Effect of preoperative smoking cessation interventions on postoperative complications and smoking cessation

Thomsen, Thordis; Tønnesen, Hanne; Møller, Ann Merete

doi:10.1002/bjs.6591

Cited by 227 publications

(145 citation statements)

References 46 publications

(166 reference statements)

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“…Factors found to be significant in other studies, such as presence of diabetes mellitus, chronic obstructive pulmonary disease, obesity or advanced age, showed no association with SSI in this study's sample [19][20][21][22][23] .…”

Section: Discussioncontrasting

confidence: 59%

Rates of Surgical Site Infection in Cholecystectomy: Comparison between a University Teaching Hospital, Madrid Region, Spain, and USA Rates

Rodríguez-Caravaca

Gil-Yonte

Del-Moral-Luque

et al. 2017

RIC

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Section: Discussioncontrasting

confidence: 59%

Rates of Surgical Site Infection in Cholecystectomy: Comparison between a University Teaching Hospital, Madrid Region, Spain, and USA Rates

Rodríguez-Caravaca

Gil-Yonte

Del-Moral-Luque

et al. 2017

RIC

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“…Smoking impairs wound healing because microvascular traction leads to tissue ischemia. Thomsen et al [54] reported that patients may benefit from intensive preoperative smoking cessation interventions, which must have been initiated at least 4 weeks before surgery and have included nicotine replacement therapy. Therefore, patients have to stop smoking before surgery.…”

Section: Discussionmentioning

confidence: 99%

A methodological, systematic review of evidence-based independent risk factors for surgical site infections after spinal surgery

Xing

et al. 2012

Eur Spine J

131

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Objective To identify the independent risk factors, based on available evidence in the literature, for patients developing surgical site infections (SSI) after spinal surgery. Methods Non-interventional studies evaluating the independent risk factors for patients developing SSI following spinal surgery were searched in Medline, Embase, Sciencedirect and OVID. The quality of the included studies was assessed by a modified quality assessment tool that had been previously designed for observational studies. The effects of studies were combined with the study quality score using a best-evidence synthesis model. Results Thirty-six observational studies involving 2,439 patients with SSI after spinal surgery were identified. The included studies covered a wide range of indications and surgical procedures. These articles were published between 1998 and 2012. According to the quality assessment criteria for included studies, 15 studies were deemed to be high-quality studies, 5 were moderate-quality studies, and 16 were low-quality studies. A total of 46 independent factors were evaluated for risk of SSI. There was strong evidence for six factors, including obesity/BMI, longer operation times, diabetes, smoking, history of previous SSI and type of surgical procedure. We also identified 8 moderate-evidence, 31 limited-evidence and 1 conflictingevidence factors. Conclusion Although there is no conclusive evidence for why postoperative SSI occurs, these data provide evidence to guide clinicians in admitting patients who will have spinal operations and to choose an optimal prophylactic strategy. Further research is still required to evaluate the effects of these above risk factors.

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“…6,7 Two systematic reviews showed that preoperative smoking cessation programs increased short-term (up to six months) abstinence. 8,9 Consequently, both the American Society of Anesthesiologists 10 and the Canadian Anesthesiologists' Society 11 recommend promoting smoking cessation before surgery. However, surgery is frequently scheduled within a few weeks of diagnosis of certain conditions, thus precluding longer periods of preoperative abstinence.…”

Section: Constatations Principalesmentioning

confidence: 99%

Arrêt à court terme du tabagisme en préopératoire et complications postopératoires: revue systématique de la littérature et méta-analyse

Wong

Lam

Abrishami

et al. 2011

Can J Anesth/J Can Anesth

312

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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Effect of preoperative smoking cessation interventions on postoperative complications and smoking cessation

Cited by 227 publications

References 46 publications

Rates of Surgical Site Infection in Cholecystectomy: Comparison between a University Teaching Hospital, Madrid Region, Spain, and USA Rates

Rates of Surgical Site Infection in Cholecystectomy: Comparison between a University Teaching Hospital, Madrid Region, Spain, and USA Rates

A methodological, systematic review of evidence-based independent risk factors for surgical site infections after spinal surgery

Arrêt à court terme du tabagisme en préopératoire et complications postopératoires: revue systématique de la littérature et méta-analyse

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