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.
Since the law is the tool for implementing the state’s public policies, it is natural that its provisions (or at least some of them) seek to preserve human dignity as the source on which all rights and freedoms are based. One of the examples of humanizing the provisions of the law in France is what is known as the winter truce. What is this truce, what are the justifications for granting it, what is its historical origin, how did the legislative treatment of it develop, what are the similarities and differences between it and other legal periods included in French law, what is the scope of its application, and what are the effects resulting from it. These questions and others are what we will try to answer through this research.
The importance of kick tolerance in well operations has recently increased due to its implications in well design, in drilling and well control. To study a simple method for the application of kick tolerance concept in an effective way on the basis of field data, this research purpose is to improve knowledge about Kick Tolerance and represents a technical basis for the discussion on revision of standard procedure. The objective of this work is to review and to present a methodology of determination the kick tolerance parameters using the circulation kicks tolerance concepts. The proposed method allows to know, to evaluate and to analyze the kick tolerance problem in order to make the drilling execution safer and more economical by reducin
... Show MoreIn this paper, an approach for object tracking that is inspired from human oculomotor system is proposed and verified experimentally. The developed approach divided into two phases, fast tracking or saccadic phase and smooth pursuit phase. In the first phase, the field of the view is segmented into four regions that are analogue to retinal periphery in the oculomotor system. When the object of interest is entering these regions, the developed vision system responds by changing the values of the pan and tilt angles to allow the object lies in the fovea area and then the second phase will activate. A fuzzy logic method is implemented in the saccadic phase as an intelligent decision maker to select the values of the pan and tilt angle based
... Show MoreEnvironmental Control Systems form one of the integral tasks of the designer, resulting from his/her acquaintance with the nature of sites and the way they are deployed to achieve modern space entity which is witnessing significant development in the field of interior design.Good deployment of these systems offer us, as designers, high potential and several varied solutions to configure internal spaces characterised as a fertile field of study and knowledge.The research problem was identified in the marginalisation of the importance of Environmental Control Systems as an important designing factor to achieve integrated design. The research problem was demonstrated in Chapter One, along with defining the objectives and formulating
Linguistic studies present a distinguished place among modern human studies, as we find this clear in the scientific research institutions of the developed nations, it is the main pillar in the strengthening of links and consolidation pillars between individuals and groups. It is a language and between people's thoughts, feelings and actions, and has been able to show that language is not only a tool of expression but is closely linked to the intellectual, emotional and social life of these people individuals and groups.
The derivation is a major step in Arabic in classifying formulas into weights with special morphological values; these are of great importance in sentences and structures that are the domain of the searc
The present study addresses the behavior of gases in cultivation media as an essential factor to develop the relationship between the microorganisms that are present in the same environment. This relationship was explained via mass transfer of those gases to be a reasonable driving force in changing biological trends. Stripping and dissolution of oxygen and carbon dioxide in water and dairy wastewater were investigated in this study. Bubble column bioreactor under thermal control system was constructed and used for these processes. The experimental results showed that the removal of gases from the culture media requires more time than the dissolution. For example, the volumetric mass transfer coefficient for the removal
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The human being is a social being and human communication is a fundamental axis in the process of social interaction, and the characteristic of social shyness grows through the interaction of the individual with his environment. Identifying the level of shyness among university students, and identifying the differences in shyness among university students according to specialization (scientific, humanities). In order to achieve the objectives of the research, the researcher prepared a measure of shyness based on Zimbardo's theory, and the components that he identified are the (behavioral, cognitive, and emotional components). The validity and reliability were calculated using the Cronbach's alpha method, reaching (0.94), and the scale in
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The research dealt with the study of the element of time in the cinematic language and the role it plays in creating the aesthetic meanings in the documentary film by means of the various structural constructions with which time is constructed. The research included the introduction and the problem of research, which was represented by the following question: (Did the documentary film adopt the values of time formats in the fiction film or it created for itself special linguistic formulations and models which achieve the aesthetic concept?). It also included the importance of research, the need for it and its goal in addition to clarifying the limits of research.The theoretical framework included three sections the first of which is the
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