gms | German Medical Science

Objectives: The wide-awake hand operations have not typically performed in a minor procedure room in our hospital. This study is to report the surgical procedures that were performed in the wide-awake surgical theater inside the department ward over a year period and its impact to surgeons' efficiency and quality of life.

Methods: In our unit, a wide-awake hand surgery theater was built outside of the main operating rooms of the hospital, but inside a hand surgery ward, which is entirely managed by the Department of Hand Surgery without anesthesiologists involved. It is very close to surgeons' offices within 5-20 meters. The regulations of this wide-awake theater of the department are less stringent than those for hospital operating rooms because the operations are only for appropriate hand related patients without complex reconstruction. The surgeons have no restriction in deciding the time of surgery. Any surgery, whether outpatient or inpatient, can be performed whenever the room is available. Inside the operating room, patients usually enjoy watching movies or listening to music stored in hard drives or iPads with earphones during surgery. Questionnaires were sent to surgeons to assess the efficiency of workflow and improvement of quality of life of surgeons by this new setting.

Results: This operating room provides easy access and simplified workflow for both patients and surgeons and a more pleasant patient experience. From September 2017 to August 2018, a variety of wide-awake surgical procedures were performed in 613 patients in this theater. The number of patients underwent surgery include excision of soft tissue 143, carpal tunnel release 73, trigger finger release 76, hand fracture internal fixation/removal 62, flap transfer 50, tendon repair 25, tenolysis 8, cubital tunnel release 9, nerve repair 5, tendon transfer 4, collateral ligament repair of joints 5, release of finger joint contracture 4, wound debridement, skin graft, foreign body removal in 149 patients. There was no waiting time for these patients and questionnaire sent to surgeons indicate very favorable response from surgeons who all reported improvement of work efficiency and improvement of quality of life of the surgeons.

Conclusions: Our experience indicates that such a specialized operating room improves efficiency in hand surgeons' workflow, improves quality of life of the surgeons, and decreases waiting time for the patients and surgeons.