Ukukhuliswa kwebele: ukwelashwa kwe-hypotrophy yamabele

INCAZELO, IZINHLOSO KANYE NEZIMISO

I-Hypoplasia yebele inqunywa umthamo ongathuthukisiwe webele maqondana nokuma kwesiguli. Kungase kube umphumela wokuthuthukiswa okunganele kwe-gland ngesikhathi sokuthomba noma kwenzeke okwesibili ngokuncipha kwevolumu ye-gland (ukukhulelwa, ukulahlekelwa isisindo, ukuphazamiseka kwe-hormonal, njll.). Ukushoda kwevolumu kungahlotshaniswa ne-ptosis (isifuba "esigobile" esinezindlala, ukwelula kwesikhumba, nama-areola aphansi kakhulu).

“Lokhu kungondleki ngokuvamile akubonwa kahle ngokomzimba nangokwengqondo isiguli, esibhekana nakho njengokuhlasela ubufazi bakhe, okuholela ekushintsheni kokuzethemba futhi ngezinye izikhathi kube nokugula okujulile, okungafinyelela inkimbinkimbi yangempela. Yingakho ukungenelela kuhlongoza ukwandisa umthamo webele, okubhekwa njengento encane kakhulu, ngokufakelwa kwama-prostheses. »

Ukungenelela kungenziwa kunoma iyiphi iminyaka kusukela eminyakeni eyi-18. Isiguli esincane ngokuvamile asibhekwa njengesifanele ukuhlinzwa. Kodwa-ke, lokhu kungenzeka ezimeni ze-hypoplasia eqinile noma kumongo wokwakhiwa kabusha okufana namabele angama-tubular noma i-breast agenesis. Le nhloso yobuhle kuphela ayikwazi ukufakwa umshwalense wezempilo. Izimo ezimbalwa kuphela ezingavamile ze-genesis yebele yangempela (ukuntuleka okuphelele kokuthuthukiswa kwebele) ngezinye izikhathi ezingathemba ukubandakanyeka Kokuvikeleka Komphakathi ngemva kwemvume yangaphambili.

Izimila zebele ezisetshenziswayo njengamanje zihlanganisa igobolondo nesigcwalisi. Imvilophu ihlale yenziwe nge-silicone elastomer. Ngakolunye uhlangothi, ama-prostheses ahlukile kokuqukethwe kwawo, okungukuthi, ku-filler ngaphakathi kwegobolondo. Ukufakelwa kuthathwa njengokugcwaliswe ngaphambilini uma isigcwalisi besifakwe efekthri (ijeli kanye/noma i-serum ye-physiological). Ngakho-ke, ububanzi bemiqulu ehlukene bubekwe umenzi. Ukufakwa kwe-saline-inflated igcwele udokotela ohlinzayo, ongakwazi ukulungisa umthamo we-prosthesis ngezinga elithile phakathi nenqubo.

ISIZUKULU ESISHA AMA-IMPLANT ESIGCWALIWE SILICONE

Iningi lama-prostheses okwamanje afakwe e-France nasemhlabeni jikelele afakwe ngaphambili ngejeli ye-silicone.

“Lawa ma-implants, osekuphele iminyaka engu-40 esetshenziswa, abonakale engenabungozi futhi avumelane kakhulu nalolu hlobo lokuhlinzwa, njengoba asondelene kakhulu namabele ajwayelekile. Baphinde badlula ezinguqukweni ezibalulekile, ikakhulukazi ngasekupheleni kwawo-1990, ukuze balungise amaphutha ababengasolwa ngawo. Namuhla, zonke izimila ezitholakala e-France zihlangabezana nezindinganiso ezinembile neziqinile: Ukumakwa kwe-CE (Umphakathi WaseYurophu) + I-ANSM (I-National Agency for the Safety of Medicines and Health Products) imvume. »

Ahlanganisa ijeli ye-silicone ethambile ezungezwe igobolondo le-silicone elastomer elingangeni manzi, eliqinile futhi eliguquguqukayo elingashelela noma libe nokwakheka (rough). Ukuthuthukiswa okuphawulekayo kokufakwayo okusha, okubanika ukwethembeka okukhulu, kuhlobana nawo womabili amagobolondo kanye nejeli ngokwayo:

• amagobolondo, manje anezindonga eziqine kakhulu, avimbela ijeli "ekuphumeni kwegazi" (okwakuwumthombo oyinhloko wamagobolondo) futhi amelana kakhulu nokugqoka;

• Amajeli e-silicone "okunamathelayo", okuhambisana kwawo kungenaketshezi oluncane, anciphisa kakhulu ingozi yokusabalala uma kwenzeka kugqashuka igobolondo.

