Current Concepts in Perioperative Guidance and Outcomes in Hand Surgery Patients Taking Glucagon-Like Peptide-1 Receptor Agonists.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as semaglutide and tirzepatide, have rapidly increased in use for diabetes management and weight loss, coinciding with the rising prevalence of obesity and diabetes among patients undergoing hand surgery. Growing perioperative concerns of delayed gastric emptying and aspiration risk have prompted evolving guideline recommendations and clinical uncertainty surrounding surgical planning. Current evidence on GLP-1 RA usage and outcomes in hand and orthopedic literature remains limited, but multiple studies report no notable increase in postoperative complications. There may be potential benefits to GLP-1 RA in surgical outcomes, possibly related to reduced systemic medical morbidity and improved metabolic control. As there still are substantial limitations in the medical literature on the effects of GLP-1 RA, questions remain regarding optimal perioperative medication management, effects on bone and wound healing in the context of rapid weight loss, and anesthesia-related risk. Yet, as GLP-1 RA exposure becomes increasingly common, hand surgeons must understand the pharmacology, risk profile, and emerging evidence to guide individualized decision-making and ensure safe perioperative management for patients.