gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Wide-awake surgical operations performed over a 25-month period in Tianjin: Analysis of applications and technical extension

Meeting Abstract

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  • presenting/speaker Jianhua Xu - Tianjin Hospital, Tianjin, China
  • Ketong Gong - Tianjin Hospital, Tianjin, China
  • Haihua Zhan - Tianjin Hospital, Tianjin, China
  • Jianbing Zhang - Tianjin Hospital, Tianjin, China
  • Qiang Zhou - Tianjin Hospital, Tianjin, China
  • Li Han - Tianjin Hospital, Tianjin, China
  • Yijun Lu - Tianjin Hospital, Tianjin, China
  • Lu Yin - Tianjin Hospital, Tianjin, China
  • Zhonggang Yin - Tianjin Hospital, Tianjin, China
  • Bo Zhang - Tianjin Hospital, Tianjin, China

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-34

doi: 10.3205/19ifssh0589, urn:nbn:de:0183-19ifssh05891

Veröffentlicht: 6. Februar 2020

© 2020 Xu et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: WALANT hand surgery becomes increasingly popular. In this report we analyze our applications of wide-awake hand surgical procedures, especially the use of WALANT in emergency hand surgery procedures.

Methods: From February 2016 to March 2018, a total of 20 hand surgeons in our department performed WALANT procedures in 7673 patients. Among these patients, 5634 patients were operated in emergency settings because of open trauma, 2039 patients were operated as elective cases. In the emergency settings, we performed internal fixation for open digital and metacarpal fractures in 1380 patients. As elective cases, we operated on 340 closed fracture patients with open reduction and internal fixation of the phalangeal and metacarpal fractures. In addition, we performed 110 in situ cubital tunnel releases.

Results and Conclusions: WALANT surgery was predominantly in emergency surgeries in our department. 73% of the patients who we operated with WALANT were in emergency settings. All patients tolerated surgical procedures well in emergency settings. No epinephrine related tissue necrosis was found. We found that WALANT was feasible for internal fixation (including plating) in our 1380 patients treated in emergency settings. WALANT was very satisfactory for in situ cubital tunnel decompression in elective settings.

We conclude from our experience of WALANT surgeries in 7673 patients that this approach benefits our emergency patients greatly. We also conclude that WALANT can be used for internal fixation of phalangeal and metacarpal fractures including plating in needed patients and it provide very satisfactory approach for cubital tunnel release. Our large case series also indicates this approach is safe in both emergency and elective settings. The use of WALANT remarkably increased efficiency of emergency case of patients with hand trauma in our hospital.