ʻoki lāʻau lapaʻau sutures: ano a me kāu kiʻina hana o blending

Ma kona hana, surgeons hoʻohana sutures, loaʻa nō nāʻano o ia mau mea, kēia mea i kekahi o ka loa e like me ka ano i hoʻohana no ka hui ana liluwelo nā'aʻaʻa: na paia o ka mea na nā loko, i ka eha kihi, a me na mea e ae. Ka mea, i kōkua i ka pau ana i ke kahe ana ke koko, no ka bile, a pau hoomaikai, e koho i ka suture akau.

Ma nā makahiki, ka rula nui o ka hanaia ana o kekahi 'ano o ke ami hoi ua manaoia e e mahalo mai ana no kela a me keia kihi o ka eha, nānā' ole o kona 'ano. E e pili i ka ulana no laila, ua loaʻa i pono like ai ka eha kihi, a me kela mea keia mea o na papa o ka na hui, i pono suturing. I kēia lā i kēia mau kumu i hui ma ka māpuna'ōlelo "miomio".

Ke kaumaha ma muli i koʻi lipi ua hoʻohana 'ia e hana i ka ulana, e like me hana ana oe, i kekahi ke hoomaopopo mau ano: e manual, a me mechanical sutures. No ka uhi weld manuale ke ano o ka hoʻohana 'ana a me kaʻike mau traumatic kui kele, kui kele ma nā mea hōʻoia, tweezers a me nā mea hana. No ka mea crosslinking hiki e wae i ka kemikala absorbable suture a liluwelo ka molekumu o, mea hiki ke hooheheeia uea 'ole' ē aʻe mea.

Ke mechanical e sila ua noi ia e kekahi kūikawā mea ma ka hoʻohana 'ana o ka metala staples.

Ma stitching o ka eha a me ka ho okumu ana o anastomoses kauka e stitches i loko o ka lalani - lalani a me ka papa - elua, aʻehā lālani. A me ka mea e e hui pu i ka'ōwili kihi na nakaka, pela no ka mea, i nui pono hooki ka mea, i ke koko. Akā, aha mea i keʻano o ka suture mea i keia la?

Mea Maluna o kaʻoki lāʻau lapaʻau sutures

E like me mākou i mai la oia, i ka nakaka hiki e nā manuale, a me mechanical, akā, ma laila nō kekahi mau papa o ko lākou mau papa:

• ka mea, he poe aka wahi, e like me ka mea anaʻano hana o ko lākou noi;
• ina kā lākou kaʻana like 'ana i ka palapala - he mea, nodal, hoʻokino paha P Z, ka aa kala ole ia -a-, he 8-hoʻokino;
• i loko o kona functionality hiki ke maheleia i hemostatic, a ua makaʻeo;
• ma ka helu o ka lalani - mai kekahi, a mai i eha;
• palena pau no ka loaa i loko o ka lole - weheʻia a me ka bapetizo ana ma ka hihia mua, he kekahi manawa ma hope o ka stitches i wehe ', a ma ka lua o ka hihia noho i loko o ke kino paʻa.

No hoi ke kumukuai i hoike ia mea, ua mahele ia i kaʻoki lāʻau lapaʻau sutures lākou mau manao, ke kaumaha ma muli o ka mea i hoʻohana: ka mea hiki e absorbable ina ia catgut - i? Ueo a me Vikram Dexon - Ua kemikala. Komo i loko o ke kino lumen - keia ano o ka ulana 'ano o ka puha nā loko. A eia i - kēia mau mea i nāʻano o nā ami i mea ole wehe 'ia, ka mea noho ma ke kino ka wa pau ole, a ua hoopuniia oukou e ka connective'aʻaʻa mea hōʻikeʻikeʻuʻuku.

Maka mea no ka suturing

Sutureʻia nā likeʻole mea i hoʻohana no vascular ligation, anaʻoki lāʻau lapaʻau sutures. Ano o ka mea no ka suturing'aʻaʻa a me ka ili i kela makahiki nui e lauwili ke kaumaha ma muli pehea keʻoki kino ulu. Mea wale nō surgeons i ole hoʻohana i ka hoʻohui i nā'aʻaʻa o na nā loko a me ka ili.

• mammals tendon;
• iʻaʻili;
• loaa mai ka iole huelo ka pae;
• nä olonä o na holoholona;
• Hair ia, mai ka Mane mai o na lio;
• ka piko wale hanau ke kanaka;
• ka wehe 'ana o na moku;
• hemp ai niu olona,;
• laholio laau.