Kanye nalokhu kwanda kokwethembeka, isizukulwane esisha sokufakelwa kwe-silicone siphinde sibonakale ngezinhlobonhlobo zezimo ezitholakalayo njengamanje, ezivumela ukuthi ziqondiswe ngamunye ngamunye esimweni ngasinye. Ngakho-ke, eduze kwe-prostheses eyindilinga yakudala, kwavela izimila "ze-anatomical", ezifakwe kwiphrofayili ngendlela yeconsi lamanzi, ngaphezulu noma ngaphansi, ububanzi noma ukuphuma. Lokhu kuhlukahluka okukhulu komumo, kuhlanganiswe nokukhetha okubanzi kwamavolumu, kuvumela ukukhethwa "komuntu ngamunye" kwezitho zokwenziwa ukuthi zenziwe zakhiwe kahle futhi zivumelane nokuma kwesiguli kanye nalokho okulindelwe umuntu.

EZINYE IZINHLOBO ZOKUFAKA

Amagobolondo ama-prostheses ahlala enziwe nge-silicone elastomer, ukugcwaliswa kuhlukile. Kuze kube manje, izindlela ezimbili kuphela ze-silicone gel ezivunyelwe eFrance: I-serum ye-Physiological: lena amanzi anosawoti (ahlanganisa i-70% yomzimba womuntu). Lawa ma-prostheses angase "agcwaliswe ngaphambili" (embonini) noma "afake umoya" (ngudokotela ohlinzayo ngesikhathi sokuhlinzwa). Ngenxa yoketshezi lwazo (kunokuqukethwe kwe-gelatinous), banokungaguquguquki okungekona okwemvelo, bakha "amafolda" amaningi athintekayo, abonakalayo futhi ngokuvamile angaba yizisulu zokwehla kwamandla emali kungazelelwe futhi ngezinye izikhathi ekuqaleni. IHydrogel: Lena into yakamuva ezogunyazwa yi-Afssaps ngo-2005. Ijeli enamanzi eyakhiwe ngokuyinhloko ngamanzi agqinsiswe nokuphuma kwe-cellulose. Le jeli, enokuvumelana kwemvelo okwengeziwe kunosawoti ovamile, iphinde imunce umzimba uma kwenzeka kuqhume ulwelwesi. Okokugcina, kunama-prostheses anegobolondo le-silicone elimbozwe nge-polyurethane, elingasiza ekunciphiseni izenzakalo zegobolondo.

NGAPHAMBI KOKUNGENELELA

Ngokuya kulo mongo we-anatomical, izintandokazi nemikhuba kadokotela ohlinzayo, kanye nezifiso ezivezwe isiguli, isu lokusebenza kuzovunyelwana ngalo. Ngakho-ke, indawo yezibazi, uhlobo nobukhulu bezimila, kanye nendawo yazo maqondana nemisipha kuzonqunywa kusengaphambili (bheka ngezansi). Ukuhlolwa kwegazi ngaphambi kokuhlinzwa kuzokwenziwa njengoba kunqunyiwe. Udokotela obulala izinzwa uzohambela ukubonisana kungakapheli amahora angama-48 ngaphambi kokuhlinzwa. Ukuhlolwa kwe-X-ray yesifuba (i-mammography, i-ultrasound) kunqunyelwe. Kunconywa kakhulu ukuyeka ukubhema okungenani inyanga eyodwa ngaphambi kanye nenyanga eyodwa ngemva kokuhlinzwa (ugwayi ungabambezela ukuphola) Ungaphuzi imithi ene-aspirin izinsuku eziyishumi ngaphambi kokuhlinzwa. Cishe uzocelwa ukuthi uzile ukudla (ungadli noma uphuze noma yini) amahora ayisithupha ngaphambi kwenqubo.

