{"id":1664,"date":"2020-07-05T21:25:47","date_gmt":"2020-07-05T18:25:47","guid":{"rendered":"http:\/\/katsanas.com\/?p=1664"},"modified":"2025-07-31T13:04:57","modified_gmt":"2025-07-31T13:04:57","slug":"halsted-suturu","status":"publish","type":"post","link":"https:\/\/www.katsanas.com\/en\/halsted-suturu\/","title":{"rendered":"HALSTED S\u00dcT\u00dcR\u00dc"},"content":{"rendered":"
\n
\"\"\u015eekil 1 Kesikli Halsted S\u00fct\u00fcr\u00fc<\/div>\n
\"\"\u015eekil 2 S\u00fcrekli Halsted S\u00fct\u00fcr\u00fc<\/div>\n<\/div>\n\n\n

William Halsted, M.D. (1852-1922), ad\u0131n\u0131 ta\u015f\u0131yan temel cerrahi prensiplerini geli\u015ftiren, yenilik\u00e7i bir ABD\u2019li cerraht\u0131. Halsted, Johns Hopkins Hastanesi\u2019nin \u201cB\u00fcy\u00fck D\u00f6rtl\u00fc\u201d olarak an\u0131lan kurucu profes\u00f6rlerinden biri olarak benzersiz tekniklere sahipti, bu teknikleri hastalar \u00fczerinde b\u00fcy\u00fck bir \u00f6zg\u00fcvenle uygulad\u0131 ve \u00e7o\u011fu zaman \u00f6\u011frencilerini dahi \u015fa\u015f\u0131rtan m\u00fckemmel sonu\u00e7lar elde etti. Daha sonralar\u0131 Modern Cerrahinin Babas\u0131 olarak adland\u0131r\u0131lan Halsted, \u00e7ok say\u0131da konsept, ameliyat ekipman\u0131 ve cerrahi prosed\u00fcr geli\u015ftirdi;<\/p>\n\n\n\n

ABD\u2019deki ilk kolesistostomi operasyonlar\u0131ndan birini ger\u00e7ekle\u015ftirdi (sabaha kar\u015f\u0131 2\u2019de annesini mutfak masas\u0131nda ameliyat etti), ABD\u2019deki ilk kan transf\u00fczyonlar\u0131ndan birini ger\u00e7ekle\u015ftirdi (kan\u0131n\u0131, yeni do\u011fum yapan k\u0131z karde\u015fine verdi), asepsisin ve hijyenin \u00f6nemini vurgulad\u0131, yara iyile\u015fmesini ara\u015ft\u0131rd\u0131, meme kanseri i\u00e7in ilk radikal mastektomiyi yapt\u0131, ince lastikten yap\u0131lm\u0131\u015f cerrahi eldiveni tan\u0131tt\u0131, tiroid, safra, herni, ba\u011f\u0131rsak ve arteriyelde \u00f6nemli ilerlemelere katk\u0131da bulundu, hemostaz\u0131n ilk savunucular\u0131ndan biri ve yara iyile\u015fmesinin ara\u015ft\u0131rmac\u0131lar\u0131ndand\u0131, s\u0131cakl\u0131k takibinin t\u0131bbi kay\u0131tlara dahil edilmesinden sorumluydu.<\/p>\n\n\n\n

\u015eekil 1 Kesikli Halsted S\u00fct\u00fcr\u00fc<\/p>\n\n\n\n

Halsted s\u00fct\u00fcr\u00fc, deri alt\u0131 fasyaya yerle\u015ftirilen ve yaraya paralel uzanan hem kesikli hem de s\u00fcrekli olarak yap\u0131labilen bir inversiyon s\u00fct\u00fcrd\u00fcr. Bu teknik, yara kenar\u0131n\u0131n i\u00e7eri \u00e7evrilmesini sa\u011flar ve u\u00e7lar birbirine ba\u011flan\u0131r. Temelde Lembert s\u00fct\u00fcr\u00fcn\u00fcn (bkz. Lembert s\u00fct\u00fcr\u00fc) yaraya paralel olarak ek bir \u00e7evresel ba\u011flant\u0131 ile bir sonraki k\u00f6pr\u00fcye devam eden, s\u00fct\u00fcre destek bir yap\u0131 sa\u011flayan bir modifikasyonudur.<\/p>\n\n\n\n

