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.
Hollow core photonic bandgap fibers provide a new geometry for the realization and enhancement of many nonlinear optical effects. Such fibers offer novel guidance and dispersion properties that provide an advantage over conventional fibers for various applications. Dispersion, which expresses the variation with wavelength of the guided-mode group velocity, is one of the most important properties of optical fibers. Photonic crystal fibers (PCFs) offer much larger flexibility than conventional fibers with respect to tailoring of the dispersion curve. This is partly due to the large refractive-index contrast available in the silica/air microstructures, and partly due to the possibility of making complex refractive-index structure over the fibe
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Acquisition provisions in Islamic jurisprudence
One of the troublesome duties in chemical industrial units is determining the instantaneous drop size distribution, which is created between two immiscible liquids within such units. In this work a complete system for measuring instantaneous droplet size is constructed. It consists of laser detection system (1mW He-Ne laser), drop generation system (turbine mixer unit), and microphotography system. Two immiscible liquids, water and kerosene were mixed together with different low volume fractions (0.0025, 0.02) of kerosene (as a dispersed phase) in water (as a continuous phase). The experiments were carried out at different rotational speed (1180- 2090 r.p.m) of the turbine mixer. The Sauter mean diameter of the drops was determined by la
... Show MoreDue to the increase in the number of the satellite channels which resulted from the satellite broadcasting, the demand for the television drama production has increased dramatically, and there has been a significant competitive market, which encouraged the producers to adopt many carrots among them the inclusion of TV series large scenes whose main purpose is to show the volume of the production in the series, let alone achieving the dramatic function. The researcher called this type of scenes (the productive scenes), a name which has not been used before. The researcher studied these scenes and determined his research subject under the title (the production scenes in the TV series) where the research problem has been determined through
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Summary:
We are aware that we cannot reach a correct level of understanding of the Arabic language without using the Quran as our main source in our research. Since the word of the Quran that put an end to all words which kneeled before it all the phrases that lead to the showcasing of the Arabic language in its best self.
Arab scientist realized this truth and gave all their attention to the singular and created from it an important subject for their research in the origins of the language and the science behind. Thus, since they dealt with the structure and studied the significance of the context through the use of vocabulary. Therefore, researching Islamic words or the “surat” mentioned in the Qur’an was necessar
The roots of international relations: peace or war: A critical review A great debate has taken place about international relations between scholars concerning peace and War .The concept of root is matched with that of exception. And the importance of the research lies in the ensuing results in the report about the legitimacy of war and the space it holds, so if the origin of international relation is war .the obstacles against it are going to decrease .and if the origin lies in peace then the dimension of its legitimacy will narrow. key words: international relation –peace-war. Résumé : L’Origine des relations internationales : guerre ou paix : révisions critiques L’origine des relations internationales entre guerre et paix, a s
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The musical templates are the fundamental reason for admiration and interest among a lot of cultural and societal medias because of the beauty of it's melodic value, where a lot of Iraqi singing and music specialists and composers try to consolidate daily life idea and translate it into music in a manner that preserve the template and rhythm horizontally and vertically, through the involvement of the scientific and philosophical concepts and theories of modern thought to reach the recipient,, as is the theory of form (Gestalt), one of the most important theories that stretched to their interpretations to the field in general art and in music science, especially, as an area that can be manifested as partial components template music, conn
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The problem of internal sulfate attack in concrete is widespread in Iraq and neighboring countries.This is because of the high sulfate content usually present in sand and gravel used in it. In the present study the total effective sulfate in concrete was used to calculate the optimum SO3 content. Regression models were developed based on linear regression analysis to predict the optimum SO3 content usually referred as (O.G.C) in concrete. The data is separated to 155 for the development of the models and 37 for checking the models. Eight models were built for 28-days age. Then a late age (greater than 28-days) model was developed based on the predicted optimum SO3 content of 28-days and late age. Eight developed models were built for all
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Some responses to ancient grammarians
And contemporary researchers
In monograms
Tourism is a human phenomenon and economic and social activity. It represents an effective forces in the life of the individuals and state alike. As any other economic and human activity has appositive and negative results.
So there is a necessary to planning and activate this sector to get the most possible advantage.
Tourism has special importance out of its effect on the structure and performance of national economy. It can be regarded a dynamic activity with mutual effect include all the economic activities within and out the state. Tourism is affected and affect the production con summing , joineries , communication , ports ,hotel , restaurants ,internal and
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