The Efficacy of Wide-Awake Local Anesthesia No Tourniquet (WALANT) in Common Plastic Surgery Operations Performed on the Upper Limbs: A Case–Control Study

Abstract

Background: The wide-awake local anesthesia no tourniquet (WALANT) technique is commonly used in elective hand surgery, whereas its application in plastic surgery is still limited. The aim of the study is to evaluate the feasibility and efficacy of WALANT in common plastic surgery operations performed on the upper limbs. Methods: Patients who underwent those operations under WALANT were matched and compared with patients who had general or regional anesthesia without infiltration of a local anesthetic solution. All operations were performed by the same surgeon. Data from 98 operations were collected and analyzed for the total operation time, operation theatre time and complication and patient satisfaction rates. Results: All operations under WALANT, mainly skin tumor excision and flap repair or skin grafting and burn escharectomy with or without skin grafting, were completed successfully. No statistical difference in total operation time and complication rates was revealed. Statistical significance favoring WALANT was identified regarding the mean operation theatre time and patient satisfaction. Conclusions: WALANT is an effective method for common plastic surgery operations performed on the upper limbs that is associated with better operation theatre occupancy and high patient satisfaction rates.

Concomitant Reconstruction of Multiple Scalp Defects With One Rotational Flap

“…compared with other flaps, but has the disadvantage of a high risk of venous congestion, [4][5][6][7] such as the similarity to the other reports. 3,8 It may have something to do with the fact that the vein in the temporal region does not have as predictable a course as the artery.…”

“…1). 6,7 The 2 frontal skin defects were unified to 1, measuring 45 mm × 25 mm, while the parietal defect was 30 mm × 30 mm. Careful hemostasis was performed with the cautery.…”

Ventajas Y Desventajas De Walant en Cirugías Ortopédicas De Mano Y Muñeca.

“…Además, se debe garantizar que la seguridad del paciente se mantenga como una prioridad, asegurando que los profesionales médicos estén adecuadamente capacitados en la técnica y que se sigan los protocolos de seguridad establecidos (1).…”

“…En el ámbito de la cirugía ortopédica de mano y muñeca, el avance y la implementación de nuevas técnicas y procedimientos quirúrgicos son fundamentales para mejorar los resultados clínicos, reducir el tiempo de recuperación y minimizar el impacto en la calidad de vida de los pacientes (1). En este contexto, la técnica de anestesia ampliamente utilizada conocida como "WALANT" (Wide Awake Local Anesthesia No Tourniquet) ha ganado popularidad en los últimos años, generando un debate significativo sobre sus ventajas y desventajas en comparación con otros enfoques anestésicos tradicionales (2,3).…”

Hand surgery without tourniquet as a model for the development of surgical service innovation for competitive advantage-based service readiness

“…Clinical studies initiated at Cipto Mangunkusumo Hospital, Jakarta, demonstrated advancements, with international research publications supporting the technique's efficacy. [21][22][23][24][25][26] The presentation also highlighted challenges faced in the global plastic surgery community regarding using epinephrine in certain surgeries, emphasizing the safety measures adopted in Jakarta, where awareness gained through experimental research contributed to clinical success. 27 The surgical innovation of hand surgery without a tourniquet has proven effective, offering advantages in safety, efficiency, and good and excellent patient experience across various hand surgeries.…”