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 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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... Show MoreThis study aimed to recognize and understand the concept of strategic management accounting (SMA) and how it's the effect on the competitive advantage for industrial companies in Jordan. The study's importance arises due to the lack of Arab studies that dealt with this topic, in addition to the important and vital role of strategic management accounting on companies that represent the artery of the decision-making process, and to identify the benefits associated with SMA technology. The necessary data were collected through the literature review and theoretical study of the references that relevant to the study subject, in addition to a questionnaire developed for this purpose, the study used (124) out of (250) questionnaires tha
... Show MoreSoftware cost management is a significant feature of project management. As such, it needs to be employed in a project or line of work. Software cost management is integral to software development failures, which, in turn, cause software failure. Thus, it is imperative that software development professionals develop their cost management skills to deliver successful software projects. The aim of this study is to examine the impact of cost management success factors with project management factors and three agile methodologies – Extreme Programming (XP), Scrum and Kanban methodologies which are used in the Pakistani software industry. To determine the results, the researchers applied quantitative approach through an extensive survey on
... Show MoreThe Research aims to investigate into reality in terms of planning and scheduling management process for sake the implementation and maintenance of irrigation and drainage projects in the Republic of Iraq, with an indication of the most important obstacles that impede the planning and scheduling management process for these projects and ways of addressing them and minimizing their effects. For the purpose of achieving the goal of the research, a sci
... Show MoreAbstract A descriptive study was carried out on nurses who were working at burn. Units in Baghdad city hospitals, Al-Kindy , Al-Yarmook, Al-Qadisiya, Al-karkh, and Al-Karama hospital, in the period from 20th july 2003 to 20th November 2003. The study aimed to identify the nurses performance about pain management for burned patients at burn units and find out the relationship between the demographic characteristics and performance . A purposive (non-probability) sample of (40) nurses, (24) male nurses and (16) female. The data were collected through the use of observational checklist, which comprised (
To finalize any construction investment project, it would be necessary to identify the most significant problems and obstacles that lead to project reluctance and stalling. Unexpected events and conflicts may have disrupted these strategies and impacted project development. Due to the high initial investment costs of construction projects, crises can have an immediate impact, resulting in significant financial losses. The 2014 financial crisis was one of the most prominent crises that Iraq faced, which prompted the researcher to identify and evaluate those obstacles through this research and questionnaires using Pareto scientific theory to exclude factors that do not contribute to project lag. It was discovered that 28 o
... Show MoreExcess heat significantly reduces the efficiency and lifespan of electrical and optoelectronic devices. While passive radiative cooling is becoming more common, achieving active thermal control without physical reconfiguration remains challenging. Unlike conventional static absorbers, we propose a broadband plasmonic solar absorber designed to regulate energy absorption in the near-infrared (NIR) region without modifying the geometrical parameters. The design utilizes a coaxial cylindrical metal-insulator-metal (MIM) configuration, combining refractory copper (Cu), silicon dioxide (SiO2), and a trilayer graphene (Gr) that allows electrical tuning in a broadband solar absorber. Simulation results show a maximum broadband absorption efficienc
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