Related Experiment Video
Updated: Feb 2, 2026
07:57
An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps
Published on: December 5, 2025
266
Smoking and Flap Survival
Kun Hwang1, Ji Soo Son2, Woo Kyung Ryu2
1Department of Plastic Surgery, Inha University School of Medicine, Incheon, South Korea.
Plastic Surgery (Oakville, Ont.)
|November 20, 2018
Summary
Smokers experience significantly higher flap surgery complications, including flap loss, hematoma, and fat necrosis. Abstinence from smoking for at least one week, both before and after surgery, is crucial for smokers undergoing flap operations.
Area of Science:
- Plastic Surgery
- Surgical Complications
- Smoking Cessation
Background:
- Smoking is a known risk factor for adverse surgical outcomes.
- Nicotine's vasoconstrictive properties and reduced oxygen levels can impair wound healing.
- Understanding the impact of smoking cessation on flap surgery outcomes is critical.
Purpose of the Study:
- To compare flap surgery complication rates between smokers and non-smokers.
- To evaluate the influence of smoking abstinence duration on these complications.
- To establish evidence-based recommendations for smoking cessation in patients undergoing flap surgery.
Main Methods:
- A systematic literature review was conducted using PubMed and Scopus databases.
- Search terms included "smoking" and "flap survival".
- Data from 15 selected studies were analyzed to compare complication rates and odds ratios.
Main Results:
- Smokers exhibited significantly higher rates of flap necrosis, hematoma, and fat necrosis compared to non-smokers.
- Post-operative flap loss was significantly higher in smokers abstinent for only 24 hours (OR=4.885).
- A 1-week post-operative abstinence significantly reduced flap loss in smokers (OR=0.252), with no significant difference compared to non-smokers after 1 week of pre-operative abstinence.
Conclusions:
- Smoking significantly increases the risk of flap surgery complications due to reduced oxygenation and vasoconstriction.
- A minimum of one week of preoperative and postoperative smoking abstinence is recommended for smokers undergoing flap operations.
- This abstinence period is essential to mitigate risks such as flap loss, hematoma, and fat necrosis.
Related Concept Videos
01:18Survival Curves
718
Survival curves are graphical representations that depict the survival experience of a population over time, offering an intuitive way to track the proportion of individuals who remain event-free at each time point. These curves are widely used in fields such as medicine, public health, and reliability engineering to visualize and compare survival probabilities across different groups or conditions.
The Kaplan-Meier estimator is the most common method for constructing survival curves. This...
The Kaplan-Meier estimator is the most common method for constructing survival curves. This...
718
01:19Survival Tree
430
Survival trees are a non-parametric method used in survival analysis to model the relationship between a set of covariates and the time until an event of interest occurs, often referred to as the "time-to-event" or "survival time." This method is particularly useful when dealing with censored data, where the event has not occurred for some individuals by the end of the study period, or when the exact time of the event is unknown.
Building a Survival Tree
Constructing a...
Building a Survival Tree
Constructing a...
430
01:18Introduction To Survival Analysis
789
Survival analysis is a statistical method used to study time-to-event data, where the "event" might represent outcomes like death, disease relapse, system failure, or recovery. A unique feature of survival data is censoring, which occurs when the event of interest has not been observed for some individuals during the study period. This requires specialized techniques to handle incomplete data effectively.
The primary goal of survival analysis is to estimate survival time—the time...
The primary goal of survival analysis is to estimate survival time—the time...
789
01:20Comparing the Survival Analysis of Two or More Groups
602
Survival analysis is a cornerstone of medical research, used to evaluate the time until an event of interest occurs, such as death, disease recurrence, or recovery. Unlike standard statistical methods, survival analysis is particularly adept at handling censored data—instances where the event has not occurred for some participants by the end of the study or remains unobserved. To address these unique challenges, specialized techniques like the Kaplan-Meier estimator, log-rank test, and...
602
01:09Truncation in Survival Analysis
621
Truncation in survival analysis refers to the exclusion of individuals or events from the dataset based on specific criteria related to the time of the event. This exclusion can happen in two primary forms: left truncation and right truncation.
Left truncation occurs when individuals who experienced the event of interest before a certain time are not included in the study. This is often due to a "delayed entry" into the study where only those who survive until a certain entry point are...
Left truncation occurs when individuals who experienced the event of interest before a certain time are not included in the study. This is often due to a "delayed entry" into the study where only those who survive until a certain entry point are...
621
01:15Assumptions of Survival Analysis
425
Survival models analyze the time until one or more events occur, such as death in biological organisms or failure in mechanical systems. These models are widely used across fields like medicine, biology, engineering, and public health to study time-to-event phenomena. To ensure accurate results, survival analysis relies on key assumptions and careful study design.
425