Smoking, chronic wound healing, and implications for evidence-based practice
Jodi C McDaniel1, Kristine K Browning
1Jodi C. McDaniel, PhD, RN, Assistant Professor, College of Nursing, The Ohio State University, Columbus. Kristine K. Browning, PhD, Assistant professor, clinical nursing College of Nursing, The Ohio State University, Columbus.
Summary
Chronic wounds impact many, necessitating evidence-based care. This review explores how smoking hinders wound healing and suggests integrating tobacco dependence treatments into chronic wound management.
Area of Science:
- Wound healing and public health.
Background:
- Chronic wounds, including venous leg ulcers, diabetic foot ulcers, and pressure ulcers, represent a growing global health challenge.
- Current evidence-based guidelines for chronic wound management primarily emphasize biologic therapies.
- Behavioral risk factors, such as smoking, significantly impede wound healing but are often underaddressed in treatment plans.
Purpose of the Study:
- To elucidate the mechanisms by which smoking negatively affects wound healing.
- To propose actionable strategies for integrating evidence-based tobacco dependence treatments into chronic wound care.
Main Methods:
- Literature review of mechanisms of smoking on wound healing.
- Review of evidence-based guidelines for tobacco dependence treatment.
- Synthesis of strategies for clinical application.
Main Results:
- Smoking impairs wound healing through various pathophysiological pathways.
- Effective, evidence-based treatments for tobacco dependence exist and can be integrated into wound care protocols.
- Addressing smoking cessation is crucial for optimizing outcomes in patients with chronic wounds.
Conclusions:
- Integrating tobacco dependence treatment into chronic wound care is essential for improving patient outcomes.
- A multidisciplinary approach addressing both biologic and behavioral factors is necessary for comprehensive chronic wound management.
- Clinicians should proactively incorporate smoking cessation interventions for patients with chronic wounds who smoke.
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