Page 13 - PlasticosVol4

V O L 4 2019 I S S U E

PHYSICAL CONDITIONING The Problem •

The most common locations of the symptoms
PHYSICAL CONDITIONING FOR PLASTIC SURGEONS : AN INDISPENSABLE were the neck, shoulders, and lower back.
SOLUTION FOR A STRESS FREE CAREER ! Symptoms most often manifested late
(several hours) after surgery, but 13.6 percent
of respondents with symptoms had chronic,
me to dread my future in this profession.
persistent symptoms. The most common
factors implicated in their symptoms were
Treating the patients day in and day out, we long surgery duration, retraction of tissues,
forget to look after ourselves. Our body ages and prolonged neck flexion.
much faster with our hectic surgical practice,
and we tend to realise this only when it is too The Solution
late!
These problems stem from the fact that there
How many of us know fellow plastic surgeons is a paucity of ergonomic guidelines. Plastic Figure 1. Ergonomic Principles
suffering from surgery-related musculoskeletal surgeons are not trained in ergonomics during
pain or injury? I am sure we all do. These are their residency. Surgeons also lack awareness
a serious, albeit largely unspoken, daily reality with regards to physical conditioning. Use of surgical loupes and headlamps can
that we face in our specialty. cause significant cervical spinal issues in
Fitness transcends beyond healthy living and the long run and this can be mitigated by

Musculoskeletal disorders associated with having good looking bodies to have more using an over-the-spectacles loupes and by
performing surgery are staggeringly common, efficient surgical practice with less risk of taking periodical breaks during the surgery
with estimated rates ranging from 66% to 94% injuries. to relax the neck.
for open general surgeries. • Shoulders: Shoulders should be dropped
Ergonomic principles and hands relaxed. Intraoperative

I was shocked when I read a research that (Figure 1) stretching with arm raises is recommended.
showed that plastic surgeons have the highest Ambidexterity is always preferred especially
risk of musculoskeletal symptoms of any The most common ergonomic errors in liposuctions to avoid fatigue of unilateral
Dr Hardik Ganatra surgical specialty. Literature also showed that implicated are static/fixed postures, leaning shoulder joint.
neck pain is more often seen in plastic surgeons forward or to the side, forward head position,
Specialist Plastic Surgeon than in general population, computer users shoulder abduction, and neck flexion. • Elbows: Angle between forearm and upper
Cocoona center for aesthetic and even forestry workers exposed to heavy arm should be 90 degrees. To avoid excessive
transformation weights and vibratory tools. These problems can be prevented by following elbow flexion/extension, forearm should be
Dubai, UAE ergonomic principles governing each surgical held in horizontal position, parallel to the
Each subspecialty brings a unique set of area. Each joint should be carefully positioned floor. To avoid excessive torque, forearm
ergonomic risks to the surgeon. Surgeons felt during a surgical procedure to avoid fatigue should be held in neutral position between
I am a plastic surgeon by profession and a that the procedures most likely to trigger or and strain. supination and pronation.
fitness enthusiast by passion. exacerbate their symptoms were microsurgery, • Neck: Prolonged neck flexion could be • Wrist: Wrist should be held in slight
augmentation mammaplasty, and suction limited by adjusting the table height. This
I have spent 18 long years, so far, in the gym, lipectomy. is extremely important in long standing extension with fingers bent slightly.
Place the wrist on a firm surface during
training different forms of exercise : Weight surgeries done in sitting position like microsurgeries to avoid frequent wrist
training, Calisthenics, yoga and many more. Sadly enough, although surgeons recognize Micro surgeries and Hair transplant. Also, excursions and joint fatigue.
these risks and the resulting pain and surgeries that require suturing in multiple
As I grew into a doctor and subsequently a discomfort they experience from operating, layers (consuming a lot of time) should • Fingers: Ambidexterity is preferred to avoid
plastic surgeon, my profession started taking they rarely report injuries to their institutions. be preferably done with the table height constant pressure of instruments and
a toll on my body. Long hours of surgery, The unfortunate result is a culture of silent adjusted according to the surgeons’ height resulting fatigue and callosities in surgeries
retractions using heavy instruments and suffering that reinforces the status quo. and comfort. that involve prolonged and extensive
abnormal postures for prolonged periods led suturing and in liposuctions.

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