Wide-Awake Local Anesthesia, No Tourniquet Surgery in the Philippines.

The use of wide-awake local anesthesia, no tourniquet (WALANT) has been adapted by most hand surgeons in the Philippines. This is especially true for centers with a large volume of patients needing specialized care for the hand. The use of WALANT has enabled surgeons to do procedures on an outpatient basis, thus potentially creating cost-saving measures for patients and health care facilities. Aside from common outpatient procedures like carpal tunnel syndrome, trigger finger, and de Quervain tenosynovitis, open reduction internal fixation of hand fractures, acute tendon repairs, tendon transfers, and reconstructions have been performed under WALANT as outpatient procedures. The future of WALANT surgery in the Philippines is promising. Teaching WALANT to other areas of the country can counterbalance the large disproportion of hand surgeons to patients and the concentration of specialized care in urban areas. This will enable patients to receive surgical hand care without going to large urban centers.