Ergonomics in Dermatologic Laser Procedures.

Abstract

Due to working in static positions and use of repetitive movements over long periods of time, dermatologists are at increased risk of work-related musculoskeletal injury. Historically, studies on procedural ergonomics have focused on dermatologic surgery, however, laser procedures can also have a significant cumulative effect on physician posture. Here, we aim to highlight ergonomic challenges specific to dermatologic laser procedures and suggest areas of improvement in operating room organization, patient positioning, physician mechanics, and instrumentation. For the operating room, it is beneficial to store several devices in the same room, have central placement of electrical outlets, and to position the devices on the same side of the bed as the laser operator. When considering patient positioning, a Trendelenburg bed position can be helpful for vascular lesions on the head, and frequent repositioning of the patient can prevent uncomfortable bending of the operator and laser arm for circumferential lesions. Physicians should maintain a working position with a neutral spine and wrist position, moving the patient and bed as needed to reduce muscle tension. Lastly, laser instrumentation in the future could be improved upon with lightweight consoles and hand pieces, long multi-articulated device arms, and lightweight laser goggles with adjustable head straps. With the use of organizational, ergonomic positioning, and teamwork strategies, we can reduce the risk of musculoskeletal injury for our laser operators.