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.
The administration on the basis of the activities designed to evaluate the performance of activities in terms of cost, time and quality by identifying activities that add value and those that are no add value and enables the administration of making up their own continuous improvement in production, through lower costs and reduce the time and improve the quality and reduce the incidence of spoilage and waste, y based search Ally premise that (the continuous improvement of the adoption of management style on the basis of the activities helps management in decision-making wise to reduce costs) to prove the hypothesis has sought research to achieve its goal of Alkadivh and Alkoppelan &nb
... Show MoreRepresent choices Behaviorism available to the Managerial leaders one of the prerequisites to run any beginnings of a psychological or dilemmas Managerial barriers to working in the field of work has been varied these options until it had taken several kinds of which contributed to the left different impacts on the alleviation of these problems, which prompted the researcher to raising the problem of study within the framework of questionable content how to contribute to that shown by Choices Behaviorism accredited to the Managerial leaders in the management of frustration
... Show MoreThe management of wisdom is concerned with the level of expertise, methods of transmission, use and ability to problems and their impact on behavior and human behavior in order to improve it in the form of successful decisions. The importance of management of wisdom in making successful decisions that ensure the survival and development of society through the provision of leaders capable of planning, organization and decision-making to achieve the goals and objectives required in a complex and changing environment. Where the administration faces positions and problems that require operational decisions to organize the activities of the institution in line with the strategic decisions already taken under the proper strategic planning. The ex
... Show MoreThe self-evident truth existing in today's business environment is the continuity of change and its continuity and turmoil, also its increase over time as it is more abundant, abundant, wide and complex than ever before, and it is the dominant feature in the business environment, as different organizations and operating units can find themselves shifting from the top to the bottom. And then it requires its departments to strive to adapt to these rapid and turbulent shifts and changes by bringing about a series of organizational and adaptive changes that are not limited to one organizational aspect only but rather include all organizational components. Accordingly, this research came to determine the readiness of public organizations to chan
... Show MoreThis 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
Despite their potential as a sustainable energy technology, the operation of proton exchange membrane fuel cells (PEMFCs) in sub-freezing conditions remains a critical challenge due to the risk of ice formation and performance degradation. This study introduces a new passive thermal management technique using strategically arranged multi-layer phase change materials (PCMs) to address this challenge. A numerical model was developed to evaluate the thermal behavior across various PCM configurations, incorporating one, two, and three layers arranged both in parallel and series with distinct melting points ranging from 55 to 65 ◦C. The results show that multi-layer PCM configurations provide significant improvements over the single-layer base
... Show MoreThe 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 MoreThe 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 MoreThe 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
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