Abstract
Objectives Flap surgery using a wide awake local anesthesia no tourniquet (WALANT) technique
has historically been avoided because of technical challenges and concerns regarding
the vasoconstriction caused by the necessary injection of epinephrine alongside the
local anesthetic. The objective of our work was to evaluate the viability of the hand
flaps performed using a WALANT technique compared with those performed under regional
with a tourniquet.
Materials and Methods Seventy-four patients were enrolled in a prospective comparative single-center study
and subsequently divided into two groups: 36 patients in the locoregional anesthesia
group and 38 patients in the WALANT group. Flap viability was evaluated on day 2 and
day 10 using predetermined criteria.
Results We did not find any significant difference in outcomes assessed for flap viability
between the two groups postoperatively.
Conclusion There was no evidence to suggest that vascularization of the flaps was compromised
by the injection of epinephrine. The WALANT technique may, therefore, potentially
be able to be safely deployed within this population.
Keywords
anesthesia - flaps - viability