Akā, mahalo i ke kālā no Aey? Acaeoey, ua e lilo i mea mahaloia kemikala olona. Aia nā hihia ma ka mea hiki ke hooheheeia e ke hoʻohana no hoi.

No kekahi suture pili ana i kekahi mau olelo:

• kiʻekiʻe ka ikaika;
• Kaulu;
• elasticity;
• lōpū elongation;
• kiʻekiʻe nui o ka 'oihana o na nā'aʻaʻa.

Akā, kekahi o ka mea nui ana hoʻohālike e pili ana i ka suture nā mea hana maʻalahi me kanaka'aʻaʻa. Currently ike kumuhana i hoʻohana no ka ami, i antigenic waiwai a me ka reactogenic. Loa ano o kēia mau 'ano hakuʻole, akā, i ke oolea o ia mea e minimized.

Ua mea i nui ke suture ku sterilization, a mālama ia like loa me hiki, i ka ia manawa kona papa kuhikuhi ano e noho mua. Suture ke komo ana o kekahi a oi olona, a i interconnected ma hilo, knitting paha ¶ Ulana iho, a me kā lākou ili honua ua i laumania, e kapa komo iā ia ka mea, me ka mahuahua, mea pīlali paha teflon.

Currently,ʻoki kino ua hoʻohana 'absorbable a me ka' ole-absorbable suture meaʻAno. Mea Maluna oʻoki lāʻau lapaʻau sutures, ka hapanui o ka mea komo ai i ka hoʻohana 'ana o absorbable filaments - catgut, a ua i mai ke tunica muscularis hipa uuku naʻau liʻiliʻi, e like me ka hana ia e hoʻohana i ka submucosal, ahu iho. I kēia lā, he 13 catgut nui like 'ole e oko mawaena o lakou iho i loko o ke anawaena.

Ua mahuahua ma ka ikaika o ka weld mea me ka nui. No ka laʻana, ka mea ikaika trehnulevogo? Ueo mea ma kahi o 1400 g., Akā, no ka nui o ka ono - 11500 o kēia 'ano o ka absorbable ka pae hiki ia ma waena o 7 a me 30 lā.

O ka ole-absorbable suture iʻoki kino ka hoʻohana nā huakaʻi o ka silika, pulupulu, olonā, horsehair.

'ano o nā stitches

I ka suture ka ili kauka e lawe i loko o ka mea ana i kaumaha oki a haehae eha, kona loa, a pehea kona lua penei uhai. No hoi e lawe i ka mooolelo o ka wahi poino. i ka loa mahaloiaʻoki kino e noʻonoʻo iʻoki lāʻau lapaʻau sutures, Hawaii photo 'atikala e hōʻike i ka mea, nana e like:

• ana subcutaneous;
• subcutaneous nodules;
• cutaneous nodular;
• ana nunui-lalani, noi i loko o kaʻili;
• ana i loko o kekahi lalani, noi i loko o kaʻili.

Kēia e kōkua maopopo pono i ki ina hana like oʻoki lāʻau lapaʻau sutures olelo hoʻohana ma o ka crosslinking o ka pā eha.

Ana intradermalʻano

Kona nei hoʻohana loa pinepine, hoomaopopo ana i ka maikaʻi mea hoʻonani hopena. Kona papa kuhikuhiE ka pono i ka ka hoʻololiʻana maikaʻi o ka wahī ihola kihi, maikaʻi mea hoʻonani keia a me ka palena haʻahaʻa hoʻohuikau o microcirculation, ka wā like me nā 'ano o nā ami. Ka pae no ka stitching ua mālama 'ia i loko o ka dermis, ahu iho pelane laua ana. Eia naʻe, no ka pono o huki i ka pae mea maikaʻi, e lawe monofilament mea.

