The effects of smoking on experimental skin flaps in hamsters

To study the effects of the inhalation of cigarette smoke on the survival of skin flaps, 30 Syrian Golden hamsters were divided into three groups of 10. Two of these groups were acclimatized to cigarette smoke in increasing increments for 9 weeks in standard Hamburg I smoking cages. The third group of 10 (group A) served as controls and were sham-smoked throughout the experiment. After acclimatization, one group of 10 (group B) was smoked for a further 6 weeks. A standard axial-pattern flap was then raised on the dorsum of the animals. Ten animals in group C were smoked for 6 weeks preoperatively and for 2 weeks postoperatively, at which time the animals in all groups were sacrificed. All animals survived the experiment. The flaps in control group A all survived without necrosis. Two of the 10 dorsal flaps sustained terminal necrosis in group B animals. Six of the 10 flaps resulted in significant terminal necrosis in group C animals. Statistical analysis of the results indicated a significant comparison between control group A and group C of those animals smoked throughout the experiment. We conclude from this experiment that the inhalation of cigarette smoke consistent with that of a heavy smoker (2 packs per day) has an adverse effect on wound healing of skin flaps in hamsters. Apparently, cessation of smoking even at the time of surgical preparation of the flap obviates much of the noxious effect and increase flap survival significantly.