26 January 2017
Medical Illustration Source Book
Wide awake hand surgery
Wide awake hand surgery represents a breakthrough in surgery of the hand and upper extremity. It can be performed with no preoperative testing, no intravenous insertion, and no monitoring. Like a dental procedure, the patient simply gets up and goes home after the procedure.
Wide awake hand surgery means no sedation, no tourniquet, and no general anesthesia for hand surgery. The only medications given to the patient are lidocaine with epinephrine. Lidocaine is for anesthesia, and epinephrine provides hemostasis, which deletes the need for a tourniquet. The advantages are:
The ability of the comfortable unsedated tourniquet-free patient to perform active movement of the reconstructed structures during surgery so the surgeon can make alterations to the reconstruction before the skin is closed to improve the outcome of many surgeries;
The deletion of all risks, costs, and inconveniences of sedation and general anesthesia.
With this, patients can voluntarily move their fingers intra-operatively, thereby enabling this surgeon to make fine adjustments to repaired tendon, joints and bones before closing the skin.
Some painful hand problematic cases may originate from the neck and other upper extremities.
If the patient is suffering from diabetics, this kind of surgery is not that very effective. So take precautions for clients that have any of this disease.
By Dr Ruban Sivanoli, Consultant Orthopaedic, Hand & Microsurgeon (Daily Express, Your local Voice)