The development of one-stop wide-awake dupuytren's fasciectomy service: a retrospective review

OBJECTIVES To detail the transition to a totally one-stop wide-awake (OSWA) Dupuytren's contracture surgical service. DESIGN Retrospective review of Dupuytren's component of last 1000 OSWA cases. SETTING The UK's first totally one-stop wide-awake orthopaedic service. PARTICIPANTS 270 patients with Dupuytren's contracture out of the last 1000 OSWA cases. MAIN OUTCOME MEASURES Surgical outcomes, patient satisfaction and cost-effectiveness and efficiency. RESULTS The OSWA Dupuytren's model is safe, efficient and effective; with a low complication rate, extremely high patient satisfaction; and cost-savings to the nhs of £2500 per case treated. The service saved the NHS approximately £675,000 for the 270 cases presented. CONCLUSIONS A totally one-stop wide-awake Dupuytren's Contracture service is practicable and feasible alternative to the conventional treatment pathway, with benefits in terms of efficiency and cost-effectiveness.