Postoperative Complications of Minor Hand Surgical Procedures Performed in a Minor Operating Room: The Impact of Surgeon Level and Operative Time

Abstract

Purpose: This study aimed to assess postoperative complications after minor hand surgical procedures performed in a minor operating room and to identify factors associated with these complications.

Methods: This retrospective cohort study conducted at a tertiary university hospital in Bangkok, Thailand, included patients who underwent minor hand surgical procedures in minor operating rooms from January 2019 to October 2024. Data collected included demographic characteristics, operative time, surgeon level, and postoperative complications. Risk factors evaluated included age >60 years, comorbidities, operative time, and surgeon level. Univariate and multivariate logistic regression analyses were conducted.

Results: A total of 1,432 patients were included (mean age, 61.8 ± 13.3 years). The most common procedures were trigger finger release, carpal tunnel release, and soft tissue mass excision. Most procedures were performed by staff surgeons (72.5%), followed by residents (24.9%) and fellows (2.6%). The median operative time was 30 min. Twenty-eight postoperative complications occured (1.96%), most commonly wound dehiscence, incomplete release, and surgical site infection; 13 cases required reoperation. Longer operative time (adjusted odds ratio, 1.025; 95% confidence interval, 1.001–1.050; p = 0.043) and surgeon level were independently associated with postoperative complications. Residents and fellows had higher odds of complications than staff surgeons, whereas diabetes mellitus and age >60 years were not significantly associated with complications.

Conclusions: Minor hand surgical procedures showed a low complication rate, supporting the safety of this setting. Although residents and fellows had higher complication rates, appropriate supervision and careful case selection remain essential components of orthopedic training.