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 theatrical show depends in its formation on the technical system and the elements that it has for the theatrical show, and among these techniques is the lighting, where every director looked for a style and method of implementing them and giving aesthetic functions and characteristics that give the theatrical show an aesthetic and interpretive dimension, and that is through multiple expressions and connotations of the lighting in giving the show a functional and aesthetic character. Therefore, light has been shed on the lighting and its action in the theatrical show, due to its significant role in the modern theatrical shows. The current research, thus, has been divided into four chapt
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The designer's creative thinking depends on main skills. Fluency skill is to put t
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... Show MoreReceive money laundering phenomenon of interest to researchers and scholars on different intellectual orientation of economic or political or other, as this process is gaining paramount importance in light of business and increase the number of banks in the province of Kurdistan of Iraq and Erbil in particular and in the presence of openness developments chaotic economic and there are no factors encourage money laundering operation because of the presence of the hidden economy and the weakness of the banking and legal measures to combat them, and on this basis there is a need to examine money laundering operation in the province of Arbil, to indicate the presence or absence of a money laundering operation in working in the provin
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