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Testing or Trusting? Urine Cotinine Levels in Plastic Surgery.

Roman Rysin, Yair Shachar

Aesthetic Surgery Journal

|July 11, 2023

Summary

Urine cotinine tests are valuable for assessing nicotine exposure before elective surgery, particularly in aesthetic procedures. This biomarker aids in evaluating patient risk and promoting better surgical outcomes.

Area of Science:

Biochemistry
Surgical Sciences
Toxicology

Background:

Preoperative laboratory tests are standard in surgery.
Smoking cessation is advised before elective aesthetic surgery but rarely verified.
Urine cotinine is a reliable short-term marker for nicotine exposure.

Purpose of the Study:

To review existing literature on cotinine levels in general and plastic surgery.
To assess if data support the use of cotinine tests for high-risk surgical candidates, especially in aesthetic surgery.

Main Methods:

A PubMed literature search was performed using "cotinine" and "surgery" keywords.
The search followed the PRISMA standard flowchart for systematic reviews.
Sixty-one articles were identified and reviewed, with 15 selected for qualitative synthesis.

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Main Results:

Initial search yielded 312 papers, reduced to 61 after applying exclusion criteria.
Fifteen full-text articles were included in the final qualitative synthesis.
The reviewed literature provides substantial data on cotinine levels in surgical contexts.

Conclusions:

Sufficient evidence supports the judicious use of cotinine testing before elective surgery.
Cotinine testing is particularly recommended for aesthetic surgery patients.
This biomarker aids in managing surgical risks associated with nicotine use.