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Pain-Guided Healing

By Donald H. Lalonde, MD I am much better at patient education during WALANT carpal tunnel release than I used to be. Patients love the intraoperative advice from their surgeon. Post-op complications or complaints decrease. I tell them that if they follow the rules, they will be doing most things by 2 weeks except for […]

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Ready to Return to the “Old Normal”

By Warren C. Hammert, MD Today is Sunday, April 12.  It is remarkable how life has changed over the last month.  At the University of Rochester, in Rochester, NY, we are now 4 weeks into the “shutdown.” We are only performing urgent and emergent surgery and seeing “needed” patients in the office. Trauma has been slower […]

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Thoughts on WALANT

By Charles A. Pailthorpe, FRCS, Ed Sterling Bunnell, the father of American hand surgery, insisted on the use of a proper tourniquet as expressed in his saying, “You can’t fix a watch in a bottle of ink.” What would Bunnell think of WALANT (wide awake local anaesthesia and no tourniquet)? [Lalonde DH. Reconstruction of the […]

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WALANT and Conservation

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 […]

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A Ripe Field for Innovation

By Nathan Douglass, MD One area where hand surgery has excelled recently where other fields have not is in the area of in-office or wide-awake procedures. There has been increasing interest and popularity in performing wide-awake-local-anesthesia-no-tourniquet (WALANT) cases in the literature and in hand surgery forums (e.g. the ASSH listserv, hand society meetings, etc.). There […]

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My Many Pearls

By Kathleen A. Robertson, MD PEARLS: 1) THANK GOD each day for your talent and your ability to help people. Keep “helping others” at the forefront of your mission as a surgeon and person and your capabilities will be boundless. 2) THINK CHANGE Never be afraid to change the way you do something! *Open carpal tunnels […]

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