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.
Modal verbs are also called auxiliary verbs, helping verbs and modal auxiliaries. They are special auxiliary verbs that express the degree /of certainty of the action in the sentence, attitude or opinion of the writer concerning the action. These auxiliary verbs are can, could ,may, might, must, ought to, shall, should, will, would and had better. Modality is one of the most difficult aspects of learning English, because the form of modals does not follow the conventional rules of grammar, and there are so many meanings of modals that students often get confused about which modal to use. Also, many EFL learners face difficulty in choosing the proper modal verb that fit certain situations because each modal verb has many functions. The pr
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Background: In the traditional protocol, the patient should wait after extraction up to six months to place the dental implant in healed bone, this waiting time accompanied by varying degrees of alveolar bone changes. In order to overcome these problems, immediate implant placement in the fresh extraction socket was introduced. The Aim of this study was to evaluate the outcome of the immediate implant placement utilizing Resonance Frequency Analysis (RFA) to quantify implant stability and osseointegration. Materials and Methods: A total of (23) patients participated in the study, receiving (44) implants placed in the sockets of teeth indicated for extraction. Clinical and radiographic preoperative assessment was accomplished for each patie
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In his novel entitled Victory. Joseph Conrad asserts himself as a writer for man
as a moral agent in this universe. His characters exhibit the possibilities for isolation
and moral deterioration in modern life. The aim of this research is to investigate some
social issues that touch the core of humanity. In this novel, Conrad's perceptive eyes
has noted so many social issues that need to be tackled. Implicitly and explicitly,
Conrad launches so many controversial issues like : communication and
disengagement or skepticism , conflict between heart and mind ,fate, demonic
identification sense of guilt in man, men , women and homosexuality, the clash
between the civilized and the raw ,the disregarded local people and
The current research that entitled (t Technical Experimentation incontemporary plastic arts) deals with study in used techniques and the material's functioning and its variations in artwork.It present the following questions :- 1-Does technical experimentation for mate an important phenomenon in contemporary art.2-Does technical experimentation construct an ability in creating new constructive and formative achievement in plastic art ?.The research includes three chapters . the first one deals with the problem of the research and its limits with the specification of terms . the second chapter present the technical Experimentation in contemporary plastic art with shapes display . the third chapter involves conclusions with discussions . t
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The Education laws in Jursi produce Science
Maxillofacial trauma in females is not widely reported. This study aimed to analyze the clinical characteristics and the patterns of maxillofacial injuries in females and to determine the differences in these patterns among different causes. This retrospective study analyzed several variables, including demographic, social, injury-related, and treatment-related variables, and compared these variables in relation to the main etiologies of maxillofacial trauma. The main etiologies of maxillofacial injuries involving females were assault, followed by road traffic accidents, and falls. There were significant differences in relation to the 3 etiologies in age groups (
Here, we found an estimation of best approximation of unbounded functions which satisfied weighted Lipschitz condition with respect to convex polynomial by means of weighted Totik-Ditzian modulus of continuity
The aim of this research is to study the modern Spanish writings on the biography of Prophet Mohamed (PBUH), which gave the glorious biography its due by objective study and analysis with a scholarly approach, unlike the old Spanish and European oriental writings with its biased approach. In the past, Spanish and European writings on Prophet Mohamed were influenced by religious extremism and did not do any justiceto Prophet Mohamed. But this has changed in the modern times, and modern writing on the Prophet biography is based on objective analysis and reliance on original sources instead of the sources of the churches which were full of hate and wicked intentions to eliminate Islam.The research came to the conclusion that the modern Span
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