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.
Engineering equipment is essential part in the construction project and usually manufactured with long lead times, large costs and special engineering requirements. Construction manager targets that equipment to be delivered in the site need date with the right quantity, appropriate cost and required quality, and this entails an efficient supplier can satisfy these targets. Selection of engineering equipment supplier is a crucial managerial process .it requires evaluation of multiple suppliers according to multiple criteria. This process is usually performed manually and based on just limited evaluation criteria, so better alternatives may be neglected. Three stages of survey comprised number of public a
... Show MoreThe advancements in horizontal drilling combined with hydraulic fracturing have been historically proven as the most viable technologies in the exploitation of unconventional resources (e.g., shale and tight gas reservoirs). However, the number of fractures, well timing, and arrangement pattern can have a significant impact on the project economy. Therefore, such design and operating parameters need to be efficiently optimized for obtaining the best production performance from unconventional gas reservoirs. In this study, the process of selecting the optimal number of fractures was conducted on a section of a tight gas reservoir model (based on data from the Whicher Range (WR) tight gas field in Western Australia). Then, the optimal number
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The problem of generated waste as a result of the implementation of construction projects, has been aggravated recently because of construction activity experienced by the world, especially Iraq, which is going through a period of reconstruction, where construction waste represents (20-40%) of the total generated waste and has a negative effect on the environment and economic side of the project. In addition, the rate of consumpted amounts of natural resources are estimated to be about 40% in the construction industry, so it became necessary to reduce waste and to be manage well. This study aims to identify the key factors affecting waste management through the various phases of the project, and this is accom
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The aim of this study is to investigate the effect of environmental management accounting information (EMAI) on the design process of environmental and sustainable products of Iraqi industrial companies. This process has five different sub-processes: research process, analysis process, conceptual design process, detailed design process and design production process. The study uses the quantitative approach as the questionnaire was designed and distributed to 87 quality managers, production managers, design managers and financial managers. The MANOVA analysis shows that EMAI has a positive and significant effect on three of these processes, namely research process, analysis process and detailed design process, while EMAI has an insi
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The international business environment faces many challenges, including the intensity of competition, the speed of expansion, and control of the market. This leads to its shadow on the local business environment, which prompted many economic units to adopt modern strategies, including mergers and acquisitions, for expansion and prosperity. The research was conducted to verify the role of internal audit in the governance of strategy operations (Mergers and acquisitions) and its reflection on management decisions and making them efficient and effective. Internal auditing is the independent variable related to the other variable, the governance of strategic operations and its impact on management decisions for strategic operations as a depende
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The current study aims to examine the level of cognitive management requirement among the governmental secondary schools' managers in al-hial province in the kingdom of Saudi Arabia. To do this, the author designed a questionnaire comprised (20) item which was applied on (250) managers included (113) manager hold bachelor degree and (137) manager hold master degree. To carry out this study, the researcher utilized the descriptive approach. The findings revealed that a high level of cognitive management requirements among secondary schools' managers as well as there is a significant difference at the (0.05) level regarding degree type, but there is no a significant difference according to gender variable.
The aim of the research is to find out the nature of the relationship between the interrelationships and the interrelationships between risk management strategies (avoiding danger, risk exposure, risk exhibition, preventive programs and activities to reduce risks) and the dangers of container transportation, as an independent variable in the dangers of container transportation as a dependent variable, the study started from the problem that the company suffers from The practical aspect of the study was applied at the National Insurance Corporation, and the researcher designed a diagram according to the study's schematic diagram. The study, and for the purpose of data and information related to that, it relied on the descriptive a
... Show MoreWorldwide, shipping documents are still primarily created and handled in the traditional paper manner. Processes taking place in shipping ports as a result are time-consuming and heavily dependent on paper. Shipping documents are particularly susceptible to paperwork fraud because they involve numerous parties with competing interests. With the aid of smart contracts, a distributed, shared, and append-only ledger provided by blockchain technology allows for the addition of new records. In order to increase maritime transport and port efficiency and promote economic development, this paper examines current maritime sector developments in Iraq and offers a paradigm to secure the management system based on a hyper-ledger fabric blockchain p
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