Ke loaʻa nei iā ʻoe ka ʻeha hiki ʻole ke hoʻomanawanui ma kou mau lima a me kou mau wāwae? E aʻo kākou e pili ana i kēia ʻoki Fasciotomy!

E noʻonoʻo ʻoe ua loaʻa iā ʻoe kahi ʻeha koʻikoʻi i kou wāwae i kahi ulia. Ma hope o kekahi manawa, pehu nā ʻiʻo a puni ka ʻeha, e hōʻeha ana i ka ʻeha hiki ʻole ke hoʻomanawanui, a manaʻo ʻia kou wāwae he mae wale. ʻAʻole kēia he ʻeha maʻamau mai kahi ʻeha, he mea ʻoi aku ia ma mua o kēlā. Hiki i kēia ke lilo i pilikia olakino. ʻO ia ka manawa e pono ai ke ʻoki kino a mākou e kamaʻilio nei i kēia lā, i kapa ʻia he fasciotomy. He ʻoki kino pilikia paha kēia e hoʻopakele i kou lima, wāwae, a i ʻole kou ola.

He aha ka Fasciotomy maʻalahi?

I ka ʻōlelo maʻalahi, he hana ʻoki kino ka fasciotomy e hōʻoluʻolu i ke kaomi a puni kahi ʻiʻo. Pili kēia i ka ʻoki ʻana i ka membrane paʻakikī (fascia) e hoʻopuni ana i ka ʻiʻo, e hoʻokuʻu ana i ke kaomi i loko.

E wehewehe iki kākou i kēia. Ua ʻōwili ʻia nā ʻiʻo, nā aʻalolo, a me nā kīʻaha koko i loko o ko kākou mau lima a me nā wāwae i loko o kahi membrane paʻa a ikaika. E noʻonoʻo e like me ka ʻili a puni ka sausage. I ka lāʻau lapaʻau, kapa mākou i kēia membrane paʻa ʻo 'fascia' . ʻO ka ʻāpana holoʻokoʻa i loko o kēia fascia e loaʻa ana nā ʻiʻo, nā aʻalolo, a me nā kīʻaha koko ua kapa ʻia he 'ʻāpana ʻiʻo.'

E noʻonoʻo, he aha ka mea e hana ʻia inā nui ka pehu ʻana i loko o kēia keʻena ma muli o kekahi ulia? Ma muli o kēlā ʻūpā fascia paʻa, ʻaʻohe wahi o ka pehu e puka i waho. A laila piʻi nui ke kaomi i loko o kēlā keʻena. ʻO kēia ka mea a mākou e kapa nei ʻo 'compartment syndrome' . Ma muli o kēia kaomi nui, lilo nā kīʻaha koko ma ia wahi i paʻa, a hiki ke oki ke kahe o ke koko i nā ʻiʻo a me nā aʻalolo. Inā hana ʻia kēlā, hoʻomaka ka make ʻana o kēlā ʻiʻo. ʻO ia ka manawa e hana ʻia ai kahi fasciotomy, e ʻoki ana i kēlā membrane fascia paʻa, e hoʻokuʻu ana i ke kaomi i loko, a hoʻihoʻi i ke kahe o ke koko.

Pehea e kū mai ai kēia compartment syndrome?

Hiki ke hana i kēia kūlana ma nā ʻano nui ʻelua.

1. ʻO ka Acute Compartment Syndrome: ʻO kēia ka hihia weliweli loa a koke hoʻi. ʻO ka maʻamau ia ma hope o kahi ulia koʻikoʻi. No ka laʻana, hiki ke hana ʻia kēia ʻano ma muli o ka pehu nui ʻana ma hope o kahi ulia kaʻa, e like me ka iwi haki a i ʻole ke kaumaha nui o nā ʻiʻo. He ʻano kēia e pono ai ka mālama olakino ulia pōpilikia.

2. Chronic Compartment Syndrome: He ʻano kēia e ulu mālie ana. ʻIke pinepine ʻia i nā poʻe e hoʻohana nui ana i ka hui ʻiʻo like, e like me nā mea pāʻani a me nā limahana koa. ʻOi aku ka ʻeha me ka hoʻoikaika kino a ʻoi aku ka maikaʻi me ka hoʻomaha. ʻOiai ʻaʻole ia he pilikia, hiki ke lilo i mea koʻikoʻi i ka hala ʻana o ka manawa.

He aha ka mea e hana ʻia ma mua a i ka wā o ke ʻoki kino?

ʻOiai he pilikia ka Acute Compartment Syndrome, ʻaʻole i hoʻolālā mua ʻia ka fasciotomy. Ke komo ʻoe i ka Emergency Treatment Unit (ETU) o ka haukapila, ʻike nā kauka i kēia kūlana ma muli o kāu mau hōʻailona. Ke ʻike lākou iā ia me nā hōʻailona e like me ka ʻeha hiki ʻole ke hoʻomanawanui, ka mae ʻana, a me ka nāwaliwali i kou lima a i ʻole kou wāwae, e lawe koke ke kime ʻoki iā ʻoe i ka lumi hana.

