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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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
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The study aimed to reveal the role of social capital represented by its dimensions (structural, relational, and cognitive) in strengthening the management of excellence in Azadi Hospital / Duhok. In order to reach the goal of the study, the study variables were highlighted in theory through framing concepts and literary contributions for researchers in this field, In the field, the questionnaire was used as a basic tool to collect data from the individuals in the research sample who were represented by officials and individuals working from administrators and technicians, as (120) forms were distributed to the respondents, and (110) were retrieved from them in a way that is valid for analysis. Several statistical methods have bee
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Absence or hypoplasia of the internal carotid artery (ICA) is a rare congenital anomaly that is mostly unilateral and highly associated with other intracranial vascular anomalies, of which saccular aneurysm is the most common. Blood flow to the circulation of the affected side is maintained by collateral pathways, some of which include the anterior communicating artery (Acom) as part of their anatomy. Therefore, temporary clipping during microsurgery on Acom aneurysms in patients with unilateral ICA anomalies could jeopardize these collaterals and place the patient at risk of ischemic damage. In this paper, we review the literature on cases with a unilaterally absent ICA associa
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The study aims to use the European Excellence Model (EFQM) in assessing the institutional performance of the National Center for Administrative Development and Information Technology in order to determine the gap between the actual reality of the performance of the Center and the standards adopted in the model, in order to know the extent to which the Center seeks to achieve excellence in performance to improve the level of services provided and the adoption of methods Modern and contemporary management in the evaluation of its institutional performance.
The problem of the study was the absence of an institutional performance evaluation system at the centre whereby weaknesses (areas of improvement) and st
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The research aims to apply a modified SERVQUAL model to evaluate the quality of the educational services via conducting exploratory research for students from the College of Administration and Economics- Department of Business Administration- Evening studies at the University of Baghdad. Questionnaire of two parts was distributed to a sample of (72) students out of (720) students of the 2nd.,3rd. and 4th. year in the beginning of the second semester of the year 2008-2009 to measure the expectations and perceptions to the quality of the educational services. Five major dimensions were analyzed to see the gaps for (22) variables. The study concluded that there were (13) variables confirmed that the
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The research aims to test the relationship and impact of High Involvement Management as an independent variable in negotiation strategies as a response variable, at the headquarters of the Iraqi Ministry of Industry and Minerals in Baghdad Governorate, and then trying to come up with a set of recommendations that contribute to strengthening the negotiations carried out by the ministry’s leaders and based on the importance of the topic of research in public organizations and the importance of the surveyed organizations to the society. The descriptive-analytical approach was adopted in the completion of this research, and the research included a sample of (180) leaders of the Iraqi Ministry of Industry and Minerals, and data was
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The important factor in the success of construction projects is its ability to objective estimate of the cost of the project and adapt to the changes of the external environment, which is affected by a lot of elements and the requirements of the competitive environment. The faces of those projects are several problems in order to achieve particular goals. To overcome these difficulties has been the development of research in the last two decades and turn the focus on the role of the cost of project management, by providing information and assist management in planning and control of the budget among the main elements of the project, namely, (time-cost-quality),The research aims at the possibility of developing and implementing mechanisms
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