Infection at the site of vascular anastomosis is a serious complication of vascular surgery and is associated with a high limb loss and mortality rate. The classical method of management is ligation of the injured artery, adequate wound debridement and restoration of circulation. The latter is achieved by either in situ or extra-anatomic bypass. If the distal circulation is not maintained, subsequent amputation is most likely.
Objectives: In this study we tried to assess the efficacy of extra-anatomic synthetic bypass grafts in the treatment of vascular infection in the groin to save the limb and avoid the inevitable amputation.
Methods: Between January 2006 and December 2007, ten male patients aged twenty to thirty five years (mean=27.3years), with previous vascular surgery (reversed saphenous vein grafting) for sub-inguinal penetrating injuries complicated with infection and bleeding were admitted and managed surgically in the Department of Thoracic and Vascular Surgery, Surgical Specialties Hospital, Medical City Teaching Complex, Baghdad. These patients were studied retrospectively regarding their demographic and clinical features as well as details of the operative procedures and surgical outcome.
All patients received emergency wound debridement, arterial ligation and extra-anatomic synthetic (PTFE) bypass grafts (External iliac or common femoral to distal superficial femoral or popliteal artery, six routed laterally and four routed medially in the thigh away from the original surgical field).
Results: Excellent results were obtained in nine patients who saved amputation while one patient ended with above knee amputation. No mortality recorded.
Conclusion: Extra-anatomic bypass is a useful approach in dealing with infected and disrupted vascular anastomosis and can be used in emergency as well as elective situations as mentioned in most literatures.
The development of the world, and in light of the intensity of competition highlighted the need to research and create a sustainable competitive advantage is sustained from an internal source in the company earned by the scarcity and difficulty of imitation by competitors, and this source is green innovation. In order to achieve the objective of the research, which is the diagnosis and analysis of the relationship between green innovation (in products, processes) and sustainable competitive advantage in the group of companies Kronji, was developed a default model of the research reflects the nature of the relationship and influence among its variables, the research adopted the questionnaire as a key tool for collecting data and i
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This research aims to study the mechanism of application of international specification requirements (ISO 9001: 2015) at the Iraqi Center- Korean Vocational Training return to vocational training department at the Ministry of Labour and Social Affairs for the purpose of preparing and creating the center to get a certificate of conformity with the requirements of the standard (ISO 9001: 2015) that would elevate the level of performance and services provided in the respondent Center after it is identified and the study of the reality of the quality management system by identifying strengths and weaknesses in the system to diagnose the gap and find ways to address that gap, and adopted the researchers the case study method to conduc
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A total of 1346 hard ticks (863♂ and 483 ♀) infested 104 camels, 60 alive camels with 93.33% infestation rate and 44 carcasses of camels had 79.54% infestation rate The total infestation rate was 87.5 %. The current study results revealed ten species of hard ticks family Ixodidae Koch, 1844 related to genus Hyalomma as following: H. dromedarii Koch, 1844, H. schulzii Morel, 1969, H. turanicum Pomerantsev, 1946, H. excavatum Koch, 1844, H. truncatum Koch, 1844, H. scupense Schulzii, 1919, H. marginatum Koch, 1844, H. anatolicum Koch, 1844, H. rufipes Koch, 1844, H. impeltatum Schulze & Schlottke, 1930 from camel Camelus dromedarius Linnaeus, 1758 collected from 21 regions belonging to six provinces in middle, w
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After its 35-year occupation of Japan and the US occupation, Korea has set its sights on a long-term goal of building its country and establishing its foundations, unobtrusive and unchecked by the problems and wars that have stood in the way of its goal, surpassing all odds and achieving the best results. The most powerful Asian and global economies, which gained the respect of the world and its appreciation of the experience has become referred to as boys
One of the bigger problems in drinking water is disinfection by-products (DBPs) that come from chlorinated disinfection. This study’s goal was to evaluate the drinking water in Al-Yarmouk Teaching Hospital, Ibn Sina Hospital and Ibn-Al-Nafis Hospital. Samples were collected between October 2018 and September 2019. Physical and chemical characteristics of the water were studied, including (temperature, hydrogen ion (pH), total dissolved solids (TDS), electrical conductivity (EC), turbidity, free residual chlorine, total organic carbon (TOC), total trihalomethanes (THMs), total halo acetic acid (THAAs)). Data analysis showed the highest value of study temperature, pH, TDS, EC, turbidity, free residual chlorine and TOC which was
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Financial funding of a construction firm plays an important role in all aspects of the process development. It has been noted that financial crises have a direct impact on the construction industry. The Iraqi government, whether locally or globally, has faced a severe shortage of financing which has resulted in incomplete projects. Due to the financial crisis that Iraq went through which led to the suspension of many residential complex projects and the difficulty of the use of public financing methods, we researched the private financing (public-private partnership) methods instead of public financing methods in residential complex projects implementation. This study verified the financial problems and the factors that relate to th
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Developing countries have depended since long time on the developed countries to increase the levels of development and improving rates of growth direction to the best way where taking this dependence many shapes influenced by the evolution form of international relations and this dependence shows how the great deficiencies in sources of local financing, which called developing countries to increase their reliance on external funding sources, represented in the form of grants, subsidies, loans and foreign investment, pursuing States in that the application of economic reform policies in pursuit of faster economic growth and restructure its economy and achieve economic stability. In the early eighties of the last
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