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.
المقدمة
الحمد لله رب العالمين، وأفضل السلام وأتم التسليم على سيدنا محمد، وعلى آله وصحبه، أجمعين، وعلى من تبعهم بإحسان إلى يوم الدين، أما بعد.
فإن مسألة التعارض بين الرواية، والفتوى، من المسائل المشهورة عند الأصوليين والفقهاء،وهي من مباحث السنة عند الأصوليين، والتي تبنى عليها مسائل متعددة، وهي من أسباب اختلاف الفقهاء، فإذا ما روى أحد الرواة حديثاً معيناً، ثم عمل بخلاف ما روى، فللعل
... Show MoreThe aim of this research is to identify the impact of the effectiveness of digital transformation technology in improving the efficiency of the insurance service in the public insurance companies in Iraq through digital transformation technology in the insurance process "promotion of the insurance product, submission of insurance application, underwriting, settlement of losses" and to achieve this goal a questionnaire was designed A survey distributed in the surveyed community Which represents the decision makers in the researched companies under study, and one of the most important results of the research was the existence of a relationship between digital transformation and improving the efficiency of the insurance process, whether thr
... Show MoreObjectives: To assess the woman satisfaction with nursing care during labor.
Methodology: A descriptive analytic study about conducted for a purposive (non probability) sample of one hundred labor women interview validity and reliability of questionnaire are determined through panel of experts and pilot study. Descriptive and inferential statistical procedures were used to analyze the data, which collected by using interview technique.
Results: The study sample indicated that in general the women were satisfied in nursing care that provided during labor.
Recommendations: The study recommended educational tra
... Show MoreThe purpose of this study is to show the constants and variables geography in Russian
policy in light of variables geostrategic witnessed by the world, especially after the collapse
of the Soviet Union and the disintegration to fifteen Republic became the Russian Federation
and the heir to the Soviet Union, Geography particularly important because the impact of its
data in policy making less change ofothers, and explain the political choices cannot achieve
security through its relationship constants geographical (natural or human) paint forms of
economic activity and determine the points they national security. issue is the geographical
this or that country is determined by its policy also specifies the way in which
Clopidogrel is a prodrug that must be transformed into an active metabolite by hepatic cytochrome P450 (CYP) isoenzymes to prevent platelet clotting. Polymorphisms of the CYP2C19 gene can cause a reduction or complete loss of CYP2C19 enzyme activity resulting in inhibiting clopidogrel metabolism, effectiveness and increase stroke recurrence risk in ischemic stroke patients. This study aims to investigate the correlation between genetic polymorphisms in CYP2C19*2 and*3 and recurrent risk in patients with ischemic stroke taking clopidogrel 75mg in Kurdistan region –Iraq. This retrospective case-control study was carried out at Kurdistan, Erbil, Medicina medical center, and Rizgary general hospital from January 2021 to
... Show More
(2)
(1)
Despite the importance of sustainable development and its dimensions in developing performance and supporting competitive advantage in economic units, there is a gap and lack of coordination between Combined Assurance providers (management, internal audit, external audit) to report on sustainable development, and the research aims to propose a model for the Combined Assurance report to achieve development sustainable development in the Iraqi economic units, especially the Baghdad Municipality, enables assurance providers to coordinate efforts that lead to the achievement of Combined Assurance, The research found the proposed model for the Combined Assurance report in achieving sustainable development in the Iraqi economic units, es
... Show MoreThe rubber ropes exercises affected muscle groups, which in turn affects the corners of the conditions of the body before and over the barrier where affected the time passed. To change the angle of the approaching and payment impact on passing each times the barrier 1-5. That passed over the barrier 1and gate 5 impacts on the nature of the achievement, where time has become less. Find the values of cruise missiles and other phases and stages of pitch angle other categories which it enshrines stood as compelling rejection men's 110m hurdles. Find the value of the instant messaging distances between different barriers and stages. Studies by adding rubber sling barriers race categories, measurement of kinematic variables. Emphasis on the devel
... Show MoreKE Sharquie, AA Noaimi, RA Flayih, Am J Clin Res Rev, 2020 - Cited by 4
Meditationsuggetsthat the theatrical world and the receiptindicatethattherie a thread connection or relationshipbetweenthembecausetheateris an art thatfailsinto the abyss of the humanfield ,receivingis a practice thatisreffered to by corners of society and islocated in the context of thisfield. Thus, the relationshipbetweenalgeriantheater and the recepientissanctified by the nature of theaterwhichisbased on a social basis thatbuildsitsexistance and continuityfrom the recepient.Its impossible to imagine a real theaterthatwillbeestablishedunlessit’sassociatedwith an audience so one hand never claps to makesound. This connectionis the first phenomenonthatcanbecome accessible to all people and itremains the second phenomenonthatrequires th
... Show More