Abstract: Work-Related Musculoskeletal Disorders Among Plastic Surgeons: A Systematic Review

Abstract

INTRODUCTION: Work-related musculoskeletal disorders (WMSDs) are a group of disabling yet preventable disorders united by well-defined ergonomic risk factors. Plastic surgeons bear many of these risk factors. To date, no review has been conducted on the growing body of literature describing various WMSDs, ergonomic hazards, and potential interventions relevant to plastic surgeons. This systematic review aimed to (1) define the scope of coverage of this important issue in the peer-reviewed literature; (2) critically assess the evidence; and (3) provide recommendations for future directions. METHODS: We conducted a literature search of Medline, Embase, Web of Science, and PubMed from the inception of each database until 2016. All articles reporting on WMSDs or ergonomics among plastic surgeons were reviewed, summarized, and assessed for trends. RESULTS: The search returned 180 unique papers. Sixteen articles met our inclusion criteria including 5 editorials, 4 cross-sectional studies and case reports/series, 1 review, and 6 intervention articles. Four papers presented evidence on disease burden. The most commonly described WMSD was cervical spine disease, for which 1 study reported a prevalence of 24.7% (prevalence in the general population: 0.1–0.4%); 3 studies reported 64 cases resulting in surgical intervention, decreased productivity, or involuntary early retirement; and 8 studies described interventions, most of which were aimed at redesigning the operating microscope. CONCLUSION: The plastic surgeon’s plight with cervical spine disease has long been substantiated by anecdotal evidence and sparse data with little context. This review found some evidence of plastic surgeons’ vulnerability to a WMSD at times severe enough to end careers. However, all studies in this review represented low levels of evidence. Further investigation is needed to clearly define this important problem in plastic surgery. Specifically, future directions should include more methodologically rigorous epidemiologic studies evaluating disease burden.