Once lawe mai i ka iniiaiieʻoki lāʻau lapaʻau lapaʻau o ka eha, hiki ke waeʻano o nā stitches okoa, akā, pinepine kauka makemake absorbable sutures: Biosyns, monokrilu, polysorbate, Dexon a me na mea e ae. A mai filaments i e ole hoike mai, i maikaʻi monofilament polyamide paha polypropylene.

keʻakeʻa No Lilo

'O kēia kekahi i kekahi o na kanaka kaulanaʻano o foxmike ulana. A me kona hanaia'na, kaʻili ua punctured pono ana kui kele. Inā e hana ia, ka mea e hou ana i nana e like me ka triangle kona kumu ua kuhikuhi i kaʻeha. Keia ano o ka puncture hiki reliably paʻa i ka suture. Ke kui kele ma ua hookomoia ma ka epithelial, ahu iho i kokoke i ka wahī ihola maka, hehi o ka 4 mm o, a laila, laweʻia ma luna o ka kēlā i loko o ka subcutaneous'aʻaʻa ana iki e neʻe aku, mai ka maka, e like me ka hiki i hiki.

Once loaʻa i ka mea kiʻekiʻe a me ka maka o ka eha, i ke kui kele ma ua ke ka ao i ka midline, a ua injected i loko o ka wahi hohonu o kaʻeha. Ke kui kele ma keia hihia kŰlń ao ma ka pololei symmetrical lole wahi iho la ma ka kekahi lima, wale nō i loko o keia hihia, no ka ulana loaʻa ka hookahi helu o fabrics.

Papamoe, a me ka vertical mattress suture

Kind oʻoki lāʻau lapaʻau stitches a me knots i waeʻia e ke surgeon ke kaumaha ma muli o ka oolea o ka eha, ina he mea uuku pilikia ma ke kapakai a ka eha kihi, ka mea, ua? Aeiiaiaoaony e hoʻohana i ka mattress suture i loko o ka palapala o ka palapala P, hiki horizontally. Inā pili nodal iniiaiieʻoki lāʻau lapaʻau suture he hohonu eha, ma keia hihia, e hiki haʻalele koena lua. Ua hiki ke ohi i mea hoʻokaʻawale i kaʻeha a me ka hele aku ai i fester. Ua hiki ke käpae 'ina ka suture i loko o kekahi mau palaoa. Kēia hana o ka suturing me ke kūʻokoʻa o ma ka Hub, a me nā ana type.

Kekahi pinepine pili ulana Donatti (vertical mattress suture). I kona manaʻo mua ua lawe mai ma ka puncture 2 knm mai ka wahi iho la penei. Vykoli mea ma kaʻaoʻao e ku pono ana, a ma ka mea hookahi mamao. I ka lawe ana mai i ka ia puncture a me ka vykoli mamao mai ka wahi iho la kaʻe mea kāinoa mua 0.5 knm, nā huakaʻi nakinaki wale ma hope o nā mea a pau na nakaka, i kau mai ai pela i hiki ke kōkua i ka manipulation i loko o ka hohonu o kaʻeha. E ho ohana i ka ulana Donatiʻo ia ka mea hiki ke humuhumu i ka eha a me ka diastasis nui.

E loaa i ka mea hoʻonani, ina pono e akahele hana i kekahi hana iniiaiieʻoki lāʻau lapaʻau lapaʻau o kaʻeha, e koho pololei 'ia o ke ano o stitches. Inā sloppy ń ka wahi iho kihi, i ka hopena, e alakai i ka loa scarring. Inā mākou e pili excessive ikaika ka wā puakai ka wahi mua, ka mea e e ölelo 'transverse laau ki, a i aia ma ka holoʻokoʻa loa o ka me ka makaʻu no.

Like no ka E hīkiʻi ana knots, a pau i ka silika pae hoopaa mau aka wahi, a me ka kemikala a me ka catgut - ekolu.

Kind oʻoki lāʻau lapaʻau sutures a me kāu kiʻina hana o ko lākou noi

I ka wa ana i kekahi 'ano o ka ulana, a me kā lākou he nui hoʻohana iʻoki kino, ia mea nui i ka pololei hoopili aku i ka hana i keʻano hana. Pehea pono pili mau hīpuʻu suture?

Me ke kui kele ma luna o ke kui kele ma paa ua mua ia io maka ma ka mamao 1 knm, e paa ana forceps. A pau vkoly paa e ku pono ana kekahi i kekahi. Ke kui kele ma ua 'ae' e lawe mai ana ma nā kihi, akā, ma ka huli hiki ke lawe mai, alaila, ma hope o kekahi, a laila, i loko o kekahi. Ma hope o ka pau 'ana o ka huakaʻi hope e paa ana forceps, a ua weheʻia ke kuikele, a ua pili i ka pae, kahi e e summed i na kihi o kaʻeha a hiki i kekahi i kekahi, e like me ka pili loa i hiki. No laila, e hana ana i kekahi koena nakaka, a like loa me kaʻeha ua ole; akeke i loa. Kēlā me kēia mau pono ia i ka mamao o ka 1-2 knm mai kekahi i kekahi. Ma kekahi mau hihia, hiki e nākiʻi i nā aka wahi mai, i ka wa a pau na nakaka, i kau mai ai.

