Wide-awake Local Anesthesia and no Tourniquet (WALANT) in Plastic Surgery

Study Overview
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Brief Summary
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Wide-awake local anesthesia no tourniquet (WALANT) was proposed and performed in hand operations. Aim of this study is to present the use of WALANT in operations performed on the upper and lower limbs, evaluate its efficacy in terms of feasibility, total operation time, total operating room time, bleeding, patient discomfort and satisfaction and control for potential drawbacks. The hypothesis is that WALANT is a viable option in common operations performed by plastic surgeons on the upper and lower limbs.

Detailed Description
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Wide-awake local anesthesia no tourniquet (WALANT) was proposed and performed in hand operations. Little has been studied, regarding its indications and efficacy in general plastic surgery operations. Aim of this study is to present the use of WALANT in operations performed on the upper and lower limbs, evaluate its efficacy in terms of feasibility, total operation time, total operating room time, bleeding, patient discomfort and satisfaction and control for potential drawbacks. The hypothesis is that WALANT is a viable option in common operations performed by plastic surgeons on the upper and lower limbs. A prospective study will be conducted comparing the use of WALANT in operations performed on the upper and lower limbs to the traditional use of tourniquet with general or regional anesthesia.

Official Title
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Wide-awake Local Anesthesia and no Tourniquet (WALANT) in Plastic Surgery: Indications, Clinical Applications and Outcomes

Conditions
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Upper Limb Wound, Lower Limb Wound, Anesthesia, Local

Intervention / Treatment
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* Procedure: WALANT


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: upper or lower limb operation indication for flap or skin grafting operated by the principal investigator Exclusion Criteria: other concomitant operations performed known allergy to any of the ingredients of local anesthesia mixture

Ages Eligible for Study
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Minimum Age: 14 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| WALANT group<br>WALANT was used exclusively as anesthesia method for the operation | Procedure: WALANT<br>* WALANT as anesthesia method for upper and lower limb palstic surgery operations<br>|
| control<br>tourniquet with regional or general anesthesia was used for the operation | Procedure: WALANT<br>* WALANT as anesthesia method for upper and lower limb palstic surgery operations<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| total operation time | the difference between skin incision and skin closure in minutes | through operation completion | 
| operation theatre time | the difference between entry and exit of the patient from the operation theatre in minutes | through operation completion with exit from the operation theatre | 
| Patient satisfaction | estimated by a 10-point visual analogue scale (1-10, 10 is the best outcome) | at 8 weeks | 
| feasibility of the WALANT method | percentage of cases, which could not be completed under WALANT with conversion to the traditional method of anesthesia | through operation completion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| complications | number and type of complications in each group | at 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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upper limb, WALANT, plastic surgery, lower limb