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.
It is no secret to anyone that the Koran is a speech to people, and how it is not a speech to humans is a home to them and suitable for their understandings, and the people of rhetoric mean great care has never been before in the division of the Koranic discourse, followed by linguists and science of the Koran. After reading the letter, I followed it in the Holy Quran, taking advantage of what was written by former writers in language and interpretation. Thanks to God, I have done what I wanted. Perhaps one of the most important reasons that led me to write my research and optional for this topic; is related to the Koran. So I started to develop the research plan, and divided it as I saw it, I started to pave the way, and then divided it
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The manufacturing industry in Iraq has faced, during the time stages, several obstacles that have had devastating effects on the Iraqi economy. These obstacles are represented by political events and wars that have led to the depletion of most human and material resources and the suspension of most vital industrial facilities from working, And the occurrence of this major deviation in the process of economic development, For the same reasons, the contributions of the manufacturing sector to the gross domestic product varied fluctuatingly, indicating instability in the growth rates of this sector, On the other hand, the supremacy of the belief that the dominance of oil resources as a main source for creating economic growth and achieving a h
... Show MoreThe mix promotion important to any organization in general, has been selected promotional mix tools in this research to identify the role in maximizing the Organization of sales growth business, which included the research problem several fundamental questions about the role of each promotional tool of advertising, public relations and personal selling and sales promotion direct marketing within the promotional mix in the promotion of business sales organization. The research aims to provide theoretical and field organizations surveyed about the role played by the mix promo in sales growth, and importance of research on the identification of more than promotional tools impact on sales gr
... Show MoreThe lexical connotation is one of the types of connotation that linguists have dealt with, and stipulated in their studies, meaning access to the real meanings of the words, that the lexicon can address after tracing the real meaning of the metaphorical meanings, if any, and this is known to the semantics additional significance, and the rhetorical meaning Figuratively.
The miraculous Qur'an in its systems often refers to the metaphorical uses of the words as well as the real use. The significance of the words in the Holy Qur'an came in a variety of contexts, making each word a special significance that belongs to it exclusively. This is the miracle of the Holy Qur'an. The coming of the slow walk, with its eight words (came, came, cam
God Almighty has imposed on us obligations and set limits on us, and among these obligations is the prayer, which is considered a pillar of Islam. And recently on the statement of its importance, and through extensive explanations, they elaborated on the statement of its pillars, its obligations, its Sunnahs, its rituals, and its bodies, and it is known that the imam in prayer is an important part of the parts of prayer. Whoever assumes this responsibility must be aware of these conditions, the most important of which is jurisprudence in religion, and there has been a disagreement between the jurists, especially the owners of the four schools of thought, about who is qualified to lead the imamate, and this is within many and wide details
... Show MoreA lab-scale packed Bio film reactor was used for ethanol production by fermentation of sugar solution using a local
isolated yeast saccharomyces cerevisia and glutaraldelryde on gelating as a covalent bounding agent. In this study four
types of packing in the reactor were used. They are; polypropylene mesh, glass rashig rings, ceramic rashig rings and
glass beads. Glucose solutions were used as substrate with four concentrations; (5, I 0, I 5, 20 g/l). Results show that the
ethanol productivity was increase with increasing sugar concentration. Also it was found that polypropylene mesh
packing give the highest productivity while glass beads gives the lowest productivity. The experiments were conducted at
three temperatur
The study of the (dualist antagonism) of a poet, will be determined by the poet's potential, and according to the system of concepts and creativity, and this means that there is a difference between the rooting of the meaning and its roots, and poetic sources by tracking the poets and their attitudes.
Therefore, poetry is a variable function according to the values of the movement, which is the freedom and continuous fuel. With these units of measurement, can measure the dose (Ahmed Bakheet) of freedom and mechanisms of investment, Bakheet (moment) of the time of hair dimensions of the limits of his experience. This is what the researchers will address in their research.
Considering the science of speech in the light of its purposes is an accurate scientific study that looks at it from its reality in which it originated, and its topic that it dealt with and its goals that it sought, and it follows its main course in the directions of approving the belief and inferring it, and repelling the objections to it, and this study comes to show the realism of the science of speech in its emergence Its subject and method, since its launch was from the reality of the Islamic nation and based on its intellectual needs, so its presence was necessary in the life of the Islamic nation because of its role in facing the challenges faced by the Islamic faith, and the dangers it was exposed to as a result of the intellectu
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