Pehea e nakii i ka knot

Ma ka hapanui o hoopii, surgeons hoʻohana i ka mea pa alima no ka paa i ka suture. A hana ia pela: ma hope o ka suture ua wili i loko o ka maka o ka eha, na welau pili pu, a nakii knot, a ma luna o ia mea i kekahi.

Surgeon ka knot hiki ke hana ia ma kekahi alanui: like me ka pae 'ia ka pae i loko o ka eha, hoʻokahi-hema lawe ma kekahiʻaoʻao, a me nā' ē aʻe ma hope o ka mea'ē aʻe, a lawe mai la a pili pu i ka eha kihi, e ka papalua knot, a ua ma luna o ka mea noonoo ole. Ka pae welau iʻoki i ka mamao o ka 1 knm mai ke anaina kanaka.

Pehea e humuhumu iho ai i ka eha, ka hoʻohana 'ana i ka mea hiki ke hooheheeia māhele

paha e kekahi, a ua nānā 'ia ma kaʻeha paena IIeEeAIEUAA Kind oʻoki lāʻau lapaʻau sutures a me kāu kiʻina hana o ko lākou mau palapala noi. Kekahi koho i e keʻa-e kuhikuhi ana ma ka mea o ka mea hiki ke hooheheeia staples.

Staples i mea hiki ke hooheheeia papa nona ka laula o kekahi mau mm o, a me ka lōʻihi - e pili ana i kenimika, akā, i e aku. He mau welau ona, e hōʻike mai iā ia i loko o ka palapala o nā apo, a me nā mea i loko o ka maka, a komo iloko o ka'aʻaʻa a me ka malama ole ho one i na lou.

E pili e koo aku i kaʻeha ma hope o nā kihi, e hoʻopio i ka kūikawā tweezers, e lawe mai ia lakou i kahi hookahi, paa pono, no laila hoʻopaʻa i kekahi lima, e pono e lawe i kekahi māhele tweezers. Ma hope iho o ia, pili ia ma luna o ka ulana laina,'ōpā pū i nā wēlau, e ka ho'āʻo pono. E like me ka hopena o keia manipulation māhele ka manao a me ka uhi i nā kihi o kaʻeha. E hoʻokō i ka mamao o ka 1 knm mai kekahi i kekahi.

Wehe i staples, e like me na ami, ma hope 7-8 lā o ko lākou kau ana. No keia mea i ka makau, a me ka kūikawā paʻa o tweezers. Ma hope o ana o ka māhele hiki e ua kūponoʻia, sterilized, a hoʻohana 'ia no ka suturing hou eha.

Kind o stitches ma cosmetology

Mea hoʻonaniʻoki lāʻau lapaʻau suture hiki ke i ma kekahi o na? Ueony sutures: silika, catgut, ka pae i hiloʻia, he wiwi uea, Michel clamps paha horsehair. I waena o nā mea a pau i kēia mau mea, wale ka suture hoike mai, a mai na mea e ae a pau hana. Nā sutures i submerged a weheʻia.

Ma ka blending i kūpono ma ka cosmetology hoʻohana i ke ana a me ka knotty ami, i ka la mahope, i hiki ke maheleia hou ia i loko o kekahi mau hoailona ia mea: kai, ano o na wahine a meʻoki lāʻau lapaʻau.

Ma ka nodularʻano, he mea ka papa kuhikuhiE lanakila kekahi ma ke ana: ia a paa paʻa i kaʻeha lua penei. Akā, ana ulana mea i loko o koi no ka mea, ua noi koke aku a me ka hoʻokele waiwai e like me ka mea i hoʻohana. Ma cosmetology, mau ano hiki ke hoʻohana:

• mattress;
• ana ulana Reverdy;
• ana furrier;
• kā (kilokilo);
• subcutaneous ( 'Amelika ulana Halsted).

