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Cigarette smoking increases complication rate in forefoot surgery
Clayton C Bettin1, Kellen Gower2, Kelly McCormick3
1University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery & Biomedical Engineering, Memphis, TN, USA clayton.bettin@gmail.com.
Foot & Ankle International
|January 14, 2015
Summary
Cigarette smoking significantly increases complication risks following forefoot surgery. Active smokers face a 4.3 times higher complication rate than nonsmokers, highlighting the need for smoking cessation before procedures.
Area of Science:
- Orthopedic Surgery
- Surgical Complications
- Tobacco Use Research
Background:
- Cigarette smoking is a known risk factor for perioperative complications.
- Previous research has not specifically evaluated smoking's impact on forefoot surgery outcomes.
Purpose of the Study:
- To investigate the association between cigarette smoking and complication rates after forefoot surgery.
- To quantify the increased risk of complications for active and former smokers undergoing forefoot procedures.
Main Methods:
- Retrospective comparative study of 602 patients undergoing forefoot surgery (2008-2010).
- Patients categorized into active smokers, former smokers, and nonsmokers based on documented smoking status.
- Complications including nonunion, delayed union, wound healing issues, infection, and persistent pain were reviewed.
Main Results:
- Active smokers exhibited a significantly higher complication rate (36.4%) compared to former smokers (16.5%) and nonsmokers (8.5%).
- Active smokers were 4.3 times more likely to experience complications than nonsmokers.
- Former smokers who quit prior to surgery were 1.9 times more likely to have complications, with an average cessation of 17 years.
Conclusions:
- Forefoot surgery patients who smoke have a substantially elevated risk of complications.
- Surgeons should counsel smoking patients on risks and strongly encourage smoking cessation before forefoot surgery.
- Even quitting years prior to surgery may not fully mitigate the increased risk.
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