Surgery
the patient showing active movement intra- operatively and post-operatively.
Perioperative pathway l Simplified, with reduced need for pre-operative assessment, intra-operative anaesthetic professionals or post-anaesthetic recovery.
l Reduction in elective surgery in traditional operating theatre (room) with the majority being undertaken in a day (ambulatory) surgery setting.
l Field sterility only may be appropriate. l Presents an opportunity to perform the surgery in an outpatient, minor treatment, healthcare centre (office) setting.
Cost Reduction l No tourniquet reduces equipping and consumable costs.
l Reduced costs in anaesthetics (general or regional).
l Reduced staffing requirements (e.g. anaesthetist).
l Increases operating theatre (room) efficiency.
l No post-operative recovery.
Time to sit up Although operating on a patient partially or fully sat up is not a new concept, for example to avoid acute respiratory compromise where required, the vast majority of hand surgery has been undertaken to date with the patient laid down. In 2022, Prof. Matthew Gardiner, Consultant Hand and Plastic surgeon of Frimley Health NHS Foundation Trust, developed a technique for performing WALANT hand surgery with a distinct difference – the patient would always be fully sat up. This not only caters for patients with
respiratory concerns, it vastly reduces the vulnerability a patient may feel, enables greater communication with the surgeon pre, intra and post-operatively and helps to further reduce patient anxiety. It also allows patients to watch their surgery should they wish to, offering them a greater level of engagement in their treatment. Post-operatively, a patient would need time once sat up from being laid flat, to avoid orthostatic (postural) hypotension and the potential for dizziness or fainting, especially in elderly patients. Where Prof. Gardiner’s patient’s seen are all walk-in, walk-out, it seemed unnecessary for this potential post- operative issue that may result in additional treatment being required, delay their discharge and delay subsequent procedures.
Looking for an alternative to chlorine tablets in your Trust?
Fuse is your answer. 7 MIN 5
SPORICIDAL IN
5 MINS
EFFECTIVE AGAINST BIOFILMS
5L PASSED
COMPLIANT TO
EN 17846
QUICK AND
MIN 5 MIN 5 UNIFORM AND SHORT EASY-TO-USE CONTACT TIME TM
Current procedures being undertaken utilising this approach are: l Carpal tunnel release. l Cubital tunnel release. l Trigger finger. l Trapeziectomy. l Surgery for Dupuytren’s disease. l Removal of skin lesions and soft tissue tumours.
l Scar revision.
The patient feedback Prof. Gardiner has received to date has been overwhelmingly in favour. This adaption to the WALANT technique further expands the scope of healthcare facility where hand surgery could be undertaken, lending itself well to an outpatient, minor treatment, healthcare centre (office) setting, which may offer treatment at a location
more convenient to a patient, within their community, where compared to a main hospital, day (ambulatory) surgery centre or private healthcare provider where more distant travel may be required.
The future Where healthcare resources are under pressure, hand surgery is often out-competed for operating theatre (room) and anaesthetic resources. This has played a part in driving elements of hand surgery out of the traditional setting and to seek out innovative ways of working to deliver treatment to their patients efficiently.4
Although hand surgery is classified
in many instances as being high volume, low complexity, it forms part of the NHS Recovery Plan and is included in the GIRFT surgical specialty pathways, the UK Government and the NHS are
Scan to request your free evaluation
Copyright © Tristel Solutions Limited - Mkt-Adv-3279 - 09/SEP/2025 - V1
October 2025 I
www.clinicalservicesjournal.com 45
t
E
4
N
1
8
6
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68