Ma ia mau hihia a pau, ina o ka hoʻomanawanui i ka ikaika hoʻopilikia o na nā'aʻaʻa, ke kauka i ke hoʻohana i ka pā a me ke kēpau una nakaka a me ka ulana rollers, ma i ia mea hiki ke pani nui mā a me ka maluhia hoopaa i ka lole ma kekahi wahi.

Ma Ka lula ea Keʻoki kino e like me ke kauka hiki i kekahi manawa hoʻohana apodaktilny ulana. Kona o Mānoa, ke moe ia ma ka mea i ka mea, ua noi ia, a nakinaki me ka kūikawā mea paahana wale: ke kui kele ma paa, forceps, a me Pean torsion.

Lio lauoho - keia mea i ka oi suture mea. Kind oʻoki lāʻau lapaʻau sutures a me nā aka wahi e ola ana ma cosmetology, pono e ho okumu ana me ia. pinepine He hoʻohana 'ia i loko o ENT hana, no ka mea, aneane ole iho mailoko o, ole-o keʻano ukiuki i kaʻili a me ka'aʻaʻa, a me ka wahi ia ua ole blending suppuration a me ka scarring. Lio lauoho laholio, no laila, e like silika, ka mea e ole oki i loko o kaʻili.

I ka hoʻohana 'ana o sutures ma dentistry

Nā kauka niho i hana nāʻano o nā stitches, e hooki aku i ke kahe ana ke koko ole, e hoʻopaʻa i ka wepa i ka maka o kaʻeha nui. Kela ano keia ano o ka ami iʻoki lāʻau lapaʻau dentistry mau mea i like loa me ka poʻe mākou i hōʻike ia, ka mea wale nō mea e loaʻa nā oko aoʻuʻuku i loko o nāʻano o ka mea paahana. Suture ma moʻolelo o ka lua ua loa pinepine i hoʻohana:

• ke kui kele ma paa;
• ophthalmicʻoki lāʻau lapaʻau forceps;
• bidentate uuku makau;
• maka'ūpā.

E hoʻomaka ana i ka moʻolelo o ka lua hiki e paakiki, a me ka wale 'oihana o ka hana, e e hiki ke hana i kēia hana pono, no ka mea, mea nui,ʻaʻole wale nō kiʻekiʻe-kbps iniiaiie kanaka o ka eha. Kind o stitches ma dentistry mea i nui, e koho i ka pono, akā, ka hapanui o nā mea a pau - e Aloha i ka mea 'aʻole i No Lilo. A oia kau like penei:

1. Hana mau ua pono e hou na aoao a elua o kaʻeha ma ka lawa kaawale mai kekahi i kekahi, i ka huakaʻi e hohola like ka nui me hiki, a waiho wale i ka meaʻuʻuku hopena - 1-2 knm.
2. Ka pau loa o ka pae a me ke kui kele ma ua paʻa i loko o ka lima hema, a laila ka mea pono, e uhi i ka puka o paa clockwise 2 manawa.
3. Me ke kōkua o ke kuikele paa e hoʻopio i ke kihi pōkole, a huki ma ka loop - keia mea o ka mua loa o kaʻaha kanaka, ke akahele tighten, lohi e lawe pu ana i nā kihi o kaʻeha.
4. Nō hoʻi, e paʻa ana i ka loop, oe e hana i ka ia manipulation, e pepa ee-clockwise kekahi manawa.
5. Tighten maopopo i hana noiʻi, eʻoiaʻiʻo e kanaka hoʻoponopono i ka uniformity o ka huakaʻi hoʻopilikia.
6. Shift pa alima a me ka oki laina, e oki i ka pau ana o ka pae, i ka mea a pau i makaukau i ka weld.

Ua mea i ke kumukuai o hoomanao ana pono stitches pono ai, mai ka hapalua like-ʻeha, a me na stitches hana i oi aku pinepine ai i ole e hoʻopilikia i ke koko holo i loko o nā nā'aʻaʻa. I ka ho'ōla mai steadily, pakahi aku la ia no kaʻeha mai ana trauma, ia mea pono, e hoʻouka mau lā nōkahea ma waena o nā nakaka.

