Document Type : Preliminary preprint short reports of original research
Authors
1
Plastic Surgery Unit, Surgery Department, Faculty of Medicine, Alexandria University.
2
Department of Plastic Surgery Unit, Faculty of Medicine, Alexandria University
3
Department of Plastic and Reconstructive Surgery,Faculty of Medicine, Alexandria University.
4
Department of Anaesthesia and Surgical Intensive Care, Faculty of Medicine, Alexandria University.
5
Department of PlasticSurgery, Faculty of Medicine, Alexandria University
Abstract
Flexor tendon injuries are relatively common and occur mostly by penetrating traumaleading to significant morbidity and limited function if not properly addressed.
The incidence is higher in men and is inversely related to age. Due to the anatomy of the flexor tendons, which are located in a flexor sheath, there have unique characteristics that require good surgical technique as well as a good rehabilitation protocol to regain function
Up to a decade ago, this surgery was performed under general anesthesia, brachial plexus block, or local anesthesia with sedation, but the problem is the bloody field and poor visibility. To prevent blood loss, a tourniquet must be used to maintain a bloodless field. However, tourniquets also cause problems for patients, such as pain, discomfort, and short duration. In addition, the flexion-extension test was performed passively by the surgeon.
With the advent, a new technique, wide-awake local anesthesia no tourniquet (WALANT), has been introduced using different drugs such as lidocaine for anesthesia in combination with epinephrine for hemostasis, and the operations can proceed while the patient is awake in tendon repair surgery, so the flexion-extension test is directly performed by the patient that can actively move the tendon during surgery, before skin closure.
Keywords
)
View on SCiNiTO