UHLOBO LWE-AESTHESIA KANYE NEZINDLELA ZOKULAlisa

Uhlobo lwe-anesthesia: Imvamisa lena i-anesthesia ejwayelekile yakudala lapho ulele ngokuphelele. Ezimweni ezingavamile, nokho, i-anesthesia "eqaphile" (i-anesthesia yendawo ethuthukisiwe nge-tranquilizer efakwe emthanjeni) ingasetshenziswa (ngokuvumelana nodokotela ohlinzayo kanye nodokotela obulala izinzwa). Izindlela zokulaliswa esibhedlela: ukungenelela ngokuvamile kudinga ukulaliswa esibhedlela usuku olulodwa. Ukungena bese kwenziwa ekuseni (noma ngezinye izikhathi ngayizolo) futhi ukuphuma kuvunyelwe ngakusasa. Kodwa-ke, kwezinye izimo, ukungenelela kungenziwa "ngesisekelo sokugula", okungukuthi, ngokuhamba ngosuku olufanayo ngemva kwamahora ambalwa okubuka.

UKUNGENELELA

Udokotela ohlinzayo ngamunye usebenzisa indlela yakhe futhi ayivumelanise nesimo ngasinye ukuze athole imiphumela engcono kakhulu. Kodwa-ke, singagcina izimiso eziyisisekelo ezijwayelekile: Ukusikwa kwesikhumba: kukhona "izindlela" ezimbalwa okungenzeka:

• imigudu yomoya eyi-areolar ene-incision engxenyeni engezansi yesiyingi se-areola noma imbobo evundlile ezungeze ingono ukusuka ngezansi (1 no-2);

• i-axillary, ngokusikwa ngaphansi kwengalo, ekhwapheni (3);

• indlela ye-submammary, enembobo emseleni ongaphansi kwebele (4). Indlela yalokhu kusika ngokusobala ihambisana nendawo yezibazi zesikhathi esizayo, ezizofihlwa lapho kuhlangana khona noma ekugoqweni kwemvelo.

Ukufakwa kwama-prostheses

Ngokudlula ekusikeni, izimila zingase zifakwe emaphaketheni adaliwe. Izikhundla ezimbili zingenzeka:

• i-premuscular, lapho ama-prostheses atholakala ngqo ngemuva kwe-gland, phambi kwemisipha ye-pectoral;

• i-retromuscular, lapho ama-prostheses atholakala ngokujulile, ngemuva kwemisipha ye-pectoral.

Ukukhetha phakathi kwalezi zingosi ezimbili, nezinzuzo zazo kanye nokubi, kufanele kuxoxwe ngazo nodokotela wakho ohlinzayo. Izenzo ezihambisanayo Endabeni yezinhlanganisela (i-breast prolapse, i-areolas ephansi) sibonile ukuthi kungase kube efiselekayo ukunciphisa isikhumba sebele ukuze kuphakame ("mastopexy"). Lokhu kususwa kwesikhumba kuzoholela ezibazini ezinkulu (ezizungeze i-areola ± mpo). Ama-drain and dressings Ngokuya ngemikhuba kadokotela ohlinzayo, kungase kubekwe umsele omncane. Lo mshini uklanyelwe ukukhipha igazi elingase linqwabelene ezindaweni zokwenziwa. Ekupheleni komsebenzi, i-bandage "yemodeli" isetshenziswa nge-bandage elastic. Kuye ngodokotela ohlinzayo, indlela kanye nesidingo esingenzeka sokuhambisana nezinqubo ezengeziwe, inqubo ingathatha ihora elilodwa kuya emahoreni amabili nesigamu.

NGEMVA KOKUNGENELELA: UKUBHALWA KWEZOKUSEBENZA

Inkambo ye-postoperative ngezinye izikhathi ingaba buhlungu phakathi nezinsuku ezimbalwa zokuqala, ikakhulukazi ngokufakelwa kwevolumu enkulu futhi ikakhulukazi uma ibekwe ngemuva kwemisipha. Imithi yezinhlungu evumelaniswe nobukhulu bobuhlungu izonikezwa izinsuku ezimbalwa. Okungcono kakhulu, isiguli sizozizwa sinokucindezeleka okukhulu. I-edema (ukuvuvukala), i-ecchymosis (ukulimala), nobunzima bokuphakamisa izingalo kuvamile ezigabeni zokuqala. I-bandage yokuqala isuswa ngemva kwezinsuku ezimbalwa. Bese ishintshwa ngebhandeshi elilula. Khona-ke amasonto ambalwa, ukugqoka ubhodisi imini nobusuku kunganconywa. Ezimweni eziningi, ama-sutures angaphakathi futhi ayangena. Uma kungenjalo, zizosuswa ngemva kwezinsuku ezimbalwa. Ukubuyisela kufanele kucatshangwe ngekhefu emisebenzini izinsuku ezinhlanu kuya kweziyishumi. Kunconywa ukuthi ulinde inyanga eyodwa kuya kwezimbili ukuze uqalise kabusha imisebenzi yezemidlalo.

