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.
To determine the evaluation of education program on women's knowledge regarding managing BSE. The present quasi- experimental study, Non-probability (purposive), sample consisting of (260) women who are employee, and students in both colleges (Nursing college, Medical and Health Techniques College). The sample consist of two groups, study group (130) including those in (Nursing college), and control group (130) in (Medical and Health Techniques College). A questionnaire was constructed which included, Demographic information, Reproductive information, Family history, Previous medical history, and information about women's knowledge toward management of breast self examination (BSE). Instrument validity and reliability was determined. Data w
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Purpose: aims the study to show How to be can to enhance measurement management by incorporating a risk-based approach and the six sigma method into a more thorough assessment of metrological performance. Theoretical framework: Recent literature has recorded good results in analyzing the impact of Six Sigma and risk management on the energy sector (Barrera García et al., 2022) (D'Emilia et al. 2015). However, this research came to validate and emphasize the most comprehensive assessment of metrological performance by integrating Risk management based approach and Six Sigma analysis. Design/methodology/approach: This study was conducted in Iraqi petroleum refining companies. System quality is measured in terms of sigmas, and t
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Today, the success or failure of organizations depends to possess the wisdom of their managers promised that the key to organizational success of the business environment, making the right decisions, and create the ability to work and think towards discrimination of products and services the organization . Seek this research to investigation the relationship between the wisdom management and differentiation strategy for service operations . It was a test of that relationship in light of the results of the analysis of the data collected through the questionnaire distributed on a sample from (98) Director Mangers, head of department and head of division in the General Establishment of Civil Aviation . The research used descriptive st
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ABSTRACT
The research aims to identify the role of scientific planning of inventory by determining the quantity of economic demand and the number of times of purchase and associated annual total costs to achieve a sufficient and appropriate level of inventory . The research was based on the case study methodology. Materials of increasing demand in the Institute of Technical Management and knowledge of the degree of conformity of the procurement plan with the standard indicators adopted in a scientific method ,its include economic order quantity and number of purchasing times .
one of The main results of the research was the existence of a large difference between the quantity of the economic purchase of ea
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This study discusses risk management strategies caused by pandemic-related (Covid-19) suspensions in thirty-six engineering projects of different types and sizes selected from countries in the middle east and especially Iraq. The primary data collection method was a survey and questionnaire completed by selected project crew and laborers. Data were processed using Microsoft Excel to construct models to help decision-makers find solutions to the scheduling problems that may be expected to occur during a pandemic. A theoretical and practical concept for project risk management that addresses a range of global and local issues that affect schedule and cost is presented and results indicate that the most significant delays are due to a
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Abstract
The project of balad's major sewerage system is one of the biggest projects who is still in progress in salahulddin province provincial - development plan that was approved in 2013 . This project works in two parts ; the 1st is installing the sewerage networks (both of heavy sewerage & rain sewerage) and the 2nd is installing the life – off units (for heavy sewerage & rain sewerage , as well) . the directorate of salahuiddin is aiming that at end of construction it will be able to provide services for four residential quarters , one of the main challenges that project's management experience is how to achieve thes
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