Ukulimala Kwe-Degloving: Izinhlobo, Izimpawu kanye Nokwelashwa

Ukulimala kwe-Degloving kungahluka kokulula isikhumba degloving kuya degloving ngokwedlulele kwemisipha kanye nezicubu ezingabangela amathambo ukuchayeka. Kungase kwenzeke ngenxa yezizathu eziningana - kusukela ezingozini kuya ekuhlaselweni kwezilwane, futhi kuyatuseka ukufuna usizo lwezokwelapha ngokushesha ukuze umise ukopha kakhulu futhi ugweme ukutheleleka. Ngaphezu kwalokho, kunconywa ukuthi ungaphathi lezi zimo ekhaya. 

Kule bhulogi, sixoxe ngezinhlobo, izimpawu, kanye nokwelashwa kwe-skin degloving. 

Kuyini Ukulimala Kwe-Degloving?

Ukulimala kwe-degloving, okwaziwa nangokuthi i-avulsion, uhlobo lokuhlukunyezwa lapho umsipha ongaphansi, ithambo, noma izakhiwo zomzimba zikhishwa ngokuphelele engxenyeni enkulu yesikhumba futhi, ngezinye izikhathi, izicubu ezingaphansi kwaso. Kungathinta izitho, umzimba, isikhumba kanye nezinye izifunda zomzimba. 

Izimbangela Zokulimala Kwe-Degloving

Iningi lalokhu kulimala lilethwa izehlakalo ezinomthelela omkhulu, okuhlanganisa imishini, izingozi zezimoto, kanye nezimboni. Ukulunywa noma ukuhlasela kwezilwane nakho kungaholela ekulimaleni okugovuzayo, ikakhulukazi uma amandla okuluma noma ukunyakaza kuklebhula isikhumba esandleni noma esithweni. Kutuswa ukuthi ugijime ngokushesha uyofuna usizo lwezempilo uma kwenzeka ukulimala kwesandla okugobile.

Izinhlobo Zokulimala Kwe-Degloving

Ukulimala kwe-Degloving kungahlukaniswa ngezinhlobo eziningana, ngayinye enezici zayo ezithile kanye nemithelela:

• I-Skin Degloving: Lolu hlobo luhlanganisa ukuhlukanisa isikhumba kusuka ezicutshini ezingaphansi, ngokuvamile ezenzeka ezithweni, iminwe, noma i-torso. Kuvame ukubonakala ezingozini zezimboni noma ezingozini ezimbi zomgwaqo.
• I-Open Degloving: Ekulimaleni okuvulekile kwe-degloving, isikhumba kanye nezicubu ezingaphansi kwesikhumba zisuswa ngokuphelele, kuveza imisipha engaphansi, imisipha, noma ithambo. Lolu hlobo luyabonakala futhi ludinga ukungenelela kwezokwelapha ngokushesha ukuvimbela ukutheleleka kanye nokwenza lula ukuphulukiswa.
• I-Degloving evaliwe (i-Morel-Lavallée Lesion): Ukulimala okuvaliwe kwe-degloved kwenzeka lapho isikhumba sihlala siqinile, kodwa izicubu ezingaphansi ziyagundwa. Ivamise ukuhlotshaniswa nokuhlukumezeka okufiphele futhi ngokuvamile kwaziwa ngokuthi ukulimala kwangaphakathi kwe-degloving.
• Ukulimala Kwe-Avulsion: Nakuba kufana ne-degloving, ukulimala kwe-avulsion ikakhulukazi kuhilela ukuklebhula ingxenye yomzimba, njengomunwe noma uzwane. Lokhu kulimala kungasukela ezingqimbeni zesikhumba namafutha ezikhumulwayo ukuze kuqedwe ukuhlukaniswa kwelungu noma i-appendage.
• I-Ring Avulsion: Ifomu elikhethekile lokukhipha i-gloving elenzeka emunweni, ngokuvamile lapho indandatho ikhishwa ngamandla, ihlubula isikhumba futhi ngokunokwenzeka ithinte ithambo nemisipha. Ukulimala okuvamile kwasekhaya noma emsebenzini. Ngakho-ke, kwaziwa nangokuthi ukulimala kwe-finger degloving.