IMIPHUMELA

Ukuhlola umphumela wokugcina, isikhathi esiyizinyanga ezimbili kuya kwezintathu siyadingeka. Lesi yisikhathi esidingekayo ukuze ibele liphinde likwazi ukuguquguquka futhi lizinzise izitho zokwenziwa.

“Ukuhlinzwa kuvumele ukuthuthukisa umthamo nokuma kwesifuba. Izibazi ngokuvamile azibonakali kakhulu. Ukwanda kwevolumu yebele kuthinta i-silhouette jikelele, inikeza inkululeko enkulu engutsheni. Ngaphezu kwalokhu kuthuthukiswa ngokomzimba, ukubuyiselwa kobufazi obugcwele nobuphelele kuvame ukuba nomphumela onenzuzo kakhulu ezingeni elingokwengqondo. »

Umgomo walo msebenzi uwukuthuthukisa, hhayi ukuphelela. Uma izifiso zakho zingokoqobo, umphumela kufanele ukujabulise kakhulu. Ukuzinza komphumela Kungakhathaliseki ubudala be-prostheses (bheka ngezansi) futhi ngaphandle kokuvela kokuhluka okuphawulekayo kwesisindo, umthamo webele uzohlala uzinzile esikhathini eside. Kodwa-ke, mayelana nokuma kanye "nokubamba" kwebele, ibele "elikhulisiwe" lizobhekana, njengebele lemvelo, emiphumeleni yamandla adonsela phansi kanye nokuguga ngamazinga ahlukene kuye ngokuthi ubudala kanye nekhwalithi yokusekelwa kwesikhumba, njengoba kanye nomthamo webele. izimila.

UBUBI BOMPHUMELA

Kwesinye isikhathi ezinye iziphambeko zingenzeka:

• i-residual volume asymmetry, engalungiswanga ngokuphelele naphezu kokufakelwa kosayizi abahlukene; • ukuqina okukhulu nokungaguquguquki okwanele kanye nokuhamba (ikakhulukazi ngezifakelo ezinkulu);

• ukubukeka kokwenziwa okuthile, ikakhulukazi ezigulini ezincane kakhulu, ngokubonakala ngokweqile kwemiphetho ye-prosthesis, ikakhulukazi engxenyeni engenhla;

• Ukuzwela ekuthinteni kwezimila kuhlale kungenzeka, ikakhulukazi ngokuqina okuncane kwesembozo sezicubu (isikhumba + amafutha + insimbi) emboza i-prosthesis (ikakhulukazi ngokufakelwa okukhulu).

• kungase kube nokwanda kwe-ptosis yebele, ikakhulukazi uma kusetshenziswa izimila ezinkulu. Uma kwenzeka ukunganeliseki, okunye kwalokhu kushiyeka kungalungiswa ngokulungiswa kokuhlinzwa ngemva kwezinyanga ezimbalwa.

EMINYE IMIBUZO

Ukukhulelwa/Ukuncelisa

Ngemuva kokufakwa kwama-prostheses webele, ukukhulelwa kungenzeka ngaphandle kwengozi esigulini noma enganeni, kodwa kunconywa ukulinda okungenani izinyanga eziyisithupha ngemva kokungenelela. Ngokuqondene nokuncelisa, futhi akuyona ingozi futhi ezimweni eziningi kuhlala kungenzeka.

Izifo ze-Autoimmune

Amaphepha amaningi kakhulu esayensi yamazwe ngamazwe aqhutshwa ngezinga elikhulu ngalesi sihloko abonise ngazwi linye ukuthi ubungozi balolu hlobo lwesifo esingavamile ezigulini ezifakwe izimila (ikakhulukazi i-silicone) azikho ngaphezu kwenani labantu besifazane jikelele.

Amazinyo okufakelwa nomdlavuza

- Kuze kube muva nje, isimo sesayensi siphakamise ukuthi ukufakwa kwama-prostheses webele, kuhlanganise ne-silicone, akukhulisi ingozi yokuba nomdlavuza webele. Kusenjalo ngempela ezinhlotsheni ezivame kakhulu zomdlavuza webele (i-adenocarcinomas, engakhuli esenzeka nge-prosthesis yebele.

