Evaluating Clinical Outcomes for Determining the Optimal Delay to Skin Incision Under WALANT

Study Overview
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Brief Summary
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Further studies are needed to establish the effects of WALANT in performing most common hand surgeries, in relation to its clinical outcomes and intraoperative blood loss. Therefore, this study aims to identify the best interval time to perform elective hand surgeries using WALANT technique, document clinical outcomes and identify potential complications

Detailed Description
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To propose the optimal time delay from the injection to skin incision for most WALANT surgeries of the hand or wrist by analyzing not only intraoperative blood loss, but also postoperative pain scores and complication rates To determine if there is a difference between performing the WALANT technique with a waiting interval of 7 minutes as compared to 30 minutes prior to incision in relation to blood loss, pain scores, and complications. Initiate the use of WALANT technique and its application in practice of Orthopaedic Residents in East Avenue Medical Center

Official Title
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Evaluating Clinical Outcomes for Determining the Optimal Delay to Skin Incision Under WALANT: a Prospective Series of 34 Patients From a Low Resource Tertiary Setting

Conditions
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Hand Surgery, Orthopedic Surgery

Intervention / Treatment
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* Other: WALANT Technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: . Signed Consent Form Elective Hand Surgeries Minor Hand Surgeries Adult Male/Female ages 18 and above Multiply injured Exclusion Criteria: No Consent Multiply injured patient Traumatic Hand Injuries Known allergic reaction to either Epinephrine or Lidocaine. Known heart condition Patients on anticoagulants Patients diagnosed with bleeding disorders
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: 7 minutes group<br>surgeries performed with this group would wait 7 minutes after lidocaine+epinephrine injection prior to skin incision | Other: WALANT Technique<br>* A technique commonly used in hand surgeries where the combination of lidocaine and epinephrine is used for local blood control, thus performing the procedure without a tourniquet<br>|
| Active Comparator: 30 minutes group<br>surgeries performed with this group would wait 30 minutes after lidocaine+epinephrine injection prior to skin incision | Other: WALANT Technique<br>* A technique commonly used in hand surgeries where the combination of lidocaine and epinephrine is used for local blood control, thus performing the procedure without a tourniquet<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| VRS Score | Verbal Rating Scale 0 for no pain 1 for mild pain 2 for moderate pain 3 for severe pain 4 for very severe pain | 24 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blood Loss | Blood loss estimation using Gauze Visual Analogue Scale by Algadiem et.al. | 24 weeks |