ʻano oʻoki lāʻau lapaʻau sutures a me kāu kiʻina hana o kono kūloko ma na nakaka

'Aʻole wale na ami pono keʻauhau iā lākou pono i loko o ka'aʻaʻa pono e akeke maluhia no hoi. Kūlokoʻoki lāʻau lapaʻau suture e ia no kekahi mau ano a me kela mea keia mea ua papahana no ka stitching o kekahi mau wahi. E ka nānā i kēlā me kēia o nāʻano ma ka mea i maikaʻi i maopopo.

ulana aponeurosis

Aponeurosis - he wahi kahi i ka splice tendinous nā'aʻaʻa a i kiʻekiʻe ka ikaika a me ka elasticity. A Classic wahi aponeurosis ua manaoia e ia i ka awelika o ka abdomen laina - spliced kahi pono a me ka haʻalele i ka peritoneum. Tendon lole i ka puluniu 'ole, i mea no ke aha la i ko lakou splicing ma na olona, maoli he lākou divergence ma waena o surgeons, ua kapaʻia ka hopena o ka pahiolo i kēia hopena.

Aie i ka mea i kēia mau nā'aʻaʻa mahuahua pā no lākou keʻa-e kuhikuhi ana ka pono e hoʻohana i kekahiʻano o ka ami. Ua Ua noʻonoʻo pono i ka loa ike loea ana, hoopuniia ae stitch, aʻo ka hoʻohana 'ana i ka kemikala absorbable sutures. I ka poe nā "Polisorb", "Biosyns" "Vicryl". Ma ke ano o absorbable sutures hiki ole ai ligature fistulas. Nō hoʻi, no ka mea, e pili ana ia he ami hiki no hoi ke hoʻohana 'ole-absorbable ka pae - "Lavsan". Me kā lākou kōkua, e hiki ke pale ia i ke kahua o hernias.

Ke ulana i ka adipose'aʻaʻa a me ka peritoneum

Ma nā makahiki, loa kākaʻikahi sutured mau ano o fabrics, no ka mea, ia lakou iho i ka maikai a me ka kuʻi nukeliu kokololio ho'ōla. Eia hou, i ka wa e kaawale aku o na nakaka, aole ia e hoopilikia koko ma ke kahua o ka me ka makaʻu no ho okumu. Ma ia mau hihia, ina i ulana hiki ole ke hana, i ke kauka ke pili ia ka hoʻohana 'ana absorbable sutures - ". Hookahi aniani o"

na nakaka intestinal

No ka stapling o puha nā loko hoʻohana mau ami:

• Single lalani sero-muscular-submucosal suture Pirogov, iʻaha kanaka ua kau ma luna o ka pā iwi kino.
• Mateshuka ulana, kona hiʻona o ka mea i ka paena i kona hanaia'na koe i loko o ke kino, i loko o kona mucosa.
• Single lalani ulana Gumby ua hoʻohana 'ia ka wā o ka surgeon hana i ka nui naʻau liʻiliʻi, i loko o kona' ana i kūpono ka mea i like loa me ka ulana Donati.

na nakaka ake

Aie i ka mea i ke kino lawa "crumbly" a pauʻona nō i loko o ke koko a me ka bile, e hana ma luna o kona ili ulana ka loa paʻakikī a hiki i ka 'oihana surgeon. Loa pinepine, ma keia hihia, ke kauka e ukuhi i ka ana ulana me ka hihia ole ana mattress suture.

Gallbladder me ka hoʻohana 'U-hoʻokino' ole ewalu-hoʻokinoʻoki lāʻau lapaʻau sutures.

Na nakaka ma na moku

Kind oʻoki lāʻau lapaʻau sutures hoʻohana ma ka traumatology, i kā lākou mau 'ano. Inā 'oe makemake e humuhumu iho ai na moku, ma keia hihia e like me hiki kōkua ana ulana me ka hihia, a e hōʻoiaʻiʻo ike loea hoailona iho la i. E ho ohana i ka mea pinepine hiki aku ai i ke kahua o ka "bunching", akā, e pale aku i kēia hookoia, e hiki, ina oe e hoʻohana i ka hookahi-lalani suture heleuma.

ʻoki lāʻau lapaʻau sutures ano i hoʻohana ma traumaʻoki kino a me ka like. Kēlā me kēia? Ueo i kona drawbacks a me ka pono, akā, inā i ka akau kokoke i ko lakou kau ana, a koho i ka mea maikaʻi loa koho ia -a-, i kekahi ami ke hana kona hana, a hoopaa i kaʻeha a me ka lilo kino. Helu 'ana o ka suture i loko o kēlā me kēia hihia, ua paa pākahi, akā, nui 8-10 hola koke ka mea, e weheʻia.