Withington Community Hospital
Since 2020, Withington Community Hospital has been our hub for hand trauma surgery.
With all surgery at Withington undertaken under local anaesthetic, we have become one of the largest services in the country for local anaesthetic hand trauma surgery (WALANT), with over 2500 patients treated since the start of the pandemic.
What is WALANT surgery?
WALANT stands for Wide Awake, Local Anaesthetic, No Tourniquet, and is a modern way of undertaking hand surgery. It is quite different from the traditional approach, which involved patients being asleep under a general anaesthetic, and controlling blood loss with an arm tourniquet.
Why do we do WALANT surgery?
WALANT surgery was popularised in the early 2000s by a Canadian surgeon called Dr Lalonde. We started the practice at Wythenshawe in around 2009, with Mr Stuart Wilson being one of the early adopters of the technique, followed by Mr Jason Wong and Mr James Bedford.
Years later, the COVID-19 pandemic meant that, for a time, it was felt to be unsafe for patients to have general anaesthetics except for life threatening conditions. We made the choice to take the majority of our hand injury surgery to Withington, and expanded the use of the WALANT technique to most patients with hand injuries.
Our WALANT service has been very successful, with excellent times to treatment and very good feedback from our patients about their experience. Our service is featured as a case study in the British Society for Surgery of the Hand's guidance on operating outside of main theatres, and our work on developing the WALANT service has been widely presented and published:
- Development of the Manchester wide-awake hand trauma service in 2020: the patient experience
- Reorganisation to a local anaesthetic trauma service improves time to treatment during the COVID-19 pandemic - experience from a UK tertiary plastic surgery centre
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