Circulatory crisis caused by cigarette smoking in tissue transfer. Clinical and experimental studies

Cigarette smoking-induced circulatory crisis occurred in two patients receiving toe transfer and one patient having musculocutaneous flap. After anticoagulation and antispasm treatment, one survived and two failed. Experimental studies demonstrated that cigarette smoking is harmful to the healing of endothelia at the anastomotic site of vessels. Five days after operation, the complete recovery rate of the endothelium over sutures of anastomotic sites was 16%-19% in smoking groups, but 75% in the control group. The mechanism and characteristics of circulatory crisis caused by cigarette smoking are discussed.