Mike Bell's research while affiliated with Ottawa University and other places

Publications (4)

Article
Full-text available
Over 70% of Canadian carpal tunnel syndrome (CTS) operations are performed outside of the main operating room (OR) with field sterility and surgeon-administered pure local anesthesia [LeBlanc et al., Hand 2(4):173-8, 14]. Is main OR sterility necessary to avoid infection for this operation? This study evaluates the infection rate in carpal tunnel r...
Conference Paper
Purpose: More than 70% of Canadian carpal tunnel operations are now performed outside of the main operating room with field sterility (1). Main OR sterility comes with a fourfold cost in money, and generates considerably more garbage (see figure 1). Is main OR sterility really necessary to avoid infection? This study evaluates the infection rate in...
Article
The Wide-Awake Approach to Dupuytren's contracture involves fasciectomy under local anesthetic with epinephrine and no tourniquet. The goal of this study is to show that the Wide-Awake Approach produces equivalent outcomes to fasciectomy under general anesthetic with a tourniquet, with fewer risks to the patient. A multicenter retrospective review...

Citations

... With this trend, it is important to consider how the procedure room differs from the traditional operating room. First, the use of field sterility instead of main-operating-room sterility has allowed for considerable cost and waste reductions, without impacting upon the likelihood of surgical site infections ( Figure 1) [29][30][31]. Instead of needing the full standard set-up for main-operating-room sterility (which includes head covers, neck-to-knee sterile surgeon gowns, shoe covers, laminar airflow, and full-patient-body sterile draping), CTR can safely be performed in a clinic's procedure room with nothing more than a mask, sterile gloves, and single drape. Importantly, where CTR is performed in such settings, the absence of costly, specialized ventilation systems such as laminar air filtration or high-efficiency particulate air filters has not been linked to worse outcomes. ...
... [6][7][8] Avoiding general anesthesia and sedation has many benefits, including no need for certain preoperative investigations, easier immediate postoperative patient recovery with no nausea or vomiting, a shorter hospital stay, and safe management of patients with multiple medical comorbidities such as morbid obesity and diabetes. 9 The WALANT technique has been shown to be highly effective in carpal tunnel release, 10,11 tendon repair, 12,13 Dupuytren's disease, 14 trapeziectomy, 9 tendon transfer, 15 and finger fractures. 16 Anesthesia for distal radius fractures traditionally includes a tourniquet and general or regional anesthesia with intravenous sedation. ...
... Wide awake local anesthetic no tourniquet DD surgery is equivalent to general anesthesia or block anesthesia with a tourniquet. 34,43 Although current general or regional block anesthesia as currently practiced is exceedingly safe, an extensive review of over 153,376 DD operations showed significant risks for LF and DF surgeries using these techniques versus strictly local anesthesia PNF. 36 Serious systemic complications at 90 days after LF and DF included myocardial infarction (0.88%), acute kidney injury (0.09%), and lower respiratory tract infection (0.22%). ...