Kodwa-ke, esimweni sokuhlolwa komdlavuza ngemva kokufakelwa, ukuhlolwa komtholampilo kanye ne-palpation kungase kuphazamiseke, ikakhulukazi esimweni se-periprosthetic sheath noma i-siliconoma. Ngokufanayo, ukuba khona kwezimila kungaphazamisa ukusebenza nokuchazwa kokuhlolwa kwe-mammograms, okufanele kwenziwe njalo. Ngakho-ke, kufanele uhlale ubonisa ukuthi une-breast implants. Ngakho-ke, kuye ngesimo, izindlela ezithile ezikhethekile ze-radiological (ukuqagela okuqondile, izithombe ezifakwe kudijithali, i-ultrasound, i-MRI, njll.) zingasetshenziswa. Ngaphezu kwalokho, uma kwenzeka kuba nokungabaza okuxilonga ngokuphathelene nomdlavuza webele, umuntu kufanele aqaphele ukuthi ukuba khona kwezitho zokwenziwa kungase kudinge ukuhlolwa okuhlaselayo ukuze kutholakale isiqiniseko sokuxilonga.

- I-Anaplastic big cell lymphoma (ALCL) ehlotshaniswa nokufakelwa kwebele (ALCL-AIM) iyindlela yomtholampilo eyingqayizivele esanda kwenziwa yomuntu ngamunye. Leli bhizinisi kufanele lifunwe kuphela esimweni sezimpawu zomtholampilo ezifakazelwe (ukukhishwa kwe-periprosthetic okuphindaphindekayo, ububomvu bebele, ukukhuliswa kwebele, isisindo esizwakalayo). Khona-ke kuyadingeka ukwenza ukuhlolwa okunembile kwe-senological ukuze kucaciswe uhlobo lwesilonda. Ezimweni ezicishe zibe ngu-90%, lesi simo sinesimo esihle kakhulu sokubikezela futhi ngokuvamile selashwa ngokuhlinzwa okufanele, okuhlanganisa ukukhishwa kwe-prosthesis kanye ne-periprosthetic capsule (ingqikithi nengqikithi ye-capsulectomy). Ezimweni ezingaba ngu-10%, ukugula kubi kakhulu futhi kudinga ukwelashwa ngamakhemikhali kanye/noma ukwelapha ngemisebe eqenjini eligxile ekwelapheni i-lymphomas.

Impilo yesevisi yezimila

Ngisho noma singabona ukuthi ezinye iziguli zigcina izithombo zazo amashumi eminyaka ambalwa ngaphandle kwezinguquko ezinkulu, ukubekwa kwezitho zokwenziwa kwebele akufanele kuthathwe njengento eqinisekile "yokuphila konke". Ngakho, isiguli esifakwe izitho zokufakelwa singase silindele ukuthi ngolunye usuku kudingeke ukuthi sishintshe izitho zokufakelwa ukuze silondoloze umphumela omuhle. Izimila, kungakhathaliseki ukuthi ziyini, zinesikhathi sokuphila esingenamkhawulo esingenakulinganiswa ngokunembile ngoba kuncike esimweni sokugqoka ngenani eliguquguqukayo. Ngakho-ke, impilo yesevisi yezimila ayikwazi ukuqinisekiswa. Kodwa-ke, kufanele kuqashelwe ukuthi ukufakelwa kwesizukulwane esisha kwenze inqubekelaphambili ebalulekile mayelana namandla nokuthembeka. Kusukela ngonyaka weshumi, kuzodingeka uphakamise umbuzo wokushintsha ama-prostheses lapho ukuguqulwa kokuvumelana kubonakala.

ukubonwa

Kubaluleke kakhulu ukuthi ukuhlolwa uyalwe udokotela wakho ohlinzayo amasonto ambalwa bese kuba yizinyanga ngemuva kokufakelwa. Kamuva, ukuba khona kwezimila akukhululi ekugadweni okujwayelekile kwezokwelapha (ukugadwa kwezifo zabesifazane kanye nokuhlolwa komdlavuza webele), ngisho noma kungadingi ukuhlolwa okwengeziwe okuhlobene nalokhu kugadwa. Nokho, kubalulekile ukwazisa odokotela abahlukahlukene ukuthi unezakhi zokwenziwa zamabele. Ukubonisana nodokotela ohlinzayo wepulasitiki mayelana nokufakwa kunconywa njalo eminyakeni emibili kuya kwemithathu, kodwa ngaphandle kwalokhu kulandelela, okokuqala kubalulekile ukuza futhi ubonisane ngokushesha lapho ukuguqulwa kwebele elilodwa noma womabili kutholwa. noma ngemva kokulimala kanzima.

