Determination of the Duration of Preoperative Smoking Cessation to Improve Wound Healing after Head and Neck Surgery

Kuri, Michioki; Nakagawa, Masashi; Tanaka, Hideo; Hasuo, Seiko; Kishi, Yoshihiko

doi:10.1097/00000542-200505000-00005

Cited by 173 publications

(116 citation statements)

References 17 publications

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“…1). There were seven prospective cohort studies, 12,[20][21][22][23][24][25] 16 retrospective cohort studies, [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] and two RCTs (Table 1). 42,43 Both RCTs offered nicotine replacement therapy.…”

Section: Resultsmentioning

confidence: 99%

“…42,43 Both RCTs offered nicotine replacement therapy. 42,43 There were 14 studies from North America, 12,21,23,26,[30][31][32][33][34][35]37,[39][40][41] six from Europe, 22,27,28,38,42,43 four from Asia, 20,25,29,36 and one from Australia. 24 There were more male than female smokers, and smokers were younger than non-smokers or ex-smokers in many of the studies.…”

Section: Resultsmentioning

confidence: 99%

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Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis

Wong

Lam

Abrishami

et al. 2011

Can J Anesth/J Can Anesth

323

161

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Purpose The literature was reviewed to determine the risks or benefits of short-term (less than four weeks) smoking cessation on postoperative complications and to derive the minimum duration of preoperative abstinence from smoking required to reduce such complications in adult surgical patients. Source We searched MEDLINE, EMBASE, Cochrane, and other relevant databases for cohort studies and randomized controlled trials that reported postoperative complications (i.e., respiratory, cardiovascular, woundhealing) and mortality in patients who quit smoking within six months of surgery. Using a random effects model, meta-analyses were conducted to compare the relative risks of complications in ex-smokers with varying intervals of smoking cessation vs the risks in current smokers. Principal findings We included 25 studies. Compared with current smokers, the risk of respiratory complications was similar in smokers who quit less than two or two to four weeks before surgery (risk ratio [RR] 1.20; 95% confidence interval [CI] 0.96 to 1.50 vs RR 1.14; CI 0.90 to 1.45, respectively). Smokers who quit more than four and more than eight weeks before surgery had lower risks of respiratory complications than current smokers (RR 0.77; 95% CI 0.61 to 0.96 and RR 0.53; 95% CI 0.37 to 0.76, respectively). For wound-healing complications, the risk was less in smokers who quit more than three to four weeks before surgery than in current smokers (RR 0.69; 95% CI 0.56 to 0.84). Few studies reported cardiovascular complications and there were few deaths. Conclusion At least four weeks of abstinence from smoking reduces respiratory complications, and abstinence of at least three to four weeks reduces wound-healing complications. Short-term (less than four weeks) smoking cessation does not appear to increase or reduce the risk of postoperative respiratory complications.Author contributions Jean Wong was involved in data abstraction, interpretation of data, drafting and revising, and final approval of the article. David Paul Lam was involved in data abstraction and drafting of the article. Amir Abrishami was involved in drafting and revising the article, data analysis, and interpretation of the data. Matthew Chan revised and approved the final version of the article. Frances Chung was involved in the conception and design, revising, and final approval of the article. (RR: 0,77; IC a`95 %: 0,96 et RR: 0,53; IC a9 5 %: 0,76, respectivement). Concernant les complications lie´es a`la cicatrisation, le risque a e´te´plus faible chez les fumeurs ayant cesse´plus de trois a`quatre semaines avant l'intervention que chez les fumeurs actifs (RR: 0,69; IC a`95%: 0,56-0,84). Peu d'e´tudes ont de´crit des complications cardiovasculaires et il n'y a eu que peu de de´ce`s. Conclusion Un minimum de quatre semaines d'abstinence du tabagisme diminue le risque de complications respiratoires et un minimum de trois a`quatre semaines re´duit le risque de complications lie´es a`la cicatrisation. L'arreˆt à court terme (moins de quatre semaines) du tab...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis

Wong

Lam

Abrishami

et al. 2011

Can J Anesth/J Can Anesth

323

161

View full text Add to dashboard Cite

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“…Smoking appears to suppress the immune system [18]. It was found that the percentage of impaired wound healing was greater in nonsmokers than individuals who had not smoked for more than 22 days (47% nonsmokers versus 67%, p\0.05) after head and neck surgery [11]. A risk reduction of 19% is seen for each week of cessation before surgery [19].…”

Section: Discussionmentioning

confidence: 99%

What Factors are Associated With a Surgical Site Infection After Operative Treatment of an Elbow Fracture?

Claessen

Braun

Leeuwen

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Surgical site infections are one of the more common major complications of elbow fracture surgery and can contribute to other adverse outcomes, prolonged hospital stays, and increased healthcare costs. Questions/purposes We asked: (1) What are the factors associated with a surgical site infection after elbow fracture surgery? (2) When taking the subset of closed elbow fractures only, what are the factors associated with a surgical site infection? (3) What are the common organisms isolated from an elbow infection after open treatment? Methods One thousand three hundred twenty adult patients underwent surgery for an elbow fracture between January 2002 and July 2014 and were included in our study. Forty-eight of 1320 patients (4%) had a surgical site infection develop. Thirty-four of 1113 patients with a closed fracture (3%) had a surgical site infection develop.Results For all elbow fractures, use of plate and screw fixation (adjusted odds ratio [OR]= 2.2; 95% CI, 1.0-4.5; p = 0.041) and use of external fixation before surgery (adjusted OR = 4.7; 95% CI, 1.1-21; p = 0.035) were associated with higher infection rates. When subset analysis was performed for closed fractures, only smoking (adjusted OR = 2.2; 95% CI, 1.1-4.5; p = 0.023) was associated with higher infection rates. Staphylococcus aureus was the most common bacteria cultured (59%). Conclusions The only modifiable risk factor for a surgical site infection after open reduction and internal fixation was cigarette smoking. Plate fixation and temporary external fixation are likely surrogates for more complex injuries, therefore no recommendations should be inferred from this association. Surgeons should counsel patients who smoke. Level of Evidence Level IV, prognostic study.

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“…Smokers have a higher incidence of postoperative pulmonary complications than non-smokers, 1 and smoking is associated with impaired wound healing and increased incidence of infection. 2,3 Hospitalization and the period of forced cessation it entails is often characterized as a ''window of opportunity'' for delivering cessation interventions. 4,5 Hospital-based smoking cessation interventions are effective, and even brief advice delivered by a health professional can enhance quit rates.…”

Section: Résumémentioning

confidence: 99%

Smoking cessation interventions in the pre-admission clinic: assessing two approaches

Sachs

Wild

Thomas

et al. 2012

Can J Anesth/J Can Anesth

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Determination of the Duration of Preoperative Smoking Cessation to Improve Wound Healing after Head and Neck Surgery

Abstract: Preoperative smoking abstinence of longer than 3 weeks reduces the incidence of impaired wound healing among patients who have undergone reconstructive head and neck surgery.

Cited by 173 publications

References 17 publications

Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis

Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis

What Factors are Associated With a Surgical Site Infection After Operative Treatment of an Elbow Fracture?

Smoking cessation interventions in the pre-admission clinic: assessing two approaches

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