At the American Society of Plastic Surgeons Plastic Surgery 2007 conference in Baltimore, physicians reported that patients are released sooner from care and recover better if they are given local anesthesia and kept awake during hand surgery.

"Patients with fractures, carpal tunnel syndrome, and other common hand problems can have reconstructive plastic surgery while they are able to move and provide real-time feedback," says Donald Lalonde, MD, ASPS member surgeon, and course presenter. "The ability to speak and move an appendage contradicts one’s mental image of surgery. However, having the patient awake and coherent provides better outcomes and they are amazed the procedure is pain free."

With the "wide-awake" approach, no tourniquet is used, so patients can perform a full range of motion with their fingers, allowing the surgeon to make any necessary adjustments on reconstructed tendons and bones before the skin is closed. This approach decreases the need for revision surgery in tendon transfers and tendon repairs.

Common hand surgeries performed with the "wide-awake approach" include trigger finger release, tendon, nerve, carpal tunnel, and fracture repair.

[www.medicalnewstoday.com, October 30, 2007]