Our Summary

This study wanted to compare the outcomes of non-traumatic hand surgeries using the WALANT technique (Wide-Awake Local Anesthesia No Tourniquet) and traditional methods that use regional anesthesia or local anesthesia with a tourniquet. For this, the researchers reviewed all relevant scientific literature until October 2018.

Out of 496 studies, they selected 9 for a detailed review. They found that surgeries using the WALANT technique took slightly longer (around 2 minutes more on average), but that patients experienced less pain after surgery (by about two points on a pain scale).

However, they found no significant differences between the two methods in terms of patient satisfaction and complication rates. In other words, patients were just as happy with their surgical results and experienced similar levels of complications regardless of the technique used.

So, the WALANT method takes a bit longer but results in less post-surgery pain, while other factors like patient satisfaction and complication rates are about the same for both WALANT and traditional methods.

FAQs

  1. What is the WALANT technique for hand surgeries and how does it compare to traditional methods?
  2. Does the WALANT method result in less pain after non-traumatic hand surgery compared to traditional methods?
  3. Are there any significant differences in patient satisfaction and complication rates between the WALANT method and traditional techniques for hand surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hand surgery using the WALANT technique is that while the surgery may take slightly longer, it can result in less post-surgery pain. Additionally, patients can expect similar levels of satisfaction and complication rates compared to traditional methods. It is important to follow post-operative care instructions carefully and attend follow-up appointments to ensure proper healing and recovery.

Suitable For

Patients who are recommended hand surgery typically include those with conditions such as carpal tunnel syndrome, trigger finger, tendon or nerve injuries, arthritis, Dupuytren’s contracture, ganglion cysts, and other hand and wrist injuries or deformities. These patients may experience symptoms such as pain, numbness, tingling, weakness, limited range of motion, or difficulty performing daily activities due to their hand condition. Hand surgery may be recommended to alleviate symptoms, improve function, restore mobility, and enhance overall quality of life for these patients.

Timeline

Before hand surgery:

  • Patient meets with a hand surgeon to discuss their condition and treatment options
  • Patient undergoes pre-operative testing and evaluations
  • Surgery date is scheduled and patient receives instructions on how to prepare for the procedure
  • Patient arrives at the hospital or surgical center on the day of surgery and meets with the surgical team
  • Anesthesia is administered and the surgery is performed

After hand surgery:

  • Patient wakes up from anesthesia and is monitored in the recovery room
  • Pain management is provided to help with post-operative discomfort
  • Patient may undergo physical therapy to aid in recovery and rehabilitation
  • Follow-up appointments are scheduled to monitor healing and address any concerns
  • Patient gradually resumes normal activities and regains full function of their hand

Overall, the patient may experience some discomfort and limitations in the immediate post-operative period, but with proper care and rehabilitation, they can achieve a successful outcome from hand surgery.

What to Ask Your Doctor

  1. How does the WALANT technique differ from traditional methods of hand surgery?
  2. Will using the WALANT technique result in less post-surgery pain compared to traditional methods?
  3. Are there any additional risks or complications associated with the WALANT technique?
  4. How much longer can I expect the surgery to take if the WALANT technique is used?
  5. Will the WALANT technique have any impact on my recovery time or overall outcome of the surgery?
  6. How many procedures have you performed using the WALANT technique and what is your success rate with this method?
  7. Are there any specific criteria that make me a better candidate for the WALANT technique over traditional methods?
  8. Are there any alternative pain management options available for hand surgery besides the WALANT technique?
  9. What post-operative care and follow-up will be needed if I choose to have the surgery done using the WALANT technique?

Reference

Authors: Evangelista TMP, Pua JHC, Evangelista-Huber MTP. Journal: J Hand Surg Asian Pac Vol. 2019 Dec;24(4):469-476. doi: 10.1142/S2424835519500619. PMID: 31690188