Hana ʻia ke ʻoki kino ma lalo o ka anesthesia laulā, ʻo ia hoʻi, ʻaʻole ʻoe e manaʻo a hoʻomanaʻo paha i kekahi mea. E hana ke kauka ʻoki kino:

• Hana ʻia hoʻokahi a ʻelua paha ʻoki ʻili ma luna o ka ʻāpana ʻiʻo kūpono.
• A laila ua ʻike ʻia ka fascia i loko, ʻoki ʻia, a hoʻokuʻu ʻia ke kaomi. Pono paha e hoʻokuʻu i kekahi mau keʻena ma kēia ʻano.
• A laila, nānā lākou i kekahi ʻiʻo i hōʻino ʻia a make paha a wehe iā ia. Nānā pono lākou inā ua hoʻihoʻi ʻia ke kahe o ke koko.
• ʻAʻole i humuhumu koke ʻia kēia ʻoki. He mau lā ka lōʻihi e iho loa ai ka pehu, no laila ua waiho ʻia ka ʻeha e hāmama ana. I kekahi manawa hoʻohana ʻia kahi lāʻau i kapa ʻia ʻo "negative pressure wound therapy" e hōʻemi koke i ka pehu ma ka wehe ʻana i ke wai mai ka ʻeha.
• Ma hope o kekahi mau lā, e nānā hou ʻia ka ʻeha a wehe ʻia nā ʻiʻo make hou aʻe.
• Ke pau ka pehu ʻana, pani ʻia ka ʻeha. I kekahi manawa, inā ʻaʻole lawa ka ʻili e uhi ai i ka ʻeha, lawe ʻia ka ʻili mai kahi ʻāpana ʻē aʻe o ke kino a hoʻoili ʻia (he `skin graft`).
• ʻO ka hope loa, ua hoʻopaʻa maikaʻi ʻia ka ʻeha a e aʻo ʻia ʻoe i ka lōʻihi o ke kau ʻana i ke kāʻei.

He aha nā pono a me nā pilikia o ke ʻoki kino?

E like me nā ʻoki kino āpau, loaʻa i ka fasciotomy kona mau pono a me kekahi mau pilikia. E nānā pono kākou iā lākou.

He aha ka mea e hana ʻia ma hope o ke ʻoki kino? No ke aha he mea nui ka hoʻōla kino?

Hiki paha iā ʻoe ke ʻeha iki i ka pau ʻana o ka anesthesia. E hāʻawi kāu kauka iā ʻoe i nā lāʻau hōʻeha e kōkua iā ʻoe e hoʻokele iā ia. Ma hope o ke ʻoki ʻana, he mea nui ka hoʻōla kino e kōkua iā ʻoe e hoʻihoʻi i ka neʻe ʻana a me ka ikaika ma ia wahi. Inā ʻaʻole ʻoe e hana pēlā, e paʻakikī paha ke ami a i ʻole ka ʻiʻo a hiki ʻole ke neʻe pono.

ʻO kahi nīnau a kekahi poʻe e nīnau nei, "Ke hana hou nei ka fascia ma hope o ka ʻoki ʻia ʻana?" ʻAe, hana hou ia. Akā hana ia pēlā ma ke ʻano he ʻiʻo ʻeha. ʻO ia ke kumu he mea nui loa ka mālama ʻana i kēlā wahi i hohola maikaʻi ʻia ma o ka hoʻōla kino.

Nā hōʻailona e pono ai ke kōkua koke ʻana o ke kauka

Inā ua loaʻa iā ʻoe kahi ʻeha koʻikoʻi a i ʻole ke ʻoki kino a loaʻa iā ʻoe kekahi o nā hōʻailona ma lalo nei, he mea nui loa e hele koke i ka Emergency Department (ETU) o ka haukapila .

Nā hōʻailona e pono ai ka mālama koke:

• ʻEha nui a hiki ʻole ke hoʻomanawanui ʻia, ʻaʻole i kūlike me ka nui o ka ʻeha .
• ʻO ka maʻi lolo o ka lima a i ʻole ka wāwae no ka manawa pōkole, ʻo ia hoʻi ka hiki ʻole ke hoʻoneʻe iā ia.
• ʻEha ʻoi a ʻano ʻē i ka wā e hoʻolōʻihi ai i kahi ʻiʻo.
• ʻO ka maneʻo, ke ʻano o ke ʻāʻī (paresthesia).

He mea maʻamau i kekahi ke makaʻu i ka wā e haʻi ʻia aku ai he pono iā lākou ke hana i kahi ʻoki kino ulia pōpilikia e like me kēia. Akā e hoʻomanaʻo, ʻo ka fasciotomy ka hopena palekana a maikaʻi loa no ka compartment syndrome. Inā he mau nīnau a hopohopo paha kāu, e kamaʻilio me kāu kauka e pili ana iā lākou me ka wehe. Aia lākou ma laila e kōkua iā ʻoe.