Digit Replantation under Wide-Awake Local Anesthesia

Extending applications of WALANT for free flap harvest and transfer to repair the finger defects

The use of wide-awake local anaesthesia no tourniquet (WALANT) in free flap surgery has been limited and discouraged because of the concern that the adrenaline will cause vasoconstriction. We report our positive experience in free flap harvesting and transfer.Level of evidence: IV.

Ten Questions About Wide Awake Local Anaesthesia No Tourniquet (WALANT) Surgery

The aim of this review article is to provide many important tips and tricks for surgeons to start Wide Awake Local Anaesthesia No Tourniquet (WALANT) hand surgery in their practice. The massive cost reduction of this disruptive new approach will enable them to increase access to hand surgery for their patients who cannot afford unnecessary sedation or unnecessary sterility of the expensive main operating room environment. Evidence-based sterility will permit surgeons to move a lot of their surgery out of the main operating room to minor procedure rooms without a significant increase in infection rates. Important pointers on how to inject minimally painful local anaesthesia will have patients thinking the surgeon injector is a bit of a magician. WALANT enables surgeons to improve the outcomes of many hand surgery procedures. Level of Evidence: Level V (Therapeutic).