Crucial aspects of smoking in wound healing after breast reduction surgery

Bartsch, Rudolf; Weiss, Gabriel; Kästenbauer, T; Patocka, Kurt; Deutinger, Maria; Krapohl, Björn Dirk; Benditte-Klepetko, Heike

doi:10.1016/j.bjps.2006.08.001

Cited by 65 publications

(28 citation statements)

References 30 publications

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“…It is an independent risk factor across a variety of populations and conditions [5,26,30,42], but specifically associated with delayed healing and recurrence of pain in shoulder [6], back [29], neck [14], and multiple other exercise-related injuries [2]. It has deleterious effects on peak bone mass [8], bone mineral density [43], bone healing [28], and wound healing [4,25] as well as many other general complications [41]. However, the exact nature of this association still needs further investigation.…”

Section: Discussionmentioning

confidence: 99%

What Risk Factors Are Associated With Musculoskeletal Injury in US Army Rangers? A Prospective Prognostic Study

Teyhen¹,

Shaffer

Butler

et al. 2015

Clinical Orthopaedics &Amp; Related Research

107

119

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Background Musculoskeletal injury is the most common reason that soldiers are medically not ready to deploy. Understanding intrinsic risk factors that may place an elite soldier at risk of musculoskeletal injury may be beneficial in preventing musculoskeletal injury and maintaining operational military readiness. Findings from this population may also be useful as hypothesis-generating work for particular civilian settings such as law enforcement officers (SWAT teams), firefighters (smoke jumpers), or others in physically demanding professions.Questions/purposes The purposes of this study were (1) to examine whether using baseline measures of self-report and physical performance can identify musculoskeletal injury risk; and (2) to determine whether a combination of predictors would enhance the accuracy for determining future musculoskeletal injury risk in US Army Rangers. Methods Our study was a planned secondary analysis from a prospective cohort examining how baseline factors predict musculoskeletal injury. Baseline predictors associated with musculoskeletal injury were collected using surveys and physical performance measures. Army Physical Fitness Test (consisting of a 2-mile run and 2 minutes of sit-ups and push-ups). A total of 320 Rangers were invited to enroll and 211 participated (66%). Occurrence of musculoskeletal injury was tracked for 1 year using monthly injury surveillance surveys, medical record reviews, and a query of the Department of Defense healthcare utilization database. Injury surveillance data were available on 100% of the subjects. Receiver operator characteristic curves and accuracy statistics were calculated to identify predictors of interest. A logistic regression equation was then calculated to find the most pertinent set of predictors. Of the 188 Rangers (age, 23.3 ± 3.7 years; body mass index, 26.0 ± 2.4 kg/m 2 ) remaining in the cohort, 85 (45.2%) sustained a musculoskeletal injury of interest. Results Smoking, prior surgery, recurrent prior musculoskeletal injury, limited-duty days in the prior year for musculoskeletal injury, asymmetrical ankle dorsiflexion, pain with Functional Movement Screen clearing tests, and decreased performance on the 2-mile run and 2-minute situp test were associated with increased injury risk. Presenting with one or fewer predictors resulted in a sensitivity of 0.90 (95% confidence interval [CI], 0.83-0.95), and having three or more predictors resulted in a specificity of 0.98 (95% CI, 0.93-0.99). The combined factors that contribute to the final multivariable logistic regression equation yielded an odds ratio of 4.3 (95% CI, 2.0-9.2), relative risk of 1.9 (95% CI, 1.4-2.6), and an area under the curve of 0.64. Conclusions Multiple factors (musculoskeletal injury history, smoking, pain provocation, movement tests, and lower scores on physical performance measures) were associated with individuals at risk for musculoskeletal injury. The summation of the number of risk factors produced a highly sensitive (one or less factor) and specific (three o...

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Section: Discussionmentioning

confidence: 99%

What Risk Factors Are Associated With Musculoskeletal Injury in US Army Rangers? A Prospective Prognostic Study

Teyhen¹,

Shaffer

Butler

et al. 2015

Clinical Orthopaedics &Amp; Related Research

107

119

View full text Add to dashboard Cite

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“…Hydrogen cyanide inhibits oxidative metabolism and oxygen transport. 54 Plastic and Reconstructive Surgery • January 2016…”

Section: Smokingmentioning

confidence: 98%

Evidence-Based Strategies to Reduce Postoperative Complications in Plastic Surgery

Harrison

Khansa

Janis

2016

Plastic and Reconstructive Surgery

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Reconstructive plastic surgery is vital in assisting patients with reintegration into society after events such as tumor extirpation, trauma, or infection have left them with a deficit of normal tissue. Apart from performing a technically sound operation, the plastic surgeon must stack the odds in the favor of the patient by optimizing them before and after surgery. The surgeon must look beyond the wound, at the entire patient, and apply fundamental principles of patient optimization. This article reviews the evidence behind the principles of patient optimization that are commonly used in reconstructive surgery patients.

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“…44 Smokers showing impaired wound healing after breast reduction surgery also have higher levels of urine cotinine both preoperatively and postoperatively than do nonsmokers. 45 In order for any wound to heal properly, the 4 stages of healing (hemostasis, inflammation, proliferation, and remodeling) need to occur in the proper sequence and be of proper duration. 46 Although smoking has been shown to attenuate the normal inflammatory healing response by a reduction in inflammatory chemotactic responsiveness, migratory function, and oxidative bactericidal mechanisms, 47 there is also evidence that in both diabetes and periodontal disease, 48 a condition of hyperinflammation is established.…”

Section: Robertson Et Almentioning

confidence: 99%