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Ergonomic burden in microsurgery: Real-time quantification of cervical posture using biosensor technology.

Eimear Phoenix1, Clodagh Canavan1, Linda Kelly1

  • 1Department of Plastic & Reconstructive Surgery, Beaumont Hospital, Dublin, Ireland.

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|December 11, 2025
PubMed
Summary

Reconstructive microsurgeons experience significant cervical strain, especially during flap raises. Surgeon height and lifestyle factors contribute to neck pain and disability, necessitating ergonomic interventions.

Keywords:
MicrosurgeryOccupational injurySurgeon healthSurgical ergonomics

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Area of Science:

  • Microsurgery
  • Ergonomics
  • Musculoskeletal Health

Background:

  • Reconstructive microsurgeons face high risk of musculoskeletal strain from prolonged static postures and magnification use.
  • This study aimed to quantify intra-operative cervical posture and assess neck pain prevalence.

Purpose of the Study:

  • To prospectively quantify cervical posture during microsurgery.
  • To assess the prevalence of neck pain and identify associated ergonomic strain factors.

Main Methods:

  • Eleven surgeons were monitored using a posture sensor during 25 free-flap procedures.
  • Surgeons completed validated questionnaires on musculoskeletal symptoms, neck disability, and resilience.

Main Results:

  • Surgeons spent 88.5% of flap-raise time in >30° cervical flexion versus 3.9% during micro-anastomosis.
  • 54.5% reported neck pain; surgeon height, microsurgical exposure, and sedentary time were significant factors.
  • Neck pain was linked to impaired sleep and reduced recreation.

Conclusions:

  • Substantial cervical loading occurs during microsurgery, particularly flap elevation.
  • Ergonomic strain is influenced by posture, surgeon anthropometry, and lifestyle.
  • Targeted interventions are needed to improve musculoskeletal health and operative performance.