DS28 Left-handedness in dermatological surgery

Abstract Overall, 90% of the world’s population are right-hand dominant (RHD) and as such most environments are designed with right-handed individuals in mind. This extends to operating theatres, where left-hand dominant (LHD) surgeons face documented challenges when training in right-handed environments. These challenges include limited access to left-handed instruments and a lack of LHD mentors. When using right-handed instruments, LHD surgeons must reverse their natural motion or learn to operate with their right hand – both of which are unnatural and fatiguing. This study aims to explore the experiences, challenges and adaptations of left-handed dermatologists, trainees, and general practitioners with extended roles (GPwERs) in Ireland and the UK when performing dermatological surgery. An online questionnaire was distributed to dermatologists, trainees, GPwERs and specialist nurses through Irish and UK dermatology professional organizations. In total 105 respondents participated (50 consultants, 35 trainees, four GPwERs and 16 nurses). Of these, 47 (44.8%) were LHD and 58 (55.2%) were RHD. Five of 15 (33%) Mohs surgeons were LHD. Among 47 LHD respondents, 13 reported operating equally with both hands, 31 with primarily the left hand, and three with primarily the right hand. Only 6% (n = 3) of LHD respondents have access to left-handed instruments, although only 10 respondents had requested them: two successfully and eight unsuccessfully. Eighteen LHD respondents had tried to change handedness during their training. When comparing handedness across surgical tasks, LHD trainees were more likely than RHD trainees to report using their nondominant hand or demonstrating ambidexterity when using scissors (47% vs. 7%), suturing (38% vs. 5%) and undermining (34% vs. 14%). No difference was found in electrocautery (9% vs. 10%) or scalpel use (9% vs. 5%). When asked whether hand dominance significantly affected the learning curve in dermatological surgery, 53% (25 of 47) of LHD respondents felt it did not, compared with 22% (13 of 58) of RHD respondents, although previous research has shown increased efficiency using handed-matched vs. handed-unmatched needle drivers. Themes from open-ended questions highlighted initial difficulties with scissors and needle holders, but all reported adaptation. Some respondents noted logistical challenges in acquiring and maintaining left-handed equipment within departments, and many indicated they were self-taught, struggling to find adequate resources for left-handed surgical training techniques. This study highlights challenges faced by LHD dermatologists, trainees and GPwERs, particularly due to limited access to left-handed instruments and training resources. While most respondents did not feel their handedness significantly affected their learning curve, the lack of appropriate tools and mentorship remains a barrier. Improving access to left-handed instruments and tailored training could enhance the learning experience and reduce the physical strain on LHD practitioners in dermatological surgery.