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Smoking and plastic surgery, part II. Clinical implications: a systematic review with meta-analysis
I Pluvy1, M Panouillères1, I Garrido2
1Service de chirurgie orthopédique, traumatologique, plastique, reconstructrice et assistance main, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France.
Annales De Chirurgie Plastique Et Esthetique
|December 3, 2014
Summary
Smoking significantly increases risks for plastic surgery patients, leading to delayed wound healing, surgical site infections, and cutaneous necrosis. Preoperative evaluation of smokers is crucial to mitigate these adverse outcomes.
Area of Science:
- Plastic Surgery
- Surgical Complications
- Tobacco Use Research
Background:
- Tobacco addiction is a significant risk factor for complications in plastic surgery.
- Patients undergoing surgical interventions who continue to use tobacco face heightened risks of perioperative and postoperative complications.
Purpose of the Study:
- To detail the risks of perioperative and postoperative complications in patients with continued tobacco intoxication undergoing surgical interventions.
- To systematically review the literature on complications related to tobacco use in plastic surgery patients.
Main Methods:
- Systematic review of the literature applying PRISMA criteria.
- Exploration of five databases using predefined keywords, selecting randomized, controlled observational studies.
- Evaluation of evidence levels, risk of bias assessment using the Newcastle-Ottawa Scale, and meta-analysis of incidence parameters (Odds Ratio, relative risk).
Main Results:
- Included 60 observational studies.
- Cosmetic surgery: OR 2.3 for surgical site infections, OR 2.5 for delayed wound healing.
- Bariatric surgery: OR 3.3 for delayed wound healing, OR 3.1 for cutaneous necrosis.
Conclusions:
- Smokers face significantly higher risks of cutaneous necrosis, delayed wound healing, and surgical site infections, especially after major procedures.
- Preoperative evaluation and intervention for smokers are essential to reduce these surgical risks.
- While not conclusive for free flap microsurgery, tobacco use impacts various plastic surgery outcomes.