Izimpawu ze-Degloving

Nazi izimpawu ezimbalwa ze-degloving:

• Extreme ubuhlungu
• Umsipha noma ithambo eliveziwe
• Ukulahlekelwa igazi
• Ukuvuvuka
• Ukulahleka kokuzwa
• Ukuhamba okukhawulelwe uma ingozi ithinta isitho esisodwa noma ngaphezulu

Ukulimala kwe-deglove kungaba nzima kakhulu. Ngakho-ke, kuyatuseka ukufuna usizo lwezokwelapha ukuze ululame kangcono.

Ukuxilongwa Kokulimala Kwe-Degloving

Ukuhlola kokuqala kuhlanganisa ukuhlolwa komtholampilo ukuze kubhekwe izinga lokuhlukaniswa kwesikhumba nezicubu. Udokotela angase acebise ngezivivinyo zokuxilonga ezilandelayo: 

• Ukuhlolwa Kwezithombe: Ama-X-ray, ama-CT scan, noma ama-MRIs asetshenziselwa ukuhlola ukuphuka kwamathambo okungaphansi, ukulimala kwezicubu ezithambile, kanye nezinga lokulimala.
• Ukuhlolwa Kokusebenza Kwezinzwa Nezimotho: Ukuhlola izinzwa zesiguli kanye nemisebenzi yemoto kusiza ukunquma ubukhali be inzwa ukulimala.
• I-Doppler ultrasound: Ingenziwa ukuhlola igazi ukugeleza endaweni ethintekile, okubalulekile ekuhleleni izinqubo zokwakha kabusha nokuphulukisa.
• Ukuhlolwa Kwenxeba: Ukuhlolwa kwenxeba okuningiliziwe ukuze kutholakale ukungcola, izinto zangaphandle, nokusebenza kwesikhumba esivaliwe nezicubu.

Ukwelashwa Kokulimala Kwe-Degloving

Ukwelashwa kuyehluka kuye ngobukhulu kanye nendawo kodwa ngokuvamile kuhilela lezi zindlela ezilandelayo:

• Ukunamathiselwa kabusha Kokuhlinzwa: Ukunamathiselwa kabusha kokuhlinzwa kungasiza ezimeni lapho isikhumba nezicubu kusasebenza khona. Inqubo yokunamathisela kabusha ihilela ukuhlanza isilonda kahle nokubeka kabusha isikhumba. 
• I-Skin Grafting: Ukufakwa kwesikhumba kusetshenziswa ezimeni lapho ukunamathiselwa kabusha kungeke kwenziwe. Odokotela abahlinzayo basebenzisa isikhumba esikwenye ingxenye yomzimba ukuvala inxeba. Ngakho, igama isikhumba ngokuxhunyelelwa. Inqubo isiza ukuvikela izicubu ezingaphansi futhi ikhuthaze ukuphulukiswa ngokusiza ekukhiqizeni amaseli esikhumba amasha.
• I-Flap Surgery: Ukuhlinzwa kwe-Flap kuhilela ukuthatha ucezu lwezicubu eziphilayo ezinemithambo yegazi kusuka engxenyeni eyodwa yomzimba bese uwuhambisa ukuze umboze indawo ene-degloved. Lokhu kuvame ukusetshenziselwa ukulimala okukhulu lapho ukuxhunyelelwa kwesikhumba kungase kunganeli.
• I-Negative Pressure Wound Therapy (NPWT): I-NPWT isebenzisa i-vacuum ukuze ikhuthaze ukuphulukiswa kwezilonda eziyinkimbinkimbi. Kuyasiza ukunciphisa ukuvuvukala, ukuhlanza isilonda, futhi kukhuthaze ukugeleza kwegazi endaweni, kusheshise inqubo yokuphola.
• Ukwelashwa Kwemvelo: Ngemva kokwelashwa kwenxeba kokuqala, ukwelashwa ngokomzimba kubalulekile ukuze kubuyiselwe ukusebenza. Lokhu kungabandakanya ukuvivinya umzimba ukuze kuthuthukiswe uhla lokunyakaza, ukuqeqeshwa kwamandla, nezinye izindlela zokuqinisekisa ukuthi indawo ethintekile iphinde ibe nomsebenzi omningi ngangokunokwenzeka.

