The future of wearable ergonomic devices in plastic surgery: A systematic review

Background: Throughout the last decade, surgeons across specialties are increasingly using wearable support devices to minimize occupational discomfort during procedures. However, there is still a paucity of their use in plastic surgery. This review evaluates the types of ergonomic devices used across surgical specialties and their impact on pain reduction. Methods: A systematic search was conducted on October 23, 2024, using Embase, PubMed, Scopus, Web of Science, and Cumulative Index to Nursing and Allied Health Literature. Inclusion criteria required the utilization of a wearable ergonomic device by surgeons in peer-reviewed, original research. Two investigators independently conducted the screening, extraction, and synthesis of results. Results: Of the 954 reports identified, 11 articles were selected for analysis. The average study sample size was 13, with a range from 3 to 25 surgeons. The average time reported was 108 min, with a range from 10 to 383.5 min. The physical supporting devices included 6 upper extremity/body exoskeletons, 2 posture sensing and/or training devices, 1 lower extremity/body exoskeleton, 1 neck exoskeleton, one trunk exoskeleton, 1 exoskeleton-based radiation protection apron, and 1 external surgeon support system. These studies took place mainly in general surgery, with only one study in plastic surgery. All studies reported a positive surgeon experience using their respective device. Conclusion: This review reveals that nearly half of the identified devices were upper body/upper extremity supporting devices, mainly used in general surgery with favorable experiences among the surgeons. This underscores the possibility of expanding the utilization of these devices further into plastic surgery and highlights the need for more research into plastic surgeons’ experiences using these ergonomic tools in the operating room.