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Wide-Awake Hand Trauma Surgery: Designing Strategies to Optimise Patient Experience
Alaa Elzagh1, Savan Shah2, Henry De Berker1
1Department of Burns and Plastic Surgery, Manchester University National Health Service Foundation Trust, Manchester, GBR.
Cureus
|August 6, 2024
Summary
The shift to Wide-Awake Local Anaesthetic No Tourniquet (WALANT) hand surgery improved treatment compliance and patient experience. This approach also reduced healthcare-associated carbon emissions through same-day treatment.
Area of Science:
- Orthopedics
- Hand Surgery
- Anesthesiology
Background:
- Regional hand trauma service reorganisation during COVID-19 pandemic.
- Transition from general anaesthesia (GA) to Wide-Awake Local Anaesthetic No Tourniquet (WALANT) technique.
- Implementation of strategies to optimize patient experience.
Purpose of the Study:
- Evaluate the impact of a predominantly WALANT service on patient care and outcomes.
- Assess compliance with national treatment guidelines.
- Investigate improvements in patient experience and environmental impact.
Main Methods:
- Assessed compliance with national treatment guidelines.
- Examined the role of patient information and peri-operative counselling.
- Introduced and evaluated a post-operative analgesia protocol.
- Calculated environmental impact of a same-day 'see and treat' service.
Main Results:
- Increased compliance with national standards for hand injury treatment.
- Reduced patient anxiety through education and counselling.
- Improved post-operative pain management with the new protocol.
- Significant reduction in carbon emissions due to same-day evaluation and treatment.
Conclusions:
- WALANT benefits both patients and the healthcare system.
- Advocates for a multi-modal approach focusing on patient outcomes.
- Highlights the importance of validated patient-reported outcome measures (PROMs).
