■这项研究检查了在临床环境中的广泛清醒局部麻醉无止血带(WALANT)技术的并发症发生率,并在一次私人诊所进行现场无菌。我们假设WALANT是安全有效的,并发症发生率低。
■这项回顾性图表审查包括2015年至2022年期间在一家私人诊所接受办公室WALANT手手术的1228名患者。根据手术类型将患者分为几组:腕管松解术,A1滑轮释放装置,第一背室释放,伸肌腱修复,肿块切除,异物去除,和针状动脉切开术。记录患者的人口统计学和并发症;完成队列人口统计学和并发症危险因素的统计比较,并且P<0.05对于所有统计学比较被认为是显著的。
■所有手术的总并发症发生率为2.77%,1228例患者包括A1滑轮松解术(n=962,2.7%),肿块切除(n=137,3.7%),伸肌腱修复术(n=23,4.3%),和第一背室释放(n=22,8.3%)。腕管松解术,异物去除,针式单肠切开术组无并发症。无不良事件(如血管迷走反应,数字缺血,局部麻醉毒性,在任何组中都观察到血管收缩不足)。已知自身免疫性疾病的患者和目前正在吸烟的患者的并发症发生率在统计学上显着较高。
■基于办公室的WALANT手术对于治疗常见的手部疾病是安全有效的,并且与门诊中心或医院的标准手术室的历史对照相比,并发症情况相似。
UNASSIGNED: This study examined the complication rate of Wide Awake Local Anesthesia No Tourniquet (WALANT) technique in the clinic setting with field sterility at a single private practice. We hypothesized that WALANT is safe and effective with a low complication rate.
UNASSIGNED: This retrospective chart review included 1228 patients who underwent in-office WALANT hand procedures at a single private practice between 2015 and 2022. Patients were divided into groups based on type of procedure: carpal tunnel release, A1 pulley release, first dorsal compartment release, extensor tendon repair, mass excision, foreign body removal, and needle aponeurotomy. Patient demographics and complications were recorded; statistical comparisons of cohort demographics and risk factors for complications were completed, and P < .05 was considered significant for all statistical comparisons.
UNASSIGNED: The overall complication rate for all procedures was 2.77% for 1228 patients including A1 pulley release (n = 962, 2.7%), mass excision (n = 137, 3.7%), extensor tendon repair (n = 23, 4.3%), and first dorsal compartment release (n = 22, 8.3%). Carpal tunnel release, foreign body removal, and needle aponeurotomy groups experienced no complications. No adverse events (e.g. vasovagal reactions, digital ischemia, local anesthetic toxicity, inadequate vasoconstriction) were observed in any group. Patients with known autoimmune disorders and those who were currently smoking had a statistically significant higher complication rate.
UNASSIGNED: Office-based WALANT procedures with field sterility are safe and effective for treating common hand maladies and have a similar complication profile when compared to historical controls from the standard operating room in an ambulatory center or hospital.