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Introduction: Reconstruction of defects in heel and malleoli with exposed bone has always been a challenge. Heel is a weight bearing region which needs sensation. Distally-based sural island flap is one of the options available for these kinds of defects. Here, in this study we have paid special attention to how these flaps become sensate.
Materials and Methods: This case-series study carried out on 14 patients who reffered to 15 Khordad Hospital, Tehran, from 2000 to 2003 and their defects had been covered with distally based sural island flap. Appearance of pain, temperature, light touch and two - point discrimination evaluated in flap region and compared with the contralateral site.
Results: From 14 patients with this flap; 11 subjects (9 males and 2 females) entered into the study. Seven subjects had been injured during motorcycle accident. In 10 patients (91%), two-point discrimination in flap region was.13.2 mm, which was the same as the other side.
Conclusion: Covering the defects in heel, malleoli and distal third of leg with sural island flap is technically easy and with minimal donor site morbidity. Major vessels in the lower extremities are spared and this flap can be used in weight bearing areas with relatively good sensation.

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Introduction: The use of complementary and alternative therapy is increasing and touch is one of them but several studies have indicated that premature neonates hospitalized in neonatal intensive care unit receive very little touch. The purpose of this research was to determine the effect of touch on arterial blood oxygen saturation in neonates with respiratory distress syndrome. Materials and Methods: This is a clinical trial with repeated measures that was performed on 37 neonates with respiratory distress syndrome. An information record form was used for data collection. The information record form was consisted of two parts: demographic information and a table for recording oxygen saturations. Oxygen saturation was measured by Nelkor pulse oxy meter. Information was collected in 3 sequential days. Arterial blood oxygen saturation was controlled 5 minutes before touch, then samples undergone 5 minutes touch and then in 5 and 15 minute intervals arterial blood oxygen saturation was controlled again. Data was analyzed using repeated measure ANOVA. Results: Findings showed that in the first day, arterial blood oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/67, 95/91, 96 respectively. In second day, arterial blood and oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/72, 96/05, 96/08 respectively. In third day, arterial blood oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/75, 96/16, 96/13 respectively. Arterial blood oxygen saturation in 5 and 15 minutes after touch were more than 5 minutes before touch in each 3 day(p<0.01). But there was no significant difference between 5 and 15 minutes after touch. Data analysis also showed no significant difference comparing arterial blood oxygen saturation in the 3 days. Conclusion: Findings suggested that premature neonates physiologically responded to touch. Nurses working in NICUs must be educated about the importance of touch in providing care for these neonates. Findings showed that touch is useful for premature neonates and this fact can be a start point for other investigations.

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Introduction: Due to the absence of frozen section in the majority of hospitals, malignant breast masses are being operated in two admissions first for biopsy and second for mastectomy. With simple and rapid technique of touch imprint (intraoperative cytology) both operations can be done in the same time. In this study the diagnostic accuracy of intraoperative cytology (touch imprint) in malignancy of breast masses is evaluated. Materials and Methods: During 2003 to 2006, reports of touch imprints of 70 patients with breast masses were compared to reports of their permanent section. Based on gathered data, positive and negative predictive value, sensitivity and specificity, and positive and negative likelihood ratio of the test were determined. Results: In 70 patients, 39 cases had malignant and 31 cases had benign masses. In 39 patients with malignant masses, 36 patients had malignant and 3 patients had benign cytologic reports. In 31 patients with benign masses 2 patients had malignant reports in cytology. Therefore sensitivity, specificity and accuracy of touch imprint in diagnosis of malignant breast masses were 92.3%, 93.5% and 92.9% respectively. Conclusion: Because of high specificity of touch imprint, it seems that this test can be done in centers that do not have frozen section for intraoperative diagnosis of malignant breast masses.