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Infection Rate Comparison during Transition from Hospital to Office WALANT Enabled by Virtual Reality
Tannur C Oakes1, Karren C Wong1, Kyle J Schank2
1Michigan State University College of Human Medicine, East Lansing, Mich.
Plastic and Reconstructive Surgery. Global Open
|June 15, 2022
Summary
Transitioning hand surgery from the operating room (OR) to an office-based procedure room (OPR) for wide-awake, local anesthesia, no tourniquet (WALANT) procedures did not significantly alter infection rates. Office-based procedures are as safe as OR settings for selected cases.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Patient Safety
Background:
- Hand surgery practice transitioned from the operating room (OR) to an office-based procedure room (OPR).
- The goal was to offer wide-awake, local anesthesia, no tourniquet (WALANT) procedures.
- Wide-awake virtual reality was previously shown to improve patient comfort and reduce anxiety.
Purpose of the Study:
- To assess the effect of transitioning hand surgery from OR to OPR on infection rates.
- To compare infection rates for procedures performed by a single surgeon in both settings.
Main Methods:
- Retrospective chart review of adult patients undergoing elective and closed traumatic upper limb surgeries.
- Infection definition: superficial or deep surgical site infection treated with antibiotics within 4 weeks.
- Data collected from August 2017 to August 2019.
Main Results:
- 538 cases included: 216 in OR and 322 in OPR.
- OR cohort: 2.78% superficial infections, 0% deep space infections.
- OPR cohort: 1.24% superficial infections, 0% deep space infections; no statistical significance between groups.
Conclusions:
- WALANT procedures in an office setting are as safe as traditional OR-based procedures for selected elective cases.
- Transitioning suitable cases from OR to OPR does not significantly change the surgeon's overall infection rate.
- Office-based hand surgery offers a safe alternative for patients choosing their venue.
