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First 30 Days Wound-Related Complications in Young Smokers Following Primary Achilles Repair
Solangel Rodriguez-Materon1, Samantha Trynz2, Md Ashfaq Ahmed3
1Foot and Ankle Fellow, Medstar Union Memorial Hospital, Baltimore, MD.
Insights
This study found no significant difference in Achilles tendon repair outcomes between smokers and nonsmokers in young adults. Wound healing and complication rates were similar, suggesting smoking may not impact short-term surgical results in this demographic.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Public Health
Background:
- Achilles tendon injuries are common in young to middle-aged adults.
- Previous research indicates tobacco smoking may delay postsurgical wound healing.
- Understanding risk factors for complications is crucial for patient outcomes.
Purpose of the Study:
- To investigate the impact of tobacco smoking on short-term outcomes after primary Achilles tendon repair in patients aged 18-35.
- To compare complication rates, readmissions, and reoperations between smokers and nonsmokers.
Main Methods:
- Retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database.
- Inclusion of patients aged 18-35 undergoing primary Achilles tendon repair (2011-2020).
- Comparison of outcomes including 30-day readmission, minor complications, wound healing issues, and reoperations between smokers and nonsmokers.
Main Results:
- No statistically significant differences were observed in 30-day readmission, reoperation, or minor complication rates between smokers and nonsmokers.
- Black non-Hispanic patients showed a lower likelihood of minor complications compared to White non-Hispanic patients.
- Wound-related complications were generally low in this young patient cohort.
Conclusions:
- Tobacco smoking does not appear to significantly affect short-term outcomes after primary Achilles tendon repair in patients aged 18-35.
- Wound healing and complication rates are low in this demographic, irrespective of smoking status.
- Further research may explore long-term effects and other potential influencing factors on surgical outcomes.
Abstract:
The Achilles tendon is frequently injured in the young to middle aged population. Previous studies have shown that there is an increased risk of delay in postsurgical wound healing amongst tobacco smoking patients with Achilles tendon injury. This study utilized the American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database. We included patients between the ages of 18 and 35 years who underwent primary Achilles tendon repair between years 2011 and 2020. The procedure type (with or without graft, CPT 27650 and 27652), patient demographics, and comorbidities were included. Primary outcomes of interest were 30-day readmission, minor complications, outcomes related to wound healing (wound disruption, superficial surgical site infection, deep incisional surgical site infection, organ-space site infections) and reoperations within 30 days of index surgery. A total of 1944 patients met the inclusion criteria for this study. One thousand six hundred and fifty-nine patients were nonsmokers, while 285 were smokers. Logistic regression showed no differences between smokers and nonsmokers (reference group) for 30-day readmission, reoperation, and minor complications. However, Black non-Hispanic patients were found to be 0.3 times (95% confidence interval: 0.1, 0.98) as likely to develop minor complications as compared to the White non-Hispanic patients. Wound-related complications after Achilles tendon repair remain low in younger (18-35 years) patients. When comparing clinical outcomes between nonsmokers and smokers, we found no statistically significant difference in this retrospective study.
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