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.
Abstract
quality issue is the only issue the interesting in recent years of the last century, but also came out of sync with the other issue is the issue of environment, Where they have become represent two sides of one currency, challenges faced by the world and raised by the environmental problems have made industrial organizations pay great attention to the environment by improving their environmental performance, and that's where the oil industry is one of the most dangerous industries, influential and damaging to the environment due to the organizations move away from oil for adoption The application of EMS then a tool to improve environmental performance has been chosen sam
... Show MoreBackground: Modifications of life style are often critically important to adequately control excising hypertension.
Objective: :to determine the source of information regarding hypertension and lifestyle modification practices in the management of hypertension in a sample of Iraqi hypertensive patients.
Type of the study: Across-sectional study.:
Methods: The study was conducted over a period of two months during November and December 2015 at Primary Health Care center of Baghdad Al-GidedaAwaland Bab Al Mudhum primary health care centers. The sample included 219 hypertensive patients (102 females and 117males). They were subjected to a
... Show MoreThere is a suggestion that an antidiuretic hormone-induced decrease in diuresis might contribute to the rapid relief of the acute pain in renal colic. This study was designed to evaluate the efficacy of desmopressin nasal spray compared with diclofenac given intramuscularly in patients with acute renal colic. The study included 75 patients randomized into three different groups; group A received desmopressin (40 μg, nasal spray), group B diclofenac (75 mg) intramuscularly and group C, both desmopressin and diclofenac. Pain was assessed using a visual analogue scale (a 10-cm horizontal scale ranging from `no pain' to `unbearable pain') at baseline, 10, 20 and 30 min after administering t
... Show MoreThis research aims to clarify the role of Information Technology Competency (ITC) with dimensions' (IT Usage, IT Knowledge, and IT Operations) as an independent variable in the activation of Human Resources Management Practices (HRM Practices) as a dependent variable with dimensions' (Training and Development, Recruitment, Job Design, and Performance appraisal). Based on this, the correlation and effect relationships between the independent and dependent variables are determined by formulating two main hypotheses. There are a significant relationship and effect of IT competency with HRM practices within the dimensions. Furthermore, the scope and population of this research are the Informatics and Communications P
... Show MoreThe aim of this research is to apply the concept of total value management to improve the process design of producing the toothpaste in Al Mammon factory one of the in the general company of food industry. The concept of total value management is concerning with achieve more than one values which are important for the customers as these values are related to the customers satisfaction. The research problem is that the factory did not measure the effectiveness of process design as this company has weakness in analyzing this effectiveness in synchronies with total value management. On the other side, the company did not give more attention to the cost of products and selling prices within the value cost/ profit which is one of the
... Show MoreThe research aims to determine the role of green human resource management dimensions of (employment Green, training and development, green, performance evaluation Green, compensation and green bonuses) in the performance leadership of the organization dimensions of (advance planning, efficiency, effectiveness, index pioneering, renovation and modernization), Search of paramount importance because it addresses an important and modern issue in performance leadership, namely green management of human resources, aware of the importance of the subject and expected results of the company under study, an analysis of the data obtained through field visits in
... Show MoreThe environment contemporary works for the insurance companies have seen a number of technological developments and changes rapidly in light of the intense competition in the insurance market, and this affects human behavior in the workplace, and to director in his work needs to be a set of managerial skills. so we find compensation activity in companies insurance needs a high managerial skills, so that compensation, director of the settlement procedure successfully. So research aims to test two hypotheses two major belongings variables search using some statistical methods to extract the results and interpretation and analysis (such as arithmetic mean, standard deviation, percentages, Alpha Cronbach's coefficient, Pearson correlation co
... Show MoreThe aims of the research is to know the role of strategic to manage the human resources in enhancement the process of knowledge management in the Ministry of Transportation , In addition to the effects occurred on outcomes for both the managers and practitioners .
For the purpose of achieving the objectives of the research , the researchers designed a questionnaire that included (40 Points for collecting the primary data from the sample of the research which contained (51) indiviluals. In light of that, the data was to collect and analyzed and hypotheses were tested by using the (SPSS) Program, and a number of statistical techniques was used to attain the goal of the research such as the means , Sta
... Show MoreThe study aims at explaining the extent to which the principles of educational management reform contribute to Ibn Ashour in achieving educational management reform and the extent to which the pillars of the Kingdom's Vision 2030 in the field of Education in achieving the educational management reform. The study also aims to provide a future vision of what the educational administrative reform and its results should be in the Kingdom during the next ten years. To achieve the goals of the study, the researcher followed two approaches: on the theoretical side, he relied on applying the content analysis method. As for the applied side, the researcher adopted the Delphi method by two questionnaires to ask (36) participants from the experts a
... Show MoreBackground: Anti-oxidants are used as supplements to counteract the over production of free radicals in periodontal disease.Co-Q10 functions as an intercellular antioxidant by acting as a primary scavenger of free radicals (FRs) and reactive oxygen species (ROS), this study aimed to evaluate the effect of intra pocket application of perio Q gel (coenzyme Q10) alone and as adjunct to scaling and root planing on the periodontal clinical parameters in the treatment of patients with chronic periodontitis and compare the better improvement on the clinical periodontal parameters among different treatment modalities at 3 and 6 weeks. Materials and methods: A total of 323 sites with pocket depth (5-8) mm in patients with chronic periodontitis were
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