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• W4319032905 abstract "Most surgical instruments do not express handedness, but some important ones do (eg, needle drivers). During training and clinical practice, right-handed instruments are often the only ones available, which forces left-handed surgeons to train with and use instruments that do not match their dominant handedness (handed-unmatched).1Anderson M. Carballo E. Hughes D. Behrer C. Reddy R.M. Challenges training left-handed surgeons.Am J Surg. 2017; 214: 554-557Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar,2Lee J.Y. Mucksavage P. McDougall E.M. Surgical skills acquisition among left-handed trainees- true inferiority or unfair assessment: a preliminary study.J Surg Educ. 2012; 70: 237-242Crossref PubMed Scopus (14) Google Scholar Because left-handed instruments are rarely provided in training, most left-handed physicians have had little to no exposure to handed-matched needle drivers and have limited knowledge of their value and application. We hypothesized that using handed-matched needle drivers improves ease of use, precision, and efficiency. We performed a pilot study evaluating the efficiency of dermatology residents and attending physicians using handed-matched versus handed-unmatched needle drivers. Each participant completed 3 suturing tasks (running superficial sutures, simple interrupted superficial sutures, and buried interrupted sutures) on fresh pigs’ feet with their dominant hand using both a left- and right-handed needle driver. A standardized 5-cm ellipse was used for deep sutures (4 sutures placed 1-cm apart). A 5-cm linear defect was used for simple interrupted and running superficial sutures (9 sutures placed 0.5-cm apart). An assistant used scissors to cut sutures and stopwatch to time the participants. Nonparametric statistical analyses were performed using Wilcoxon Signed Rank and Friedman analysis of variance tests. A total of 18 participants were enrolled in the study (7 left-handed and 11 right-handed). No statistically significant differences were noted between demographics of the left-handed and right-handed groups. All participants were trained using right-handed needle drivers, and only 2 left-handed participants had used left-handed needle drivers before. All participants (left-handed, right-handed, and all participant groups) were more efficient at completing each of the 3 tasks when using handed-matched needle drivers compared with using handed-unmatched; this was statistically significant using Wilcoxon’s signed rank (Table I). Both left-handed and right-handed groups were significantly more efficient when using handed-matched needle drivers. The analysis of variance test showed that there is a significant difference in time when using handed-matched versus handed-unmatched instruments for all 3 tasks among all participants. In addition, the improvement difference between right-handed and left-handed groups did not have a significant difference, thus meaning the improvement is because of the variable (handedness of the needle driver) rather than sampling or experimental error.Table ITime in seconds to complete each task by group using handed-matched vs handed-unmatched needle drivers and statistical analysis with paired T-testLeft-handed participantsCorrect-handed instrument (s)Incorrect-handed instrument (s)P valueTop running (n = 7) (mean ± SD)150.57 ± 52.00193.29 ± 61.21.0156∗Wilcoxon Signed Rank.Top interrupted (n = 7) (mean ± SD)239.57 ± 59.26302.14 ± 90.10.0156∗Wilcoxon Signed Rank.Buried (n = 7) (mean ± SD)160.86 ± 50.99201.29 ± 84.29.0156∗Wilcoxon Signed Rank.Right-handed participantsCorrect-handed instrument (s)Incorrect-handed instrument (s)P valueTop running (n = 11) (mean ± SD)157.00 ± 36.86190.27 ± 27.46.0010∗Wilcoxon Signed Rank.Top interrupted (n = 11) (mean ± SD)282.18 ± 71.71348.45 ± 109.38.0010∗Wilcoxon Signed Rank.Buried (n = 11) (mean ± SD)266.73 ± 93.51312.09 ± 109.45.0010∗Wilcoxon Signed Rank.All participantsCorrect-handed instrument (s)Incorrect-handed instrument (s)P valueTop running (n = 18) (mean ± SD)154.50 ± 42.00191.44 ± 42.05<.0001∗Wilcoxon Signed Rank.Top interrupted (n = 18) (mean ± SD)265.61 ± 68.71330.44 ± 102.19<.0001∗Wilcoxon Signed Rank.Buried (n = 18) (mean ± SD)225.56 ± 94.24269.00 ± 112.45<.0001∗Wilcoxon Signed Rank.Top running: running superficial sutures.Top interrupted: simple interrupted superficial sutures.Buried: buried interrupted sutures.∗ Wilcoxon Signed Rank. Open table in a new tab Top running: running superficial sutures. Top interrupted: simple interrupted superficial sutures. Buried: buried interrupted sutures. On average, participants were 20% more efficient performing running superficial sutures, 18% more efficient at interrupted superficial sutures, and 15% more efficient at burying interrupted sutures using handed-matched needle drivers when compared with performing the respective tasks with handed-unmatched needle drivers. Using handed-matched instruments is more efficient for practicing physicians and trainees. A repair of a 5-cm defect with buried interrupted sutures and running superficial sutures, using handed-matched needle drivers, would be 17% faster compared with using handed-unmatched. Based on our study, we believe that providing handed-matched instruments to trainees and practicing physicians would be helpful to their success and efficiency in practice. Although speed and quality do not necessarily go hand in hand, we suspect that using handed-matched instruments improves quality, surgical safety, ease of use, precision, and cost-effectiveness. Future studies to evaluate these variables would be beneficial. None disclosed. This study has been possible thanks to the efforts and interest of the Yuanyi Zhang PhD and Yong-Fang Kuo, PhD, the University of Texas Medical Branch Statistician." @default.
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• W4319032905 date "2023-06-01" @default.
• W4319032905 modified "2023-09-23" @default.
• W4319032905 title "Comparison of dermatologists’ physicians’ surgical efficiency using handed-matched versus handed-unmatched needle drivers: A pilot study" @default.
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• W4319032905 doi "https://doi.org/10.1016/j.jaad.2022.12.047" @default.
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