dr.hurt

Not healing well? Becoming smoke-free will help!

Blog Post created by dr.hurt on Sep 20, 2012

Doctors have long been aware that using tobacco can impair healing.  Research with patients who have had surgery show that smoking can lead to increased complications in the healing of surgical wounds, and more and more surgeons refuse to perform surgery on smokers because of poor outcomes (1).

Post-operative patients who smoke have more infections, wound dehiscence (the wound breaks open), and wound and flap necrosis (the skin tissue dies and needs to be cut away) (2).  Continued smoking can lead to poor outcomes with dental implants and related dental surgery (3) as well as many other kinds of surgeries including those for breast cancer, coronary artery bypass, abdominal surgeries (such as having your appendix removed), and orthopedic surgery (like having an operation on your back or having a hip replacement).  Bone fractures do not heal as well in smokers, or the most extreme, heart and lung transplants.

Smoking affects healing because of decreased oxygen delivery to the tissue.  Smoking for 10 minutes can decrease the tissue oxygen concentration for as long as 1 hour, and people who smoke a pack a day would live under almost constant tissue hypoxia (1).  Smoking causes decreased oxygenation because of the way chemicals such as carbon monoxide and hydrogen cyanide interfere with various cell functions involved in the healing process.

Stopping smoking promotes healthy healing.  There is evidence to suggest that nicotine replacement options, such as nicotine patch or gum, do not interfere with healing and are effective and safe options for quitting while you heal (4).  A Tobacco Treatment Specialist can assist in the process by helping you to put together a solid plan and discuss medication options that might be helpful for you on your journey to stay quit for good.  Seeking support from others on sites like becomanex.org can help too.

You can do this!

1) Jensen JA, Goodson WH, Hopf HW, Hunt TK (1991). Cigarette smoking decreases tissue oxygen. Arch Surg, 126, 1131-4.

2) Goldminz D, Bennett RG (1991). Cigarette smoking and flap and full-thickness graft necrosis. Arch Dermatol, 127, 1012-5.

3) Levin L, Schwartz-Arad D. (2005). The effect of cigarette smoking on dental implants and related surgery. Implant Dent, 14, 357-61.

4) Sorensen, Lt (2012). Wound healing and infection in surgery: the pathophysiologic impact of smoking, smoking cessation, and nicotine replacement therapy: a systematic review. Ann Surg., 255(6), 1069-79.
 

Outcomes