Belirtilen ad\u0131mlar izlenerek ger\u00e7ekle\u015ftirilebilir (1-4 ad\u0131mlar Lembert ile ayn\u0131d\u0131r):<\/p>\n\n\n\n

    \n
  1. \u0130\u011fne, yara kenar\u0131ndan yakla\u015f\u0131k 8 mm mesafedeki epidermise dik olarak yerle\u015ftirilir.<\/li>\n\n\n\n
  2. Hassas bilek hareketleri ile, i\u011fne dermis y\u00fczeyinin alt\u0131ndan d\u00f6nd\u00fcr\u00fcl\u00fcr ve i\u011fne ucu cildin ipsilateral taraf\u0131ndaki yara kenar\u0131ndan 2 mm uzakta \u00e7\u0131kar.<\/li>\n\n\n\n
  3. \u0130\u011fne, kesiye temas etmeden, kar\u015f\u0131 taraftaki yara kenar\u0131ndan 2 mm uzakta cilde dik olarak penetre eder.<\/li>\n\n\n\n
  4. \u0130\u011fne dermis y\u00fczeyinin alt\u0131ndan d\u00f6nd\u00fcr\u00fcl\u00fcr ve kesiden 8 mm uzaktan cildi terk eder. B\u00f6ylece di\u011fer taraftaki i\u015flemin tersi tekrar edilmi\u015f olur.<\/li>\n\n\n\n
  5. \u0130\u011fne \u00e7\u0131k\u0131\u015f\u0131ndan 6-8 mm uzakl\u0131kta, yaraya paralel olacak \u015fekilde cilde tekrar giri\u015f yap\u0131l\u0131r ve 1-4 ad\u0131mlar\u0131 tekrarlan\u0131r.<\/li>\n\n\n\n
  6. S\u00fct\u00fcr kesikli olarak yap\u0131lacaksa (\u015eekil 1) nazik\u00e7e d\u00fc\u011f\u00fcmlenir ve b\u00f6ylece bir dikd\u00f6rtgen diki\u015f yarat\u0131l\u0131r. \u0130\u015flem kesi boyunca tekrarlanarak yara kapat\u0131l\u0131r.<\/li>\n\n\n\n
  7. Devaml\u0131 olarak at\u0131lmas\u0131 planlan\u0131yorsa (\u015eekil 2), ilk giri\u015f noktas\u0131n\u0131n hizas\u0131ndan ba\u015flanacak \u015fekilde 1-5 aras\u0131ndaki i\u015flemler yara sonuna kadar tekrarlan\u0131r ve d\u00fc\u011f\u00fcm at\u0131larak yara kapat\u0131l\u0131r.<\/li>\n\n\n\n
  8. \u0130ki \u015feklinde de d\u00fc\u011f\u00fcm atma i\u015flemi s\u0131ras\u0131nda epidermis boyunca gerginli\u011fi en aza indirmek ve yara kenarlar\u0131n\u0131n a\u015f\u0131r\u0131 daralmas\u0131n\u0131 \u00f6nlemek i\u00e7in \u00f6zen g\u00f6sterilir.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    William Halsted, M.D. (1852-1922), ad\u0131n\u0131 ta\u015f\u0131yan temel cerrahi prensiplerini geli\u015ftiren, yenilik\u00e7i bir…<\/p>\n","protected":false},"author":2,"featured_media":1666,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[50],"tags":[],"class_list":["post-1664","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-tr"],"_links":{"self":[{"href":"https:\/\/www.katsanas.com\/en\/wp-json\/wp\/v2\/posts\/1664","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.katsanas.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.katsanas.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.katsanas.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.katsanas.com\/en\/wp-json\/wp\/v2\/comments?post=1664"}],"version-history":[{"count":2,"href":"https:\/\/www.katsanas.com\/en\/wp-json\/wp\/v2\/posts\/1664\/revisions"}],"predecessor-version":[{"id":14476,"href":"https:\/\/www.katsanas.com\/en\/wp-json\/wp\/v2\/posts\/1664\/revisions\/14476"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.katsanas.com\/en\/wp-json\/wp\/v2\/media\/1666"}],"wp:attachment":[{"href":"https:\/\/www.katsanas.com\/en\/wp-json\/wp\/v2\/media?parent=1664"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.katsanas.com\/en\/wp-json\/wp\/v2\/categories?post=1664"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.katsanas.com\/en\/wp-json\/wp\/v2\/tags?post=1664"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}