IZINKINGA EZINGAKHO

Ukukhulisa ibele ngezitho zokwenziwa, nakuba kwenziwa ngenxa yezizathu zobuhle kuphela, nokho kuyinqubo yokuhlinzwa yangempela eza nezingozi ezihlobene nanoma iyiphi inqubo yezokwelapha, kungakhathaliseki ukuthi incane kangakanani. Kumele kwenziwe umehluko phakathi kwezinkinga ezihlobene nokubulala izinzwa kanye nezinkinga ezihlobene nokuhlinzwa: Ngokuphathelene nokubulala izinzwa, ngesikhathi sokubonisana okuphoqelekile ngaphambi kokuhlinzwa, udokotela obulala izinzwa ngokwakhe wazisa isiguli ngezingozi ezibulala izinzwa. Kufanele wazi ukuthi i-anesthesia, kungakhathaliseki ukuthi iyini, ibangela ukusabela emzimbeni ngezinye izikhathi okungalindelekile futhi okulawulwa kalula noma kalula. Kodwa-ke, ngosizo lwe-anesthesiologist-resuscitator enekhono esebenza esimweni sokuhlinzwa ngempela, izingozi ziye zaba phansi kakhulu ngokwezibalo. Kufanele kukhunjulwe ngempela ukuthi amasu, izibulala-zinzwa, nezindlela zokuqapha zenze inqubekelaphambili enkulu phakathi neminyaka engamashumi amathathu edlule, zinikeza ukuphepha okuphelele, ikakhulukazi lapho ukungenelela kwenziwa ngaphandle kwegumbi lezimo eziphuthumayo futhi kumuntu ophile kahle; Ngokuqondene nesenzo sokuhlinzwa, ngokukhetha udokotela ohlinzayo wepulasitiki oqeqeshiwe futhi onekhono oqeqeshwe kulolu hlobo lokungenelela, unciphisa lezi zingozi ngangokunokwenzeka, kodwa ungaziqedi ngokuphelele. Eqinisweni, iningi lemisebenzi yokukhulisa ibele eyenziwa ngaphakathi kwemithetho ihamba ngaphandle kwezinkinga, inkambo ye-postoperative ilula, futhi iziguli zaneliseka ngokuphelele ngemiphumela yazo. Kodwa-ke, ngezinye izikhathi izinkinga zingenzeka ngesikhathi sokungenelela, ezinye zazo ezihlobene nokuhlinzwa kwebele, kanti ezinye zihlobene ngokuqondile nokufakelwa:

Izinkinga ezikhona ekuhlinzweni kwebele

• I-effusions, infection-hematoma: Ukunqwabelana kwegazi ezizungeze i-prosthesis kuyinkathazo yokuqala engenzeka emahoreni okuqala. Uma lokhu kubalulekile, ngakho-ke kungcono ukubuyela ekamelweni lokuhlinza ukuze kukhishwe igazi futhi kumise ukopha endaweni okuvela kuyo;

- Ukuphuma kwe-serous: ukunqwabelana koketshezi lwe-lymphatic eduze kwe-prosthesis kuyinto evamile, evame ukuhambisana ne-edema ephawulekayo. Kumane kubangele ukwanda kwesikhashana kwevolumu yebele. Inyamalala ngokuzenzakalelayo futhi kancane kancane;

– ukutheleleka: akuvamile ngemva kwalolu hlobo lokuhlinzwa. Ngeke ixazululwe ngokwelashwa ngama-antibiotic kuphela bese idinga ukubuyekezwa kokuhlinzwa ukuze kukhishwe futhi kukhishwe okokufakelwa izinyanga ezimbalwa (isikhathi esidingekayo sokufaka i-prosthesis entsha ngaphandle kwengozi). Ezinye izinhlobo ezintathu zokutheleleka nazo zingashiwo:

- ukutheleleka "okuthulile" sekwephuzile: lokhu kuyisifo esinezimpawu ezimbalwa futhi akukho ukubonakaliswa okusobala ekuhlolweni, okungenzeka ngezinye izikhathi eminyakeni eminingana ngemva kokufakelwa;

ama-microabscesses: avame ukukhula endaweni ye-suture futhi axazulule ngokushesha ngemva kokususwa kwentambo eboshiwe kanye nokwelashwa kwendawo;

Ukushaqeka okunobuthi kwe-Staphylococcal: kuye kwabikwa izimo ezingavamile kakhulu zalesi sifo esithathelwanayo esivamile.

