PDF(Pubmed)
Abstract：
UNASSIGNED: The primary concerns with operating on patients in the office setting are insufficient sterility and lack of appropriate resources in case of excessive bleeding or other surgical complications. This study serves to investigate these concerns and determine whether in-office hand surgeries are safe and clinically effective.
UNASSIGNED: A retrospective review of patients who underwent minor hand operations in the office setting between December 2020 and December 2021 was performed. The surgical procedures included in this analysis are needle aponeurotomy, trigger finger release, foreign body removal, mass removal, and reduction in a finger fracture with or without percutaneous pinning. All fractures, which primarily included metacarpal and phalangeal fractures, were subsequently splinted. Sterility and hemostatic support were achieved via the Wide-Awake Local Anesthesia No Tourniquet (WALANT) method. Major complications were defined as infection, major bleeding, and neurological deficits. Minor complications were defined as prolonged pain, prolonged inflammation, residual symptoms, and recurrence of symptoms within 1 month.
UNASSIGNED: Five patients (3.8%) returned to the office for pain, inflammation, or stiffness of the affected finger, with two of the five returning with symptoms associated with osteoarthritis or pseudogout flare-ups. Five additional patients returned due to residual symptoms or recurrence of the primary complaint within 1 month of surgery. No patients experienced exogenous infection.
UNASSIGNED: The absence of major complications and high success rate for minor hand procedures shows the high degree of safety and efficacy that can be achieved via the in-office setting for select procedures. While proper patient selection is key, our result shows the in-office procedure room setting can offer the necessary elements of sterility and hemostatic support for several common hand surgeries.
UNASSIGNED: A retrospective review of patients who underwent minor hand operations in the office setting between December 2020 and December 2021 was performed. The surgical procedures included in this analysis are needle aponeurotomy, trigger finger release, foreign body removal, mass removal, and reduction in a finger fracture with or without percutaneous pinning. All fractures, which primarily included metacarpal and phalangeal fractures, were subsequently splinted. Sterility and hemostatic support were achieved via the Wide-Awake Local Anesthesia No Tourniquet (WALANT) method. Major complications were defined as infection, major bleeding, and neurological deficits. Minor complications were defined as prolonged pain, prolonged inflammation, residual symptoms, and recurrence of symptoms within 1 month.
UNASSIGNED: Five patients (3.8%) returned to the office for pain, inflammation, or stiffness of the affected finger, with two of the five returning with symptoms associated with osteoarthritis or pseudogout flare-ups. Five additional patients returned due to residual symptoms or recurrence of the primary complaint within 1 month of surgery. No patients experienced exogenous infection.
UNASSIGNED: The absence of major complications and high success rate for minor hand procedures shows the high degree of safety and efficacy that can be achieved via the in-office setting for select procedures. While proper patient selection is key, our result shows the in-office procedure room setting can offer the necessary elements of sterility and hemostatic support for several common hand surgeries.
摘要：
■在办公室环境中对患者进行手术的主要问题是不育不足以及在出血过多或其他手术并发症的情况下缺乏适当的资源。这项研究用于调查这些问题，并确定办公室手部手术是否安全和临床有效。
■对2020年12月至2021年12月在办公室环境中接受小型手部手术的患者进行了回顾性审查。本分析中包括的外科手术是针刀切开术，触发手指释放，异物去除,质量去除,以及在有或没有经皮钉扎的情况下手指骨折的复位。所有骨折,主要包括掌骨和指骨骨折，随后被夹住。通过宽清醒局部麻醉无止血带（WALANT）方法实现无菌和止血支持。主要并发症定义为感染，大出血,和神经缺陷。轻微的并发症被定义为长时间的疼痛，长时间的炎症，残留症状,1个月内症状复发。
■5名患者（3.8%）因疼痛返回办公室，炎症,或者受影响的手指僵硬，5人中有2人出现与骨关节炎或假性痛风发作相关的症状。另外五名患者在手术后1个月内因残留症状或主诉复发而返回。无患者发生外源性感染。
■对于较小的手部手术，没有重大并发症和较高的成功率，这表明可以通过针对选定手术的办公室设置来实现高度的安全性和有效性。正确的病人选择是关键,我们的结果表明，办公室手术室的设置可以为几种常见的手部手术提供必要的无菌和止血支持。
■对2020年12月至2021年12月在办公室环境中接受小型手部手术的患者进行了回顾性审查。本分析中包括的外科手术是针刀切开术，触发手指释放，异物去除,质量去除,以及在有或没有经皮钉扎的情况下手指骨折的复位。所有骨折,主要包括掌骨和指骨骨折，随后被夹住。通过宽清醒局部麻醉无止血带（WALANT）方法实现无菌和止血支持。主要并发症定义为感染，大出血,和神经缺陷。轻微的并发症被定义为长时间的疼痛，长时间的炎症，残留症状,1个月内症状复发。
■5名患者（3.8%）因疼痛返回办公室，炎症,或者受影响的手指僵硬，5人中有2人出现与骨关节炎或假性痛风发作相关的症状。另外五名患者在手术后1个月内因残留症状或主诉复发而返回。无患者发生外源性感染。
■对于较小的手部手术，没有重大并发症和较高的成功率，这表明可以通过针对选定手术的办公室设置来实现高度的安全性和有效性。正确的病人选择是关键,我们的结果表明，办公室手术室的设置可以为几种常见的手部手术提供必要的无菌和止血支持。
