Infections and Patient Satisfaction for WALANT Hand Surgery in Hospital Procedure Room

Author

Michaela Derby, University of South Dakota Sanford School of Medicine
Kelly N. McKnight, University of North Dakota School of Medicine
Robert E. Van Demark Jr., University of South Dakota Sanford School of Medicine & Sanford Health

Files

Date of Presentation

5-8-2025

Document Type

Article

Department

Medicine

Faculty Mentor

Dr. Kelly McNight, Dr. Robert Van Demark Jr.

Keywords

WALANT, Wide Awake Surgery, infection, patient satisfaction, rural health

Subject Categories

Medicine and Health Sciences | Surgery

Abstract

Background: Wide awake hand surgery has allowed many hand procedures to be moved out of the operating room and into minor procedure rooms while increasing efficiency, maintaining safety, and reducing both patient and hospital costs. The goal of this study was to evaluate patient satisfaction and postoperative complications of wide-awake local anesthesia with no tourniquet procedures performed in a community-based hospital procedure room.

Methods: A total of 786 patients underwent 948 elective hand procedures in a hospital procedure room. At the conclusion of their surgeries, the patients were surveyed regarding their satisfaction. Following surgery, patients were evaluated for postoperative complications including infections. The trend in postoperative infection rates across eight age groups was analyzed using a Cochran-Armitage test in R.

Results: The overall infection rate was 6.2% (n=59). All infections were superficial. Carpal tunnel had the highest number of infections (n=25), followed by trigger finger (n=8), and the combination trigger finger with carpal tunnel (n=7). All infections were managed with antibiotics and/or soaks. Three patients did require a return to the operating room for irrigation and debridement. Ninety-nine percent of patients said the procedure room experience was better or the same as going to the dentist, would recommend wide-awake anesthesia to a friend or family member, and would undergo the procedure again.

Conclusion: Wide awake procedures performed in a hospital procedure room have low infection rates with high patient satisfaction.

Recommended Citation

Derby, Michaela; McKnight, Kelly N.; and Van Demark Jr., Robert E., "Infections and Patient Satisfaction for WALANT Hand Surgery in Hospital Procedure Room" (2025). Scholarship Pathways Program. 2.
https://red.library.usd.edu/spp/2