Effects of Vaping on Foot and Ankle Surgery: A Pilot Study

Vaping and electronic cigarettes (e-cigarettes) have grown in popularity over the last decade with the public health desire to limit traditional smoking and nicotine delivery methods. Tobacco has been documented in the orthopedic literature to have negative effects on bone healing and to contribute to surgical complications. The purpose of this study was to assess the effects of e-cigarette use on postoperative complications.

Data were collected from patients undergoing surgery by two board-certified foot and ankle surgeons from May 1, 2020, to February 25, 2021. Each participant was called and went through a standardized unvalidated questionnaire. Information was recorded, de-identified, and compiled into a spreadsheet. Patient demographics and medical history were documented. Four groups were compiled: tobacco smokers only (n = 29), vape users only (n = 4), smokers and vapers (n = 7), and nonsmokers and nonvapers (n = 54). Procedures comprised 30 forefoot, 32 hindfoot, and 22 other (multiple locations and soft tissue only).

Medical history of hyperlipidemia was the greatest risk factor for perioperative complications (P = .07). Odds ratios and Wald confidence intervals were calculated between the groups but were insignificant.

We were unable to identify a difference in complication rate between vapers and exclusive tobacco users. The inability to reveal a significant difference is likely attributed to the study's small sample size. More studies are warranted to evaluate the effects of e-cigarette use on foot and ankle surgery.