Participants were found to 20% more efficient performing running superficial sutures, 18% more efficient at interrupted superficial sutures, and 15% more efficient with buried interrupted sutures when using handed-matched instruments.
Clinical Pearls
This pilot study sought to determine if the efficiency of dermatologic surgeons varied when using instruments that were matched with one’s dominant hand
18 dermatology resident physicians and attending physicians were studied performing 3 suturing tasks. All participants were more efficient at all 3 tasks when using handed-matched instruments
Participants were found to be 20% more efficient performing running superficial sutures, 18% more efficient at interrupted superficial sutures, and 15% more efficient with buried interrupted sutures when using handed-matched instruments
Discussion:
This pilot study published in the Journal of the American Academy of Dermatology evaluated the efficiency of dermatology resident physicians and attending dermatologists when using handed-matched needle drivers versus handed-unmatched needle drivers. When training in dermatologic surgery and in clinical practice, left-handed instruments are often not available. This forces naturally left-handed physicians to train with and use instruments that do not match their dominant hand.
In this study 18 dermatology resident physicians and attending physicians, 7 of whom were left-handed and 11 right-handed, completed 3 suturing tasks. These included running superficial sutures, simple interrupted sutures, and buried interrupted sutures on fresh pig’s feet. Each participant performed these tasks with their dominant hand twice, once with a left-handed needle driver and again with a right-handed needle driver. Of note, all participants were trained using right-handed needle drivers and only 2 left-handed participants had ever used left-handed needle drivers in the past. The efficiency of each participant’s suturing was determined via time to completion with a stopwatch.
All 18 participants were found to be more efficient in completing all 3 tasks when using handed-matched needle drivers when compared to using handed-unmatched drivers. This difference was found to be statistically significant. Additionally, the improvement difference between right-handed and left-handed groups was not significant, indicating the improvement in efficiency was due to the variable tested rather than due to experimental or sampling error. Participants were found to 20% more efficient performing running superficial sutures, 18% more efficient at interrupted superficial sutures, and 15% more efficient with buried interrupted sutures when using handed-matched instruments. In summary, this study sheds light on an often-disregarded topic in dermatologic surgery and medical education. Future studies to better investigate the effect of handed-ness and using the correct instruments will provide better data to hopefully incorporate change in dermatologic training and clinical practice.
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