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A Study of Hand Flap Viability when Using a Wide Awake Local Anesthesia No Tourniquet (WALANT) Technique
Clément Prénaud1, Lorenzo Merlini1,2, Simon A Hurst1,3,4
1Avicenne Teaching Hospital, Bobigny, Paris, France.
Journal of Hand and Microsurgery
|September 13, 2023
Summary
Hand flap surgery using the Wide Awake Local Anesthesia No Tourniquet (WALANT) technique is safe and effective. Epinephrine in local anesthesia did not compromise flap viability in this study.
Area of Science:
- Plastic Surgery
- Hand Surgery
- Anesthesiology
Background:
- Wide Awake Local Anesthesia No Tourniquet (WALANT) technique is often avoided for hand flap surgery due to concerns about epinephrine-induced vasoconstriction.
- Technical challenges have also historically limited the use of WALANT in these procedures.
Purpose of the Study:
- To evaluate the viability of hand flaps performed using the WALANT technique compared to those performed under regional anesthesia with a tourniquet.
Main Methods:
- A prospective comparative study included 74 patients, divided into a locoregional anesthesia group (36 patients) and a WALANT group (38 patients).
- Flap viability was assessed on postoperative days 2 and 10 using predefined criteria.
Main Results:
- No significant differences in flap viability outcomes were observed between the WALANT group and the regional anesthesia with tourniquet group.
- Postoperative assessment showed comparable flap survival and integrity in both groups.
Conclusions:
- The use of epinephrine in local anesthesia for WALANT hand flap surgery did not compromise flap vascularization.
- The WALANT technique appears to be a safe and viable option for hand flap procedures.
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