WALANT for hand wound exploration in isolated conditions: Feasibility study

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Military Medicine

Background:

• Military doctors often manage hand wounds in austere environments without immediate access to specialized surgical centers.
• The Wide Awake Local Anesthesia No Tourniquet (WALANT) technique offers a potential solution for remote hand wound management.

Purpose of the Study:

• To evaluate the effectiveness of WALANT for hand wound exploration by military doctors in non-specialized settings.
• To compare diagnostic accuracy, patient satisfaction, and pain levels between military doctors trained in WALANT and hand surgeons in a specialized center.

Main Methods:

• A comparative, prospective, multicenter study involving military doctors trained in WALANT.
• Hand wound exploration and assessment were performed in an emergency setting outside a specialized center.
• Patient and operator questionnaires assessed satisfaction, pain, and diagnostic precision, compared to a specialized FESUM center.

Main Results:

• No significant differences were observed in diagnostic capacity, patient satisfaction, comfort, or perceived pain intensity between the two groups.
• WALANT enabled precise lesion assessment under conditions simulating operational military environments.

Conclusions:

• WALANT is an effective tool for hand wound exploration and assessment for military doctors, including submariners and special forces.
• The technique is suitable for operational conditions, maintaining patient comfort and diagnostic efficacy outside specialized centers.