Evaluating the Safety of the Hand Surgery Procedure Room: A Single-Center Cohort of 1,404 Surgical Encounters

Stephens, Andrew R.; Presson, Angela P.; Jo, Yeon Jung; Tyser, Andrew R.; Wang, Angela A.; Hutchinson, Douglas T.; Kazmers, Nikolas H.

doi:10.1016/j.jhsa.2020.11.018

Cited by 10 publications

(7 citation statements)

References 38 publications

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“…High patient satisfaction rates have been reported both in the United States and abroad. 2,3,6,7,10,12,14,25,[43][44][45][46] Our study found similar results, with 99% of patients rating their experience as better than or the same as going to the dentist. Ninety-nine percent of our patients would recommend wide-awake hand surgery to a friend or family member and would also do surgery while wide awake again if needed.…”

Section: Discussionsupporting

confidence: 76%

“…Recently, Stephens et al 14 evaluated the safety of WALANT anesthesia in a procedure room. A group of 1,401 patients with 1,796 procedures were reviewed to look at the safety of a hand surgery procedure room .…”

Section: Discussionmentioning

confidence: 99%

“…Procedure rooms are less expensive and more efficient. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 The savings begin before the patient steps foot in the procedure room, with no need for preoperative laboratory testing and medical evaluations. In a study of preoperative carpal tunnel patients, Greenfield et al 8 found a per-patient average cost of $858.74 was spent on preoperative work-ups and nonsurgical management of patients who underwent carpal tunnel release.…”

Section: Discussionmentioning

confidence: 99%

“… 8 Additionally, there are cost savings associated with the decreased need for surgical drapes, equipment, and hospital staffing. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 There is also a decrease in the waste generated by these procedures, as they are typically done under minor field sterility, which consists of sterile prep, a single drape, a minor instrument tray, sterile gloves and a mask (no gown or antibiotics), and local anesthesia. 16 , 29 …”

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confidence: 99%

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Wide-Awake Hand Surgery Has Its Benefits: A Study of 1,011 Patients

McKnight¹,

Smith²,

MacFadden³

et al. 2022

Journal of Hand Surgery Global Online

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Wide-Awake Hand Surgery Has Its Benefits: A Study of 1,011 Patients

McKnight¹,

Smith²,

MacFadden³

et al. 2022

Journal of Hand Surgery Global Online

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“…The boundaries of the wide-awake local anesthesia no tourniquet (WALANT) method have been pushed to new frontiers in the face of limited operating room capacity. There are reports of using local anesthesia for open reduction and internal fixation to treat distal radial fracture 93 , for trapeziometacarpal joint arthroplasty 94 , and for hand fracture fixation 68 , further establishing WALANT as a safe, inexpensive means for surgical care associated with a satisfying patient experience [95][96][97][98] .…”

Section: Covid-19mentioning

confidence: 99%

What’s New in Hand and Wrist Surgery

Bohn

Wise

2022

Journal of Bone and Joint Surgery

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The intent is to serve as an update of the hand surgery literature for the practicing general orthopaedic surgeon. Carpal Tunnel SyndromeCarpal tunnel syndrome is one of the most common disorders in hand surgery. Nevertheless, the optimum method for diagnosis remains controversial. A growing body of evidence suggests that electrodiagnostic studies [1][2][3][4] are not more sensitive and specific than diagnosis by ultrasound or clinical history and examination. D'Auria et al. 5 examined the role of electrodiagnostic studies compared with clinical judgment and found that the utility of electrodiagnostic studies may be greatest in patients for whom a diagnosis of carpal tunnel syndrome is questionable. Even so, electrodiagnostic studies are performed in many patients with carpal tunnel syndrome 6 . Less expensive, office-based diagnostic tools such as the Carpal Tunnel Syndrome 6 (CTS-6), a 26-point scale that incorporates aspects of the history and clinical examination to predict the probability of carpal tunnel syndrome, and ultrasound will likely supplant the routine use of electrodiagnostic studies for carpal tunnel syndrome.Strong evidence exists for the use of night splints and corticosteroid injections for early treatment of carpal tunnel syndrome. In a comparison of the 2 treatments, 100 patients with a diagnosis of carpal tunnel syndrome were randomized to a night splint or a corticosteroid injection 7 . In the 95 patients who completed follow-up, corticosteroid injections were superior in terms of nocturnal paresthesias, pain, and Boston Carpal Tunnel Questionnaire (BCTQ) function and symptom domains at 1, 3, and 6 months.A novel study on hand function with decreased sensation showed that a digital nerve block to the thumb had the greatest negative impact on dexterity and a loss of sensation in the index and long fingers caused decreased grip and chuck pinch strength, thus explaining the common symptoms of decreased dexterity and strength in patients with carpal tunnel syndrome 8 .Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/G899).

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