• I-Cutaneous necrosis Yenzeka ngenxa yokuntuleka komoya-mpilo kwezicubu ngenxa yokungatholakali kwegazi okwanele kwendawo, okungase kube nengxenye kukho ukuzikhandla ngokweqile, i-hematoma, ukutheleleka, noma ukubhema kakhulu esigulini. Lokhu kuyinkimbinkimbi engavamile kakhulu kodwa eyingozi, ngoba ezimweni ezimbi kakhulu kungaholela ekuvezweni kwendawo ye-prosthesis, ikakhulukazi, ngenxa yokuhlukana kwe-sutures. Ukuhlinza okubukeziwe ngokuvamile kuyadingeka, ngezinye izikhathi kudinga ukususwa kwesikhashana kokufakelwa.

• Ukuphulukisa okudidayo Inqubo yokuphola ihilela izenzakalo ezingahleliwe, ngezinye izikhathi kuyenzeka ukuthi ngokuhamba kwesikhathi izibazi zingabonakali ngendlela elindelekile, ezingase zithathe izici ezihlukahlukene: ukunwebeka, ukuhoxiswa, ukudayiswa, i-hyper- noma i-hypopigmented, i-hypertrophic (ivuvukele) noma i-keloid kuphela.

• Ukushintsha ukuzwela. Zivame kakhulu ezinyangeni zokuqala, kodwa ngokuvamile zihlehla. Kodwa-ke, ezimweni ezingavamile, izinga elithile le-dysesthesia (ukunciphisa noma ukwanda kokuzwela ekuthinteni) kungase kuqhubeke, ikakhulukazi endaweni ye-areola kanye nengono. • I-Galactorrhea/effusion yobisi Izimo ezingavamile kakhulu zokugqugquzelwa kwama-hormone kwangemva kokuhlinzwa okungachazwanga okuholela ekugelezeni kobisi (“galactorrhea”) okunoketshezi ngezikhathi ezithile eduze kwe-prosthesis kuye kwabikwa.

• I-Pneumothorax Engavamile, idinga ukwelashwa okukhethekile.

Izingozi ezihlobene nezigxivizo

• Ukwakhiwa kwe "folds" noma ukubonakala "kwamagagasi"Njengoba ama-implants aguquguqukayo, kungenzeka ukuthi igobolondo labo lizoshwabana, futhi le migoqo ingazwakala noma ibonakale ngaphansi kwesikhumba ezindaweni ezithile, inikeze umbono wamagagasi. Lesi simo sivame kakhulu ezigulini ezinomzimba omncane futhi singelashwa nge-lipomodelling, okubandakanya ukusebenzisa ungqimba oluncane lwamafutha ngaphansi kwesikhumba sebele ukuze "kufihlwe" ukufakelwa.

•"Amagobolondo 

Ukusabela komzimba, okujwayelekile kanye nokungapheli komzimba womuntu ebukhoneni bomzimba wangaphandle ukuwuhlukanisa nezicubu ezizungezile ngokwenza ulwelwesi olungangeni moya oluzungeza ukufakelwa futhi lubizwa ngokuthi "i-periprosthetic capsule". Ngokuvamile, leli gobolondo lincane, liguquguqukayo futhi alibonakali, kodwa kwenzeka ukuthi ukusabela kuyaqina futhi i-capsule iyaqina, ibe ne-fibrous futhi ihlehlise, icindezela ukufakelwa, okubizwa ngokuthi "igobolondo". Ngokuya ngokuqina kwalesi senzakalo, lokhu kungaholela: ukuqina okulula kwebele, ngezinye izikhathi ukuvinjelwa okucasulayo, ngisho nokukhubazeka okubonakalayo nge-globulization ye-prosthesis, okuholela ezingeni elidlulele esimweni esinzima, esibuhlungu, esingaphezulu noma esingaphansi. indawo eccentric. Le fibrosis ye-retractile ngezinye izikhathi ilandela i-hematoma noma ukutheleleka, kodwa ezimweni eziningi ukwenzeka kwayo kuhlala kungalindelekile ngenxa yokusabela okungahleliwe kwemvelo.

