By Rey N. Ramirez, MD

It is impossible to miss the amount of trash generated in the hospital. Single-use, individually wrapped items are ubiquitous. I find it most noticeable at the end of a carpal tunnel release. Even this simple procedure typically generates a full bag of trash.

I believe that one way to practice conservation in hand surgery is by utilizing WALANT (wide awake local anesthesia no tourniquet) techniques. In addition to its numerous other benefits, this technique eliminates all of the disposables needed for MAC or general anesthesia as well as the tourniquet. The simpler workup for local anesthesia (in my practice I generally get no preoperative tests) is also a “green” alternative. 

Rey Ramirez
Cooper Hospital
Camden, NJ