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Comparing Complication Rates in Procedures Performed in the Operating Room Versus In-Office: A Cohort Study.

Jordan T Carter1, Justin Rock2, Jason Coffman1

  • 1The University of Texas Health Science Center San Antonio, USA.

Hand (New York, N.Y.)
|April 20, 2026
PubMed
Summary
This summary is machine-generated.

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In-office Wide Awake Local Anesthesia No Torniquet (WALANT) procedures are safe for most hand surgeries, but smokers and those with autoimmune diseases may face higher risks compared to operating room settings.

Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Anesthesiology

Background:

  • In-office Wide Awake Local Anesthesia No Torniquet (WALANT) is gaining popularity for minor hand procedures.
  • Comparison of complication rates between in-office and operating room settings is crucial for patient care.

Purpose of the Study:

  • To compare the complication profiles of common hand procedures performed in-office using WALANT versus the traditional operating room (OR).

Main Methods:

  • Retrospective cohort study of 2182 patients undergoing specific hand procedures between 2018-2022.
  • Procedures were stratified by location: in-office WALANT vs. OR.
  • Statistical analysis included Student's t-test and Chi-squared test for continuous and categorical variables, respectively.
Keywords:
WALANTcarpal tunnelcomplicationshandin-officetrigger finger

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Main Results:

  • No significant difference in overall complication rates between in-office WALANT and OR settings.
  • Patients in the WALANT group were older with more comorbidities.
  • Smokers and patients with autoimmune diseases showed higher complication rates in the office setting.

Conclusions:

  • In-office WALANT is a safe and convenient option for most minor hand procedures.
  • Certain patient groups, including smokers and those with autoimmune conditions, may experience increased risks in the office setting.
  • Findings aid in patient counseling regarding procedure setting selection.