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.
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The task of an educational institution such as kindergartens need to run by managers possess the knowledge to manage the administration of the importance in the development of kindergarten has been the goal of research to identify knowledge management at Riyadh managers, and achieve the objectives of Search selected sample of directors of kindergartens in the city of Baghdad was (160) director was Akhtarhn simple random way, been building measure for knowledge management and presented to the group of experts and extracted stability in a way re-testing and Alvakronbach and reach search to a discrepancy between managers Riyadh in knowledge management and put the researcher set of recommendations including the establishment of seminars and
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Human resources constitute the most important recourses that the organization owned today, as it may have developed financial and technology resources to achieve their goals, but they are not able to use it with required efficiency and effective and quality desired unless there is human resources that have good skills, experiences and talents that able to directing and exploited ideally that compatible with market requirements, where today's market and business organizations which compete naturally inherent talent, so the task is to attracting and developing talented resources and preservation these talented resources from the challenges that facing organizations.
The research seek to achieve
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The objective that the researcher seeks to achieve through this research is to clarify the relationship between strategic management accounting techniques and the reliability of financial statements, and to measure the impact of these techniques as an independent variable with its three dimensions, which are: activities-based cost, target cost, and benchmarking on the reliability of financial statements as a dependent variable. To achieve this objective, the researcher did the following: First: Determine the research problem through the following question: Do strategic management accounting techniques affect the reliability of financial statements in industrial companies listed on the Palestine Exchange? Second: Making the analytical des
... Show MoreProject management are still depending on manual exchange of information based on paper documents. Where design drawings drafting by computer-aided design (CAD), but the data needed by project management software can not be extracted directly from CAD, and must be manually entered by the user. The process of calculation and collection of information from drawings and enter in the project management software needs effort and time with the possibility of errors in the transfer and enter of information. This research presents an integrated computer system for building projects where the extraction and import quantities, through the interpretation of AutoCAD drawing with MS Access database of unit costs and productivities for the pricing and
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Abstract
The research aims to investigate the existence of correlations and influence between agricultural insurance risk management and economic development in the National Insurance Company with farmers, as agriculture is one of the leading branches of the national economy, ensuring food security and eliminating poverty to ensure sustainable ec
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