Background: The use of tourniquet is very common in orthopedic surgeries. By obstructing blood flow in the limb, tourniquet may result in muscle ischemia and skin flap hypoxia. This study aimed at determining and comparing the effects of tourniquet release time on wound healing in patients undergoing tibia fracture plating surgery. Methods: This study was a randomized clinical trial, wherein 40 patients with acute extra-articular tibia fractures were randomly assigned to 2 groups of A (releasing the tourniquet after fracture fixation and before wound closure) and B (releasing the tourniquet after wound closure and application of compression dressing). Duration of surgery in each group was recorded and independent t test was utilized to compare the 2 groups. The wound healing rate was investigated in the patients 24 hours and 14 days after surgery using the Redness, Oedema, Ecchymosis, Discharge, Approximation (REEDA) scale. In this tool, 0 represents "lack of the variable" and 3 indicates "maximum variable score". The scores in this scale range from 0 to 15. The Mann-Whitney test was used in order to compare the wound healing rates between the 2 groups. Results: There was no significant difference between the 2 groups concerning the average duration of surgery. Wound redness, edema, ecchymosis, discharge, approximation, and the general condition of wound healing showed no significant difference in the 2 groups 24 hours after surgery, while there was a significant difference 14 days after surgery with the aforementioned parameters being greater in group B than group A. Conclusions:The results showed that releasing the tourniquet before wound closure in group A led to improved wound healing. Wounds need oxygen for restoration and prevention from infections. As the use of tourniquet occludes blood flow to the limb for a while, it can result in increased wound hypoxia after surgery and delayed healing process; hence, less tourniquet time is more desirable for oxygenation of tissues and wound dryness.

Background: Severe skeletal class III malocclusions usually need a combined treatment of orthodontics and orthognathic surgery. Knowing about changes occurred following such treatments lead to improve facial esthetics and better treatment results. Objectives: This study was done to determine cephalometric changes of facial soft tissue after combined treatment in patients with skeletal class III problem. Methods: 25 patients with skeletal class III discrepancy who needed a combined treatment, were selected. Changes in nasolabial angle , upper lip and lower lip to E-line distance, angle of convexity , lip-chin-throat angle and lower anterior facial height were measured before and 6 -12 months after surgery. Changes in parameters were analyzed with Paired t-test. Results: Upper lip to E-line distance (P < 0.0001) and angle of convexity (P < 0.001) changed significantly following surgical procedures while changes of other parameters were not significant. Conclusions: Clinical changes in the soft tissue following a combination of orthodontic treatment and orthognathic surgery in patients with skeletal class III discrepancy are significant while these changes mostly improves esthetics of patient's facial profile.

Surgical site infection is one of the most common health-related infections, which can cause problems for health care providers by increasing morbidity and mortality, length of hospital stay, and costs. Undoubtedly, one of the most efficient and cost-effective ways to fight infection is to prevent it. An essential measure in infection control is the disinfection of the surgical team members to remove fat and contamination, eliminate transient microorganisms, and prevent the growth and proliferation of resident microorganisms on the skin. This study aimed to introduce different types of soap and alcohol disinfectant solutions for surgical scrub and describe the advantages and disadvantages of each by reviewing several recent research studies. This study is a brief overview of the recently conducted articles as searched in library resources, the Google Scholar Search Engine, Pubmed, UpToDate, Cochran, and Scopus databases using the English keywords of "hand hygiene", "infection control", "hand disinfection/methods", "hand disinfection/standards", and "Surgical Procedures, Operative" as well as the Persian keywords of "surgical scrub", "Povidone-iodine", "alcohol", and "hand disinfection". After reviewing 76 articles and eliminating the duplicate sources, 43 studies published from 2007 to 2019 were fully reviewed. Finally, 26 sources were selected as eligible with substantial relevance to the subject matter and subsequently reviewed. Based on the review of articles, it can be concluded that alcoholic solutions are often effective alternatives to soap scrub solutions due to their high disinfecting properties, safety, rapid effectiveness, and greater compliance with instructions.

Introduction: Appendicitis is a challenging condition for emergency specialists and surgeons to diagnose. If it is not treated in time, the inflamed tissue of the appendix ruptures, causing peritonitis and shock. This study evaluated the diagnostic value of clinical and laboratory symptoms in the diagnosis of acute appendicitis. Methods: This descriptive cross-sectional study was carried out on a total of 134 patients with suspected appendicitis referring to the Emergency Department of Imam Reza Hospital in Birjand, Iran, within 2013 and 2015 using convenience sampling. The data collection tool was a questionnaire covering patients’ demographics, clinical signs, and laboratory and pathology test results. Sensitivity and specificity, positive predictive value, negative predictive value, likelihood ratio, area under the receiver operating characteristic (ROC) curve (AUC), and cut-off point of each test (i.e., white blood cell, aspartate transaminase, alanine transaminase, C-reactive protein, polymorphonuclear leukocytes, lymphocytes, total and direct bilirubin, iron, and total iron-binding capacity) were analyzed using SPSS software (version 18) and MedCalc software (version 19). A p-value of 0.05 was considered statistically significant. Results: In this study, 68 and 66 participants were male and female, respectively. The mean age of the patients was 24. (44±11).26 years. Pathological examination showed that six patients underwent a negative appendectomy. A positive appendectomy was noted in 128 subjects. Histopathological results confirmed the perforation of the appendix in 78 patients. Among the laboratory tests, only the accuracy of serum iron was fair in the diagnosis of acute appendicitis (AUC numerical value in the ROC curve=0.787). The accuracy of other tests based on the AUC numerical value in the ROC curve was poor or failed. Conclusions: Although the accuracy of serum iron based on the numerical value of AUC in the ROC curve was diagnostically fair for acute appendicitis, it is suggested to carry out further studies with larger sample sizes in order to draw definitive conclusions given the small sample size in this study.

Background: Tourniquet is used in limb surgeries in order to create a clear blood-free surgical filed. Despite its considerable benefits, tourniquet has potential risks such as neuromuscular injuries, decreased joint range of motion, and pain. Present study was made to compare the effects of two tourniquet times on pain and knee range of motion after internal plate fixation of tibia fractures.