New concepts in hand surgery

What is wide-awake hand surgery?

Wide awake hand surgery refers to performing surgery on the hand using local anaesthesia only without the use of a tourniquet. It is abbreviated to WALANT in the medical literature (Wide Awake Local Anaesthesia No Tourniquet).

What conditions can be treated this way?

Many specific hand conditions both traumatic and chronic such as flexor and extensor tendon repair, trigger finger and carpal tunnel release, tenolysis, Dupuytren’s disease, tendon transfer and phalangeal fractures.

What are the advantages of WALANT?

There are many advantages to using WALANT. For example, there is no need for general anaesthesia or sedation. The patient can safely go home after their surgery. The procedure is carried out like a minor surgical operation with the patient being fully awake and cooperative. This is extremely advantageous when performing surgery such as tendon transfer or tenolysis, when full active movement of the joint needs to be determined.

What are the disadvantages of WALANT?

WALANT is not suitable for everyone. The injection of local anaesthesia can be slightly uncomfortable for the first 10 to 15 seconds much like a “bee sting”. It is the same feeling as a dental injection. Additionally, some patients may not like the feeling of being awake during their procedure.

 What should I do if I need surgery on my Hand?

At 152 Harley Street, our expert team of hand surgeons will assess your suitability for the WALANT procedure and advise you accordingly. We look forward to welcoming you soon.


David Dunaway on treating Stefan Slavic – a BBC World Radio Report

David Dunaway, co-founder and director of the specialist plastic surgery unit at 152 Harley Street, has played his part in changing the life of a young Bosnian boy.

David-Dunaway-152-Harley-StreetStefan Slavic was born with a Tessier facial cleft came to attention of Mr Dunaway via the initiatives of former Staff Sergeant Wayne Ingram, a soldier who had met Stefan while on peacekeeping duties. He followed through with a promise he made to help Stefan, and with the notable help of Mr Dunaway, Stefan’s life has changed for the better.

For more information about this heart warming story please visit the Daily Mail online.