Our Summary

This research paper provides advice for surgeons interested in using a new technique for hand surgery called Wide Awake Local Anaesthesia No Tourniquet (WALANT). This approach uses local anesthesia without requiring the patient to be sedated, or the use of a tourniquet, a device traditionally used to control blood flow during surgery.

The benefits of this approach include a significant reduction in costs, making it more accessible for patients who cannot afford the high costs associated with traditional surgery methods. It also allows surgeons to perform these surgeries in minor procedure rooms instead of the main operating room, without increasing the risk of infection.

The authors also provide tips on how to administer local anesthesia with minimal pain, leaving patients impressed with the surgeon’s skill. The paper suggests that using WALANT can improve the results of many hand surgery procedures.

FAQs

  1. What is the Wide Awake Local Anaesthesia No Tourniquet (WALANT) technique in hand surgery?
  2. What are the benefits of using the WALANT approach in hand surgery?
  3. Does the use of WALANT technique increase the risk of infection during hand surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hand surgery is to follow all post-operative care instructions carefully to ensure proper healing and recovery. This may include keeping the hand elevated, avoiding strenuous activities, and attending follow-up appointments as scheduled. Additionally, patients should communicate any concerns or changes in symptoms to their doctor promptly to address any potential complications.

Suitable For

Patients who may benefit from hand surgery using the WALANT technique include those with conditions such as carpal tunnel syndrome, trigger finger, tendon injuries, fractures, arthritis, and cysts. This approach can also be used for procedures such as tendon repair, nerve decompression, and joint arthroplasty.

Patients who are not good candidates for traditional surgery due to medical conditions that make sedation risky may also benefit from WALANT. Additionally, patients who are unable to undergo surgery in a traditional operating room setting due to financial constraints may find this approach more accessible.

Overall, patients who are looking for a less invasive, cost-effective, and efficient option for hand surgery may be recommended for WALANT procedures. Surgeons considering using this technique should carefully evaluate each patient’s individual needs and medical history to determine if they are a good candidate for this approach.

Timeline

Before hand surgery:

  1. Consultation with a hand surgeon to discuss the procedure and determine if surgery is necessary.
  2. Pre-operative testing and preparation, including blood tests and physical examinations.
  3. Administration of local anesthesia before the surgery begins.
  4. Patient is awake and alert during the surgery, able to communicate with the surgeon if needed.

After hand surgery:

  1. Patient may experience some pain and discomfort after the surgery, which can be managed with medication.
  2. Physical therapy and rehabilitation may be necessary to regain strength and mobility in the hand.
  3. Follow-up appointments with the surgeon to monitor healing and address any concerns.
  4. Patient may gradually return to normal activities, with full recovery taking several weeks to months depending on the procedure.
  5. Patient may experience improved function and reduced pain in the hand after the surgery, leading to a better quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hand surgery using the WALANT technique may include:

  1. What specific hand surgery procedure do you recommend for my condition, and why do you believe the WALANT technique is the best approach for me?
  2. What are the potential risks and complications associated with hand surgery using WALANT, and how likely are they to occur in my case?
  3. Will I be fully awake during the surgery, and will I feel any pain or discomfort during the procedure?
  4. How long is the recovery process for hand surgery using WALANT, and what can I expect in terms of post-operative pain management and rehabilitation?
  5. Are there any specific precautions or limitations I should follow after the surgery to ensure a successful outcome?
  6. What are the success rates of hand surgery using the WALANT technique, and what are the expected outcomes in terms of function and appearance of my hand after the procedure?
  7. Are there any alternative treatment options available for my condition, and how does the WALANT technique compare to traditional surgery methods in terms of effectiveness and safety?
  8. What is the experience and expertise of the surgical team in performing hand surgery using the WALANT technique, and what is their success rate with this approach?
  9. Will I need any follow-up appointments or additional treatments after the surgery, and what is the long-term prognosis for my hand condition following the procedure?
  10. Are there any specific lifestyle changes or modifications I should consider after the surgery to optimize the results and prevent future complications?

Reference

Authors: Lalonde DH. Journal: J Hand Surg Asian Pac Vol. 2022 Apr;27(2):219-225. doi: 10.1142/S2424835522300031. Epub 2022 Apr 19. PMID: 35443890