RESUMO
BACKGROUND: Additional studies on clinical outcomes to determine the optimal time delay from injection of local anesthesia to skin incision for WALANT surgeries are needed. The authors aimed to propose the optimal time delay from local injection to skin incision for WALANT surgeries of the hand and wrist by analyzing intraoperative blood loss, postoperative pain scores, and complication rates. METHODS: Thirty-four patients were consecutively recruited and allocated by either 7-min or 30-min delay for skin incision from local injection of epinephrine with lidocaine. Intraoperative bleeding and postoperative pain scores were analyzed between both groups by Mann-Whitney U-test, while complication rates were compared using Fisher's exact test. RESULTS: The present study did not find significant differences in mean intraoperative blood loss (8 ± 5.8 mL vs. 5 ± 2.2 mL, p=0.074), complication rates (18% vs. 0%, p=0.227), and mean pain scores (1.2 ± 0.5 vs. 1.4 ± 0.5, p=0.307) between the 7-min and 30-min groups. CONCLUSION: The authors conclude that a waiting time of 7 min from the injection of local anesthesia is sufficient to achieve comparable clinical outcomes for minor hand and wrist surgeries under WALANT.
RESUMO
OBJECTIVES: To determine the incidence of MRSA among admitted hand patients at UP-PGH from 2005 to 2010 and determine the antibiotic susceptibility pattern. METHODS: Records of admitted hand patients of all ages were identified and wound culture results were reviewed. A total of 482 wound cultures from the S-year period were examined. RESULTS AND CONCLUSION: From an initial decreasing trend, there was a sharp increase in incidence of MRSA hand infections from 2008 (11.8%) to 2009 (22.5%).Vancomycin had the highest number of susceptible cases from 2005 to 2008, but dropped quite sharply to the least number of susceptible cases in 2010. Chloramphenicol and erythromycin had the highest number of susceptible MRSA hand cases in recent years.