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. 2024 Nov 5:15589447241284814.
doi: 10.1177/15589447241284814. Online ahead of print.

Infections and Patient Satisfaction in WALANT Hand Surgery in a Hospital Procedure Room

Michaela J Derby  1 , Kelly N McKnight  2 , Robert E Van Demark  3
Affiliations

Infections and Patient Satisfaction in WALANT Hand Surgery in a Hospital Procedure Room

Michaela J Derby et al. Hand (N Y). .

Abstract

Background: Wide-awake hand surgery has allowed many hand procedures to be moved out of the operating room and into minor procedure rooms while increasing efficiency, maintaining safety, and reducing both patient and hospital costs. The goal of this study was to evaluate patient satisfaction and postoperative complications of wide-awake local anesthesia with no tourniquet procedures performed in a community-based hospital procedure room. Methods: A total of 786 patients underwent 948 elective hand procedures in a hospital procedure room. At the conclusion of their surgeries, the patients were surveyed regarding their satisfaction. Following surgery, patients were evaluated for postoperative complications including infections. The trend in postoperative infection rates across 8 age groups was analyzed using a Cochran-Armitage test in R. Results: The overall infection rate was 6.2% (n = 59). All infections were superficial. Carpal tunnel had the highest number of infections (n = 25), followed by trigger finger (n = 8), and the combination trigger finger with carpal tunnel (n = 7). All infections were managed with antibiotics and/or soaks. Three patients did require a return to the operating room for irrigation and debridement. Ninety-nine percent of patients said the procedure room experience was better or the same as going to the dentist, would recommend wide-awake anesthesia to a friend or family member, and would undergo the procedure again. Conclusion: Wide-awake procedures performed in a hospital procedure room have low infection rates with high patient satisfaction.

Keywords: WALANT; hand surgery; infection rate; patient satisfaction; procedure room.

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Conflict of interest statement

Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Hospital-based procedure room.
Figure 2.
Figure 2.
Patient satisfaction survey.
Figure 3.
Figure 3.
Proportion of patients with infection by age group, with the number of patients in each group given above each bar.
See this image and copyright information in PMC

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