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.
The problem of the study is concerned with the work of The Iraqi Airways Company in political, economic, and social environment that suffers instability for many years. This has its negative outcomes regarding its decisions of providing services to its markets and customers as a result of the orientations, behavior, and marketing values the company management adopted. The aim of this study is to investigate the marketing philosophy adopted by the management and to identify the extent it suits the materialistic and the human capacities of the company and its current environmental circumstances within the marketing culture common to the thoughts and behaviors of the management and their employees. And in order to achiev
... Show MoreThis research has investigated the effect of the customer knowledge management CKM in sustainable promotion SP. The research conducted a quantitative method on a sample of employees in the Al-Furat State Company for Chemical Industries affiliated / the Ministry of Industry and Minerals in Iraq. The research’s problem presented a set of questions, one of the most important was (is there a relation and impact between the dimensions of customer knowledge management and sustainable promotion). The aim of the research is to identify the extent to which customer knowledge management activities are applied in understudy organization. This research adopted the questionnaire as a main instrument to collect information from (140) participants in
... Show MoreAbstract
The research aims to shed light on the extent to which the practices of performance management in achieving organizational excellence in one of the formations and the Ministry of Finance (GCT). The importance of the selection of these organizations is that they occupies a large and exceptional importance in the national economy through income redistribution add it to cover a large part of the state budget revenues, these organizations possess functionally diverse cadre of them pregnant initial certification and other senior and he fairly stable To meet this target, and on the basis of the data search exploratory researcher built model hypothesis for the search included variable impressionist and
... Show MoreThe aim of the research is to find out the nature of the relationship between the interrelationships and the interrelationships between risk management strategies (avoiding danger, risk exposure, risk exhibition, preventive programs and activities to reduce risks) and the dangers of container transportation, as an independent variable in the dangers of container transportation as a dependent variable, the study started from the problem that the company suffers from The practical aspect of the study was applied at the National Insurance Corporation, and the researcher designed a diagram according to the study's schematic diagram. The study, and for the purpose of data and information related to that, it relied on the descriptive a
... Show MoreThe aim of this study is to investigate the effect of environmental management accounting information (EMAI) on the design process of environmental and sustainable products of Iraqi industrial companies. This process has five different sub-processes: research process, analysis process, conceptual design process, detailed design process and design production process. The study uses the quantitative approach as the questionnaire was designed and distributed to 87 quality managers, production managers, design managers and financial managers. The MANOVA analysis shows that EMAI has a positive and significant effect on three of these processes, namely research process, analysis process and detailed design process, while EMAI has an insi
... Show MoreThe international business environment faces many challenges, including the intensity of competition, the speed of expansion, and control of the market. This leads to its shadow on the local business environment, which prompted many economic units to adopt modern strategies, including mergers and acquisitions, for expansion and prosperity. The research was conducted to verify the role of internal audit in the governance of strategy operations (Mergers and acquisitions) and its reflection on management decisions and making them efficient and effective. Internal auditing is the independent variable related to the other variable, the governance of strategic operations and its impact on management decisions for strategic operations as a depende
... Show MoreThree types of extracts ( aquatic, alcoholic, and oily ) were prepared from the fruits of coconuts, and a series of chemical tests were conducted in addition to the use of the FTIR equipment to determine the active locations in the prepared extracts. The results indicated the presence of active compounds (tannins, saponins, flavonoids, turbines and steroids) in the extracts prepared from the fruits of coconuts, also the antimicrobial capability of these extracts were tested on pathogenic bacteria isolated from wounds and burns infections cases. The results proved that the concentration 80 mg/ml of the aquatic extract is the minimum inhibitory concentration for the microbes: Proteus vulgaris and Pseudomonas fluorescence, while the
... Show MoreExcess heat significantly reduces the efficiency and lifespan of electrical and optoelectronic devices. While passive radiative cooling is becoming more common, achieving active thermal control without physical reconfiguration remains challenging. Unlike conventional static absorbers, we propose a broadband plasmonic solar absorber designed to regulate energy absorption in the near-infrared (NIR) region without modifying the geometrical parameters. The design utilizes a coaxial cylindrical metal-insulator-metal (MIM) configuration, combining refractory copper (Cu), silicon dioxide (SiO2), and a trilayer graphene (Gr) that allows electrical tuning in a broadband solar absorber. Simulation results show a maximum broadband absorption efficienc
... Show More