[Tobacco and plastic surgery: An absolute contraindication?]

Area of Science:

• Plastic and Aesthetic Surgery
• Public Health
• Surgical Risk Management

Background:

• Smoking significantly elevates perioperative risks, including impaired wound healing, increased infection rates, and microsurgical procedure failure.
• Current consensus on managing smoking patients in plastic and aesthetic surgery remains undefined.
• This study investigates the practices of French plastic surgeons regarding smoking patients.

Purpose of the Study:

• To analyze the current practices of French plastic surgeons concerning the management of smoking patients.
• To evaluate surgeons' approaches to patient information, smoking cessation, and surgical indications for smokers.

Main Methods:

• A questionnaire was emailed to French plastic surgeons to assess their practices.
• Data collected included patient information on smoking risks, pre- and postoperative smoking cessation periods, intervention types, cessation support, screening test usage, and refusal criteria for smokers.
• Statistical analyses compared results based on practice type, surgeon's smoking habits, and years in practice.

Main Results:

• Nearly all surgeons (147/148) discussed smoking risks with patients.
• 49.3% of surgeons offered smoking cessation support, more commonly in public practice settings (P=0.019).
• A significant majority (85.4%) did not employ screening tests for smoking, and surgical indications varied with surgeon experience (P=0.02). Average cessation periods were 4 weeks pre- and 3 weeks post-surgery.

Conclusions:

• Opportunities exist to enhance care for smoking patients undergoing plastic surgery.
• Recommendations include implementing smoking cessation assistance programs and utilizing screening tests.
• Establishing absolute contraindications for certain procedures or defining consumption limits for smokers is suggested.