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.
(1)
After word war ll, the United States of America pursued a policy of containment aimed at preventing the Soviet Union from penetrating into the countries of the world, especially the regions of the Middle East, Therefore, it worked to emphasize the establishment of relations that include various political, economic and even cultural aspects, and focused its policy in his aspect on Turkey due to its geopolitical position. At a time when Turkey was undergoing developments at various levels and a change in govemment policy after the Demccratic Party came to power, which focused in its foreign policy on strengthening reltions with the West in general and the United States America in particular. The US government was the supporter of Democrat
... Show MoreThe aim of this study is to identify the effect of enabling the effectiveness of the work of the audit committees in private commercial banks and to identify the extent of awareness of the importance of empowerment in the work of these committees, especially as it is known that these committees, especially the inspection committees that go to private banks and from various sources including committees of the Central Bank of Iraq Committees of the Securities Commission and finally committees of the external audit offices, through an analysis of the determinants of empowerment in the performance of the most important work of the audit committees, namely: supervising the process of preparing reports, supervising the system of intern
... Show More
The present study discusses the significant role of the historical memory in all the Spanish society aspects of life. When a novelist takes the role and puts on the mask of one of the novel’s protagonists or hidden characters, his memory of the events becomes the keywords of accessing the close-knit fabric of society and sheds lights on deteriorating social conceptions in a backwards social reality that rejects all new progressive ideas and modernity. Through concentrating on the society flawing aspects and employing everything of his stored memory, the author uses sarcasm to criticize and change such old deteriorating reality conceptions.
&nbs
... Show More
(3)
(3)
Background: Atherosclerosis is well known related to age and certain cardiovascular diseases. Aging is one reason of arteries function deterioration which can cause loss of compliance and plaque accumulation, this effect increases by the presence of certain diseases such as hypertension and diabetes disease. Aim: To investigate the reduction of blood supply to the brain in patients with diabetes and hypertension with age and the role of resistive index in the diagnosis of reduced blood flow. Method: Patients with both diseases diabetic and hypertension were classified according to their age to identify the progression of the disease and factors influencing the carotid artery blood flow. By using ultrasound and standard Doppler techniq
... Show More
(3)
(1)
With the advent of the globalization, the rapid development in technology and the intensity of competition companies attemptto maintain competition advantages and retain customers. The traditional methods in managerial accounting become irrelevance to achieve the objectives of these companies especially with the rapid changes in modern manufacturing environment .Thus there is a need to new tools in accounting such as lean accounting, which is considered as a costing method that support creating value for the customer by costing the entire value stream, eliminating waste in the accounting process, reduced lead time, improved quality, lowered time delivery and increased available capacity. Using value stream focuses not only on the waste&n
... Show More
This study included 50 blood samples that were collected from patients with age ranged between 35-65 years. Thirty samples were collected from patients with Type 2 Diabetes Mellitus (T2DM), while 20 blood samples were collected from healthy individuals as a control sample. The polymorphism results of TGF-β1 gene in codon 10: +869*C/T position by using amplification refractory mutation system (ARMS-PCR) showed that the T allele was suggested to have a protective effect, while C allele was associated with an increased risk of T2DM. The TT and CT were suggested to have a protective effect, while CC genotype was associated with an increased risk of T2DM. The polymorphism results of TGF-β1 gene in codon 25: +915*G/C position in samples
... Show More
(1)