Physicians at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2007 conference in Baltimore say patients do better if kept awake during hand surgery:

The innovative technique, in which plastic surgeons can make adjustments during surgery, may reduce the need for revisions, complications with general anesthesia, expense, and recovery time. “Patients with fractures, carpal tunnel syndrome and other common hand problems can have reconstructive plastic surgery while they are able to move and provide real-time feedback,” said Donald Lalonde, MD, ASPS Member Surgeon and course presenter. “The ability to speak and move an appendage contradicts one’s mental image of surgery. However, having the patient awake and coherent provides better outcomes and they are amazed the procedure is pain free.”

With this technique, no tourniquet is used, so patients can perform a full range of motion with their fingers, allowing the surgeon to make any necessary adjustments on reconstructed tendons and bones before the skin is closed. The wide-awake approach has the potential to decrease the need for revision surgery in tendon transfers and tendon repairs.