululama, nezibazi kuzo zombili izindawo ezinikezayo nezamukelayo. Ukwakhiwa kabusha nge-implant kungase kube ngcono uma ukhetha ukululama ngokushesha, unezicubu ezinikezayo ezilinganiselwe, noma ufuna ukugwema ezinye izindawo zokuhlinzwa.

Izinto eziningi zithonya lesi sinqumo, okuhlanganisa indlela yakho yokuphila, uhlobo lomzimba, ukwelashwa kwangaphambilini, nezintandokazi zakho. Udokotela ohlinzayo wakho angakusiza ukuthi ulinganise lezi zinto ukuze wenze ukukhetha okukulungele.

Ziyini izinkinga ezingase zibe khona zokwakhiwa kabusha nge-flap?

Ngenkathi ukwakhiwa kabusha nge-flap kuvamile ukuthi kuphephile, kuyindlela yokuhlinzwa eyinkimbinkimbi ethwala kokubili izingozi ezivamile nezingavamile. Ukuqonda lezi zinto ezingenzeka kukusiza ukuthi wenze isinqumo esinolwazi futhi uqaphele izimpawu ezidinga ukunakekelwa kwezokwelapha.

Inkinga enkulu kakhulu ukuhluleka kwe-flap, lapho izicubu ezithuthiwe zingatholi ukuhlinzekwa kwegazi okwanele futhi zifa. Lokhu kwenzeka cishe kuma-1-5% amacala futhi kungase kudingeke ukuhlinzwa okwengeziwe ukuze kususwe izicubu ezingaphumelelanga futhi kucatshangelwe ezinye izindlela zokwakha kabusha.

Izinkinga ezivamile ongase uzithole zihlanganisa:

• Ukuqaqeka okwesikhashana noma unomphela ezindaweni ezinikezayo nezamukelayo
• Izinkinga zokuphola kwamanxeba noma ukuphola okubambezelekile
• Ukuqoqwa kwamanzi (seroma) okudinga ukukhipha amanzi
• Ukutheleleka ezindaweni zokuhlinzwa
• Izibazi ezingase zibe banzi noma zibonakale kakhulu kunokulindelekile
• Ukungalingani phakathi kwamabele okudinga ezinye izinqubo

Izinkinga ezingavamile kodwa ezingathi sína zihlanganisa amahlule egazi, izinkinga zokuphefumula ezivela ku-anesthesia, nokulimala kwezakhiwo eziseduze ngesikhathi sokuhlinzwa. Ithimba lakho lokuhlinzwa lizokuqapha ngokucophelela futhi lithathe izinyathelo zokuvimbela lezi zinkingo.

Izinkinga eziningi ziyelapheka uma zitholwe ngesikhathi, yingakho ukulandela udokotela ohlinzayo nokubika noma yikuphi ukukhathazeka ngokushesha kubaluleke kakhulu ngesikhathi sokululama kwakho.

Kufanele ngibone nini udokotela mayelana nezinkinga zokwakhiwa kabusha kwe-flap?

Kufanele uthinte udokotela wakho ohlinzayo ngokushesha uma uqaphela noma yiziphi izinguquko ekubukekeni noma ekuzweni kwe-flap yakho ngesikhathi samasonto ambalwa okuqala ngemuva kokuhlinzwa. Ukungenelela ngesikhathi kuvame ukuvimbela izingqinamba ezincane ukuthi zingabi yizinkinga ezinkulu.

Shayela udokotela wakho ngokushesha uma uhlangabezana nanoma yiziphi lezi zimpawu zokuxwayisa:

• Ushintsho emibaleni yesikhumba - i-flap iba luhlaza okwesibhakabhaka, noma mnyama kakhulu
• Isikhumba esizizwa sibanda ngokungavamile noma sishisa kakhulu uma sithintwa
• Ukwanda okungazelelwe kobuhlungu noma umuzwa wokushaya
• Umkhuhlane ongaphezu kuka-101°F (38.3°C) noma ama-chills
• Ukugeleza okunuka kabi noma i-pus evela ezindaweni zokuhlinza
• Ukuvuvukala okukhulu noma ububomvu obuqhubeka buqina
• Ukwahlukana kwemiphetho yokuhlinza noma izicubu ezibonakalayo ngaphansi

Ngesikhathi sokululama kwakho, kubalulekile futhi ukufuna ukunakekelwa kwezempilo ngezinhlungu zesifuba, ukuphefumula kanzima, noma ukuvuvukala komlenze, njengoba lokhu kungase kubonise amahlule egazi. Unganqikazi ukushayela ngemibuzo noma ukukhathazeka - ithimba lakho lokuhlinza lilindele ukuzwa kuwe ngalesi sikhathi esibalulekile sokuphulukisa.

Ngemuva kokululama ngokugcwele, hlela ukulandelela njalo nodokotela wakho ohlinzayo wepulasitiki ukuze uqaphele imiphumela yakho yesikhathi eside futhi ubhekane nanoma yiziphi izinguquko noma ukukhathazeka okwenzeka ngokuhamba kwesikhathi.