Eminyakeni yamuva nje, kuye kwenziwa inqubekelaphambili enkulu mayelana nendlela yokuhlinza, kodwa ngaphezu kwakho konke ekwakhiweni nasekwakheni izimila, okuholela ekunciphiseni okukhulu kwezinga nokuqina kokuhlehlisa. Uma kunesidingo, ukusebenza kabusha kungalungisa isivumelwano esinjalo ngokusika i-capsule ("capsulotomy").

• Ukuqhekeka Sibonile ukuthi izimila azikwazi ukubhekwa njengengunaphakade. Ngakho-ke, ngokuhamba kwesikhathi, kungase kube nokulahlekelwa kokuqina kwegobolondo. Kungaba i-porosity elula, ama-pinholes, ama-microcracks, noma izimbobo zangempela. Ezimweni ezingavamile kakhulu, lokhu kungase kube umphumela wokulimala okukhulu noma ukubhoboza ngengozi futhi, ngokuvamile, umphumela wokuguga okuqhubekayo kodonga ngenxa yokuguga. Kuzo zonke izimo, lokhu kuholela kumphumela ongaba khona wokugcwalisa umkhiqizo wokufakelwa, okunemiphumela ehlukile kuye ngohlobo lwalokhu okuqukethwe:

- nge-saline noma i-hydrogel e-resorbable, i-deflation eyingxenye noma ephelele, i-deflation esheshayo noma esheshayo ibonakala;

- nge-silicone gel (engenakumuncwa), ihlala ngaphakathi kwe-membrane ehlukanisa i-prosthesis. Lokhu kungase kube nomthelela ekubukeni kwe-hull, kodwa kungase futhi kuhlale ngaphandle kwemiphumela futhi kungabonakali ngokuphelele. Kodwa-ke, kwezinye izimo, eziye zaba yivelakancane kakhulu (ikakhulukazi, ngenxa "yokunamathela" okungcono kwama-gel anamuhla), umuntu angabona ukungena kancane kancane kwejeli ezicutshini ezizungezile. Ukuphuka kwe-prosthesis ngokuvamile kudinga ukungenelela ukuze kuthathelwe indawo izimila.

• Ukuma okungafanele, ukungaboni ngaso linye Ukungalungi kahle noma ukungaqondani kahle kwesibili kwezimila, okube sekuthikameza ukuma kwebele, ngezinye izikhathi kungase kuthethelele ukulungiswa kokuhlinzwa.

• Ukuzungezisa Nakuba ukuzungezisa kwe-prosthesis “ye-anatomical” kuyivelakancane uma kuqhathaniswa, kungenzeka ngokombono futhi kungase kuthinte umphumela wobuhle.

• Ukuguqulwa kodonga lwesifuba. Ezimweni ezingavamile, ama-prostheses egobolondo ane-fibrous ashiywe endaweni isikhathi eside "angaphrinta" ezicutshini, ashiye ukukhubazeka kodonga lwesifuba okunzima ukukulungisa lapho kususwa.

• I-seroma ye-periprosthetic sekwephuzile. Ezimweni ezingavamile kakhulu, ukuphuma sekwephuzile kungase kwakheke eduze kwe-prosthesis. Ukukhishwa sekwephuzile okunjalo, ikakhulukazi uma kuhlotshaniswa nokunye ukuphazamiseka komtholampilo kwendlala yebele, kudinga ukuhlolwa kwezinzwa okwenziwa isazi se-senologist nge-radiologist. Ukuhlola okuyisisekelo kuzobandakanya i-ultrasound ne-effusion puncture. Uketshezi olulethwe ngale ndlela kuzoba yisihloko socwaningo ngokuseshwa kwamaseli e-lymphoma. I-Digital mammography kanye/noma i-MRI ingase idingeke kuye ngemiphumela yokuhlolwa kokuqala kwe-fibrous periprosthesis (capsulectomy) evumela i-biopsy ukuthi ibheke i-breast implant engavamile kakhulu ehlotshaniswa ne-anaplastic big cell lymphoma (ALCL-AIM).