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.
(10)
(9)
(3)
(2)
(298)
(283)
Background: Chronic hyperglycemia causes diabetic nephropathy(DN), which is a typical microvascular complication of type 2 diabetes mellitus. The pathogenesis of DN is not fully understanding. The inflammation may possess a significant role in the progression of DN in diabetic patients. Method: The study accomplished at teaching laboratories of medical city, Baghdad, Iraq. It was included 50uncontrolled diabetic type 2 patients with nephropathy, age range (40-78) years and 42 controlled diabetics type 2 without nephropathy, age range (35 - 52) years as a control group. The participants divided in to two groups according to HbA1c measurement which is described as follows: < 7.5% of HbA1c describes controlled diabetes, and > 9% of HbA1c
... Show More
(10)
(54)
(61)
(56)
Abstract
urgent surgical intervention and appendectomy until now represent standard treatment for uncomplicated cases of appendicitis. Nausea, vomiting and pain after surgery are the most frequent issues facing patients and affecting patient quality of life and responsible for many cases of readmission after surgery. Ketorolac and diclofenac represent the most commonly prescribed non-steroidal anti-inflammatory used in postoperative setting and they cause many side effects as gastrointestinal, kidney and cardiac adverse effect in addition to increased risk of bleeding. Paracetamol is currently among the most frequently prescribed medication worldwide and it can be used safely for all age groups. This study aimed
... Show More
(4)
(3)
Deep beams are used in wide construction fields such as water tanks, foundations, and girders in multi-story buildings to provide certain areas free of columns. In practice it is quite often occurring to create web opening in deep beams to supply convenient passage of ventilation ducts, cable channels, gas and water pipes. Experimental studies of ten 10 deep beams were carried out, where two of them are control specimens without openings and eight with large web openings in the shear spans. The variables that have been adopted are the ratio of the shear span to the overall depth of the member cross-section, location and dimensions of the opening. Test results showed that there was a decrease in the load carrying capacity of deep bea
... Show More
(9)
Arabian killifish,
In this study, the staging of normal embryonic development of
(2)
(6)
In this research, an enhancement in lubricating, rheological, and filtration properties of unweighted water-based mud is fundamentally investigated using XC polymer NPs with 0.2gm, 0.5gm, 1gm, 2gm, and 4gm concentrations. Bentonite, that had been used in the preparation of unweighted water-based mud, was characterized using XRF-1800 Sequential X-ray Fluorescence Spectrometer, XRD-6100/7000 X-ray Diffractometer, and Malvern Mastersizer 2000 particle size analyzer, respectively. Lubricating, rheology and filtration properties of unweighted water-based mud were measured at room temperature (35°C) using OFITE EP and Lubricity Tester, OFITE Model 900 Viscometer, and OFITE Low-Pressure Filter Press, respectively. XC Polymer N
... Show More
(4)