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.
It is very necessary for the political theater to be within the space of every theatrical performance, so that the theater carries the diverse and enlightened values and cultures of this world. political theatre. In the first chapter, the researcher dealt with (the methodological framework), which includes the research problem identified by the researcher with the following question (the functional diversity of the directorial vision in the political theater)
Importance, purpose, limits and seal by defining terminology.
In the second chapter, the researcher dealt with the theoretical framework on two topics, the first (transformations of directorial vision in theatrical performance) and the second topic (aesthetic experiences i
Abstract The strategic performance of the United States depends on dealing with the Middle East countries and its variants on several bases and motives that enabled them to achieve American hegemony and invest its interests at the expense of the region countries. Within this performance, the administration of the United State President Donald Trump presented the Strategic Document on December 18, 2017, which focused on the principle of "America First", to determine the direction of future US strategic performance in the formulation of means of cooperation and intersections or hostility in addition to interests and threats.The future vision of the Arab region and the Middle East as a whole, this strategy is based on the fact that
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This study aimed to evaluate the preparedness and adherence of community pharmacists to the International Pharmaceutical Federation (FIP) Health Advisory COVID-19 guidelines for pharmacists (July 2020) during COVID-19 pandemic. This was a cross-sectional study based on electronic survey using google form, which was distributed from November 19, 2020 to January 1, 2021 using social media platforms. The survey measured 21 pharmacy preventive measures (PM). A multivariate regression analysis was used to identify factors influencing pharmacy implementing of PM. Hand disinfection after serving patients represented the main adopted measure (89.3%). Surprisingly, only 35.4% of participants implemented the proper ways of hand disinfection during fa
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The purpose of the current research is to investigate the impact of cooperative learning elements upon Iraqi EFL Academic learners` Educational outcomes in Syntactic proficiency. The hypothesis of current research is that there are no statistically significant differences between the mean score of experimental groups that used Kagan’s PIES (Positive reliance, Individual Accountability, equivalent cooperation, Simultaneous Interaction) and the control group that followed conventional method. In this study, the sample of the study is (30) university ESP learners were involved at college of Education. The control group (15) students were taught in conventional teaching whereas other (15) learners in experimental groups exposed to Kagan’s P
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Earthquakes in the Holy Qur’an and the Hadith of the Noble Prophet, an intellectual approach