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• W2510150637 abstract "Speakers Bureau: Trimed Inc.(Rhee) Wide awake local anesthesia no tourniquet (WALANT) hand surgery was developed to improve access to hand surgery care while optimizing medical resources. Hand surgery in the clinic setting may result in substantial cost savings and provide a safe alternative to performing similar procedures in the operating room. A prospective cohort study was performed on the first 100 consecutive clinic-based WALANT hand surgery procedures performed at a military medical center from January 2014 to September 2015 by a single hand surgeon. Cost savings analysis was performed by utilizing the Medical Expense & Performance Reporting System (MEPRS), the standard cost accounting system for the military healthcare system (MHS), to compare procedures performed in the clinic versus the operating room during the study period. Utilizing a study-specific questionnaire, patient satisfaction, pain, and perioperative anxiety analyses were performed. The WALANT procedures consisted of carpal tunnel release (CTR, n = 34), A1 pulley release (APR, n = 33), de Quervain release (dQR, n = 4), hardware or foreign body removal (n = 14), phalangeal fracture pin fixation (n = 9), tendon repairs (n = 3), nail horn excisions (n = 2), and extensor carpi ulnar debridement (n = 1). For CTR and APR alone, there was an 85% and 70% cost savings by having the procedures performed in clinic under WALANT compared to the main operating room (OR), respectively. During the 21-month study period, CTR, APR, and dQR performed in the clinic, instead of the OR, amounted to $393,099.53 in cost savings for the MHS. Overall, 94% (62 of 66) of patients stated that they would choose WALANT again for a subsequent procedure. For 71% (47 of 66) of patients, the perioperative pain was less than a dental procedure and the mean anxiety levels (10 being the worst amount of anxiety) before, during, and after the procedures were 2.8 ± 3.4, 2.4 ± 3.2, and 0.4 ± 1.0 respectively. There were 3 complications; however, none were attributable to the WALANT procedure. •A clinic-based WALANT hand surgery program results in considerable cost savings.•Performing clinic-based WALANT hand surgery is safe without any increase in complications attributed to the WALANT procedure.•Patients tolerate the WALANT procedures well with low peri-operative pain and anxiety.•Patient satisfaction is high for clinic-based WALANT hand surgery." @default.
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• W2510150637 date "2016-09-01" @default.
• W2510150637 modified "2023-09-27" @default.
• W2510150637 title "Cost Savings, Safety, and Patient Satisfication of a Clinic-Based Wide Awake Hand Surgery Practice: A Critical Review of the First 100 Procedures." @default.
• W2510150637 doi "https://doi.org/10.1016/j.jhsa.2016.07.006" @default.
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