{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T23:56:52Z","timestamp":1781135812556,"version":"3.54.1"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Wide Awake Local Anesthesia No Tourniquet (WALANT) ist eine etablierte Form\n                        der Lokalan\u00e4sthesie in der Handchirurgie. In seltenen F\u00e4llen kann es zu\n                        isch\u00e4mischen Komplikationen durch das in der Tumeszenz-L\u00f6sung enthaltene\n                        Adrenalin kommen. Die vasokonstriktive Wirkung des Adrenalins kann hierbei\n                        durch die lokale Injektion von Phentolamin antagonisiert werden. Zur\n                        Inzidenz und Behandlung von isch\u00e4mischen Komplikationen sowie zum\n                        Kenntnisstand zu Phentolamin ist in Deutschland bislang wenig bekannt.<\/jats:p>\n                  <jats:p>Mithilfe einer Onlineumfrage von in Deutschland handchirurgisch t\u00e4tigen\n                        Chirurgen erfolgte die Evaluation des Kenntnisstandes zur Behandlung und\n                        Inzidenz von isch\u00e4mischen Komplikationen im Rahmen der Anwendung der\n                        WALANT-Technik an der Hand. Dabei sollte u.\u2009a. die Kenntnis und\n                        Verf\u00fcgbarkeit von Phentolamin als Antidot zu dem in der Tumeszenz-L\u00f6sung\n                        enthaltenen Adrenalin erfasst werden.<\/jats:p>\n                  <jats:p>Insgesamt nahmen 124 Chirurgen an der Studie teil. Erfahrungen mit\n                        isch\u00e4mischen Komplikationen lagen bei 8,3% der Anwender der WALANT-Technik\n                        vor. Beobachtete isch\u00e4mische Komplikationen traten \u00fcberwiegend nach\n                        operativen Ringbandspaltungen aber auch bei Dupuytren-Operationen und\n                        Karpaldachspaltungen auf. In keinem der F\u00e4lle erfolgte die Anwendung des\n                        Antidots Phentolamin. 47,7% der Anwender hatten keine Kenntnis \u00fcber das\n                        Antidot Phentolamin, entsprechend war Phentolamin auch nur in 53,2% der\n                        Kliniken vorr\u00e4tig. Es bestand ein Interesse an Schulungen in Form von\n                        Fortbildungen, Fachliteratur und Workshops zur verbesserten Anwendung von\n                        Phentolamin.<\/jats:p>\n                  <jats:p>Obgleich WALANT als sicheres Verfahren anerkannt ist, k\u00f6nnen isch\u00e4mische\n                        Komplikationen in seltenen F\u00e4llen auftreten. Die Studie zeigt einen\n                        unzureichenden Kenntnisstand hinsichtlich des Antidots Phentolamin bei der\n                        Behandlung solcher Komplikationen. Anwender der WALANT-Technik m\u00fcssen mit\n                        dem Verfahren und seinen potenziellen Risiken vertraut sein, um im Notfall\n                        ad\u00e4quat reagieren zu k\u00f6nnen. Auch seltene Komplikationen k\u00f6nnen im Zweifel\n                        funktionelle Sch\u00e4den und medikolegale Konsequenzen nach sich ziehen,\n                        insbesondere wenn Phentolamin nicht verf\u00fcgbar ist. Daher empfehlen wir,\n                        stets einen Vorrat an Phentolamin bereitzuhalten und regelm\u00e4\u00dfige Schulungen\n                        durchzuf\u00fchren, um die Patientensicherheit zu gew\u00e4hrleisten.<\/jats:p>","DOI":"10.1055\/a-2852-6481","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:04:26Z","timestamp":1780095866000},"page":"202-213","source":"Crossref","is-referenced-by-count":0,"title":["Umfrage zur Anwendung von WALANT in der ambulanten Handchirurgie und\n                    zum Kenntnisstand von Handchirurgen \u00fcber Phentolamin als Antidot bei\n                    isch\u00e4mischen Komplikationen"],"prefix":"10.1055","volume":"58","author":[{"given":"Lara-Sophie","family":"Kluwe","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische, \u00c4sthetische, Hand- und\n                    Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jene","family":"Weichenthal","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische, \u00c4sthetische, Hand- und\n                    Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Barros","family":"Navarro","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische, \u00c4sthetische, Hand- und\n                    Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niks","family":"Gulbis","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische, \u00c4sthetische, Hand- und\n                    Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Maria","family":"Suhr","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische, \u00c4sthetische, Hand- und\n                    Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz Rudolf","family":"Milewski","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische, \u00c4sthetische, Hand- und\n                    Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Lorbeer","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische, \u00c4sthetische, Hand- und\n                    Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doha","family":"Obed","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische, \u00c4sthetische, Hand- und\n                    Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Vogt","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische, \u00c4sthetische, Hand- und\n                    Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anieto Onochie Matthias","family":"Enechukwu","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische, \u00c4sthetische, Hand- und\n                    Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Hannover,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1177\/229255030301100408","article-title":"How long does it take phentolamine to reverse adrenaline-induced\n                    vasoconstriction in the finger and hand? 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Phentolamine as an Antidote for Ischemic Complications"],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":27,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2026,6,10]]},"published-print":{"date-parts":[[2026,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2852-6481","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0722-1819","1439-3980"],"issn-type":[{"value":"0722-1819","type":"print"},{"value":"1439-3980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,29]]}}}