Latest Advances in Wide Awake Hand Surgery

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Anesthesiology

Background:

• Traditional flexor tendon repair and finger fracture treatment can involve painful procedures.
• Existing methods may limit early patient mobilization and increase healthcare costs.
• The need for improved anesthesia and surgical techniques in hand reconstruction is evident.

Purpose of the Study:

• To evaluate the efficacy and benefits of Worldwide Anesthesia Local Anesthesia (WALANT) in flexor tendon repair.
• To assess the application of WALANT in K-wire reduction for finger fractures, enabling early movement.
• To explore the cost-effectiveness, waste reduction, and accessibility improvements associated with WALANT.

Main Methods:

• Implementation of WALANT for tumescent local anesthesia during surgical procedures.
• Utilizing WALANT in conjunction with strong sutures and pulley venting for flexor tendon repair.
• Applying WALANT for K-wire reduction in finger fractures, allowing intraoperative stability testing.

Main Results:

• WALANT anesthesia significantly reduces injection pain.
• Combined techniques improve flexor tendon repair outcomes with early active movement.
• WALANT facilitates stable K-wire fixation for early protected movement (3-5 days post-surgery).
• No significant difference in infection rates was observed between operating room and field sterility for K-wire insertion.

Conclusions:

• WALANT anesthesia is a viable, less painful alternative for hand surgery.
• The WALANT technique enhances surgical results for flexor tendon repair and finger fractures.
• WALANT offers significant advantages in cost reduction, waste management, accessibility, and affordability.