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.
This study aims to propose a novel research model to test the nexus between green human resource management processes, strategic excellence and the sustainability of educational institutions in Iraqi academic settings.
This examination in Iraqi higher education is finalised across three key stages: determining the knowledge gaps, reviewing the literature and building the hypothesised conceptual model. A case study complemented by a quantitative methodology using Statistical Package for the Social Sciences (SPSS) and Analysis of Moment
(15)
(15)
The aims of research is to identify the role of strategic human resource management Practices in organizational performance improvement in the Baghdad soft drinks company, as well as the implications of the results for both managers and practitioners.
In order to achieve the objectives of the research, the researcher designed questionnaire included (40) items to collect the initial data from the research sample consisting of (53) Single. In light of that has been collecting and analyzing data and test hypotheses using the statistical package for Social Sciences (SPSS21), and use a number of statistical methods to achieve the goal of the research, including the means, standard deviations and simple correla
... Show More
(13)
(13)
Soil water use and water storage vary by vegetative management practices, and these practices affect land productivity and hydrologic processes. This study investigated the effects of agroforestry buffers (AB), grass buffers (GB), and biofuel crops (BC), relative to row crops (RC) on soil water use for a claypan soil in northern Missouri, USA. The experiment located at the Greenley Memorial Research Center included RC, AB, GB, and BC established in 1991, 1997, 1997, and 2012, respectively. Soil water reflectometer sensors installed at 5‐, 10‐, 20‐, and 40‐cm depths monitored soil water from April to November in 2017 and 2018. Results showed significant differences in weekly volumetric water content (VWC) among treatments for all fou
... Show More
(9)
(8)
Purpose: This research seeks to provide a point of view based on the creation of sustainable value to the customer of the banks in the context of total quality management and relationship marketing. It aims to develop a model to measure the value of sustainable customer peduncular under total quality management PAL (administrative leadership, involvement of employees, continuous improvement, process improvement, staff training), through the mediation of relationship marketing and objective dimensions (administrative leadership, involvement of employees, continuous improvement, improving processes , staff training), and to explore any of the variables and dimensions more influential in the creation of sustainable value to the cust
... Show More
The research aims to identify the risks faced by projects and work on the administration, such as those risks by using professional Project Management System (Project Management Professional) by identifying those risks and their impact on the objectives of the project, if they occur and to provide appropriate responses to Ha.autam search application on the draft Law Faculty port by the General Mansour Construction Contracting company has been using a method personal interview with the heads of departments and project managers in the Al-Mansour and tools descriptive and quantitative analysis as was used (likelihood and impact of risk analysis, Ai_kaoa scheme Sbb- effect, analysis of probability and impact, risk matrix (probability
... Show More
The education sector suffers from many problems, including the scarcity of schools that can absorb the increasing number of students in light of the increasing population growth rate, as some regions suffer from a lack of opening of new schools or the expansion of existing schools to increase their capacity so that attention is required. The research sought to identify the level of maturity of project management at the research site (Building Department in Al-Karkh I/ Ministry of Education) Being responsible for educational projects and their implementation and to know that, the ten areas of the knowledge guide to project management PMBOK have been adopted according to the PM3 model (one of the models of maturity
... Show More
(7)