Izinkinga

Ukulimala kwe-Degloving kuhlanganisa ukuhlukanisa isikhumba kanye nezicubu ezingaphansi emzimbeni, ngokuvamile ezithinta izitho noma i-torso. Lokhu kulimala kungaholela ezinkingeni ezimbalwa, njengoba zibalwe ngezansi, ngayinye edinga ukuphathwa ngokucophelela:

• Ingozi yokutheleleka iyanda ngenxa yezicubu eziveziwe kanye nokungcola okungase kube khona, okudinga ukuhlanzwa okunamandla, ama-antibiotics, futhi ngezinye izikhathi ukuchithwa kokuhlinzwa ukuze kuvinjelwe. i-sepsis.
• Ukulahleka kwegazi okukhulu kungenzeka endaweni yokulimala, okungase kuholele ekushaqekeni. Ukungenelela kwezokwelapha ngokushesha kubalulekile ukulawula ukopha nokusimamisa isiguli.
• Ukulahlekelwa isikhathi eside kwezinzwa noma i-neuropathy kungase kubangele ukulimala kwezinzwa, kuthinte izinga lempilo yomuntu ohlukunyeziwe futhi kudinga ukuvuselelwa noma ukwelashwa okukhethekile.
• Ukwehluleka ukuxhunyelelwa kwesikhumba noma ukwenqatshwa kungenza kube nzima ukululama, kudinga ukuqapha ngokucophelela, okungenzeka ukuthi kuxhunywe kabusha, nokulungiswa kwemishanguzo ye-immunosuppressive ukuqinisekisa ukuthi igraft iyathathwa.
• Umthelela ongokwengqondo, okuhlanganisa i-PTSD kanye nezindaba zesithombe somzimba, ngokuvamile udinga ukusekelwa ngokwengqondo nokwelulekwa ukuze kusize iziguli zijwayele umphumela wokulimala.

Kufanele Ubonane Nini Nodokotela?

Ukulimala kwe-Degloving kudinga ukunakekelwa ngokushesha ukuze kuvinjwe ukutheleleka kanye nokulahlekelwa kakhulu kwegazi futhi okungase kusindise isitho noma indawo ethintekile. Odokotela bazohlola izinga le ukulimala, inikeze ukunakekelwa kwenxeba okufanele, futhi ingase ihlinze ukuze kulungiswe umonakalo. Futhi, kuyatuseka ukuthi ungelaphe ukulimala kwezandla okugobekile ekhaya, njengoba kungase kubhebhethekise isimo. 

Imibuzo Evame Ukubuzwa

Q1. Uyini umehluko phakathi kwe-avulsion kanye ne-degloving?

Izimpendulo. I-avulsion ukulimala lapho isikhumba noma izicubu zikhishwa khona emzimbeni, ngokuvamile okushiya isilonda esibalulekile. I-Degloving, nokho, ibhekise ngqo ekulimaleni lapho isikhumba futhi izicubu ezingaphansi zikhishwa ngenkani, ngokuvamile ezithinta izitho noma iminwe, okudala ukubukeka "okunamagilavu" kwezakhiwo ezingaphansi.

Q2. Luyini usizo lokuqala lokulimala kwe-degloving?

Izimpendulo. Usizo lokuqala lokulimala kwe-degloving luhlanganisa ukulawula ukopha ngokuqondile ingcindezi, ukugwema ukugeza noma ukubeka kabusha isikhumba, ukumboza indawo ngendwangu ehlanzekile noma ibhandishi, nokufuna usizo lwezokwelapha ngokushesha ukuze uvimbele ukutheleleka kanye nokulimala okwengeziwe.