Imibuzo evame ukubuzwa mayelana nokwakhiwa kabusha kwamabele ngokuhlinzwa kwe-flap

Q1: Ingabe ukwakhiwa kabusha kwe-flap kuhlanganiswa ngumshwalense?

Yebo, ukwakhiwa kabusha kwamabele ngemuva kwe-mastectomy kuvamile ukumbozwa ngumshwalense wezempilo, okuhlanganisa izinqubo ze-flap. I-Women's Health and Cancer Rights Act idinga ukuthi izinhlelo eziningi zomshwalense zihlanganise ukuhlinzwa kokwakhiwa kabusha kwamabele.

Noma kunjalo, imininingwane yokuhlinzekwa iyahlukahluka phakathi kwezinhlelo, futhi ungase udinge imvume ngaphambi kokwenza izinqubo ezithile. Xhumana nenkampani yakho yomshuwalense ngaphambi kokuhlinzwa ukuze uqonde izinzuzo zakho ezithile, ama-copays, nanoma yiziphi izidingo abangase babe nazo.

Q2: Ingabe ukwakhiwa kabusha kwe-flap kuhlala isikhathi esingakanani?

Ukwakhiwa kabusha kwe-flap ngokuvamile kuthathwa njengokuhlala unomphela ngoba kusebenzisa izicubu zakho eziphilayo. Ngokungafani nezitshalo, ezingase zidinge ukushintshwa njalo eminyakeni engu-10-15, ukwakhiwa kabusha kwe-flap kuvame ukuhlala impilo yonke.

Ibele elakhiwe kabusha lizokhula ngokwemvelo kanye nomzimba wakho wonke, lithole noma lilahlekelwe isisindo njengoba wenza. Abanye besifazane bakhetha izinqubo ezengeziwe ngokuhamba kwesikhathi ukuze bagcine ukulingana noma babhekane nezinguquko, kodwa ukwakhiwa kabusha okuyinhloko kuvame ukuhlala kuzinzile.

Q3: Ngizolahlekelwa yini umuzwa ebeleni lami elakhiwe kabusha?

Abesifazane abaningi baba nokulahlekelwa okuthile komuzwa ebeleni elakhiwe kabusha, nakuba lokhu kuhluka kakhulu phakathi kwabantu ngabanye. Omunye umuzwa ungase ubuye ngokuhamba kwesikhathi njengoba imizwa iphola, kodwa akunakwenzeka ukuthi kube njengoba kwakunjalo ngaphambi kokuhlinzwa.

Udkt. wakho ohlinzayo angase akwazi ukwenza ukugrafta kwemizwa ngesikhathi sokwakhiwa kabusha kwe-flap ukuze athuthukise ukululama komuzwa. Nakuba umuzwa ophelele ungavamile ukubuyela, abesifazane abaningi bathola izinzuzo zobuhle nezingokwengqondo zokwakhiwa kabusha zidlula lo mkhawulo.

Q4: Ngingakwazi yini ukwenza ukwakhiwa kabusha kwe-flap uma ngithole i-radiation therapy?

Yebo, ukwakhiwa kabusha kwe-flap kuvame ukuba yindlela ekhethwayo kwabesifazane abathole i-radiation therapy. I-Radiation ingenza izicubu zesifuba zingafaneleki ekwakhiweni kabusha kwe-implant, kodwa ukuhlinzwa kwe-flap kuletha izicubu ezintsha, ezinempilo ezinokuhlinzekwa kwazo kwegazi.

Isikhathi sibalulekile kodwa - udkt. wakho ohlinzayo angase ancome ukulinda izinyanga eziningana ngemva kwe-radiation ukuze uvumele izicubu ukuthi zitholeke ngaphambi kokuqhubeka nokwakhiwa kabusha. Lokhu kusiza ekuqinisekiseni ukuphulukiswa okungcono kakhulu nemiphumela.

Q5: Kwenzekani endaweni yomnikeli ngemva kokuhlinzwa kwe-flap?

Indawo yokunikela iyaphola ngesibazi, futhi ungase uhlangabezane nezinye izinguquko kuleyo ndawo kuye ngokuthi hlobo luni lwe-flap olusetshenzisiwe. Ngama-flap esiswini, abesifazane abaningi bayayithanda imiphumela ye- "tummy tuck" esusa isikhumba esiningi nezicubu.

Ama-flap omuva angase abangele ubuthakathaka obuthile kulowo musipha ekuqaleni, kodwa abesifazane abaningi babuyela emsebenzini ogcwele ngesikhathi kanye nokwelashwa ngokomzimba. Udokotela ohlinzayo uzoxoxa ngemiphumela ethile yendawo yakho yokunikela ekhethiwe futhi akusize uqonde okulindeleke ngesikhathi sokululama.