Inclusion Criteria:  Age 18 or older Any patient undergoing elective hand surgery  Exclusion Criteria:  Any patient with a traumatic open wound (only surgically created wounds will be included) History of chronic pain History of narcotic addiction History of recreational drug dependency History of psychiatric pathology Allergy to local anesthetics, recombinant human thrombin or tranexamic acid Any patient receiving a supra/infraclavicular block for anesthesia