[Cigarette smoking and circulatory crisis in tissue transfer]

Circulatory crisis occurred in 2 cases of toe-to-hand transfer and 1 case of musculocutaneous free flap after smoking. Two of them failed and 1 survived after exceeding anti-spasm and anti-thrombosis treatment. Experimental studies showed harmful influences of cigarette smoking on endothelial healing process at the vascular anastomosis site, which was covered by endothelial cells in 16%-32% and platelet in 8%-10% of the smoking group 5-10 days after operation, but in 75%-100% and 0% of the normal group. The mechanism and characteristics of circulatory crisis caused by cigarette smoking are discussed.