Einfluss des Zigarettenrauchens auf die Hautdurchblutung der Hand

Petschke, F. T.; Engelhardt, Timm Oliver; Ulmer, Hanno; Piza‐Katzer, Hildegunde

doi:10.1007/s00104-006-1216-1

Cited by 15 publications

(6 citation statements)

References 30 publications

(16 reference statements)

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“…However, it is common sense and underlined by many studies that smoking impairs blood flow of small vessels and leads to vascular endothelial dysfunction and endangers microvascular surgery. 4,14,15 The role of muscle in the free flap also has been analyzed in several studies. 10 There were no statistically significant differences between free muscle and free fasciocutaneous flaps for coverage of open tibial fractures.…”

Section: Discussionmentioning

confidence: 99%

Is There an Association between Comorbidities and the Outcome of Microvascular Free Tissue Transfer?

Herold

Gohritz

Meyer-Marcotty

et al. 2010

J reconstr Microsurg

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The aim of this study was to evaluate the relevant conditions for safe free flap transfers. The authors retrospectively studied the data from 150 patients who received free flaps at a single institution. Many parameters were analyzed to reveal if there was a correlation with respect to surgical or medical complications. Regarding safety of free tissue transfer, we found a worse prognosis in flaps where a revision of the microanastomosis had to be performed. Platelet count and leukocyte count had an impact on the prognosis. Patients older than 60 years did not have an increased rate of surgical complications. Apart from active osteomyelitis, the presence of comorbid conditions did not significantly impair the outcome of flap transfer, although smoking and diabetes correlated with minor surgical complications like wound breakdown or hematoma, respectively. Besides one case of lethal heart failure of an octogenarian patient, no severe medical complications occurred in this series of patients. Microvascular free tissue transfer is not significantly impaired by age and most comorbidities. Osteomyelitis as well as elevated leukocytes and lowered platelets may increase the complication rate and worsen the surgical prognosis. Smoking and diabetes might prolong the hospital course of the patients.

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Section: Discussionmentioning

confidence: 99%

Is There an Association between Comorbidities and the Outcome of Microvascular Free Tissue Transfer?

Herold

Gohritz

Meyer-Marcotty

et al. 2010

J reconstr Microsurg

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show abstract

“…As early as 1988, Shizukuishi et al used tissue spectrometry to show that gingival tissue in patients suffering from periodontitis has a lower oxygen saturation [ 34 ]. Smokers exhibit limitation in oxygen transport and metabolism, and a hypoxic environment develops, which can lead to wound healing disorders [ 8 , 10 , 11 ]. Furthermore, smoking leads to a constriction of the blood vessels, resulting in poorer blood circulation throughout the body and thus also in the oral cavity [ 35 – 38 ].…”

Section: Discussionmentioning

confidence: 99%

“…Smokers are experiencing a reduction in oxygen transport and metabolism. This in turn results in a hypoxic environment, which can lead to impaired wound healing [ 8 , 10 , 11 ]. Patients suffering from diabetes mellitus also show impaired wound healing in the context of surgery.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal analysis of microcirculatory parameters in gingival tissues after tooth extraction in patients with different risk profiles for wound healing disorders – a pilot study

Mayr,

Ciper,

Wahl

et al. 2024

Clin Oral Invest

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Objectives We aimed to establish a risk profile for intraoral wound healing disorders based on measurements of microcirculation in gingival tissues. Materials and methods Oxygen saturation (SO2) and blood flow in gingival tissues were measured with tissue spectrometry and laser doppler spectroscopy in 37 patients before/after tooth extractions. Patients were assigned to four groups: anamnestically and periodontally healthy patients (n = 7), anamnestically healthy but suffering from periodontitis (n = 10), anamnestically healthy but smoking and suffering from periodontitis (n = 10) and suffering from diabetes and periodontitis (n = 10). Measurements were performed at three different time points: Baseline measurement (T0), one day post extractionem (p.e.) (T1) and seven days p.e. (T2). Results Baseline SO2 values were higher in control patients (p = .038). This effect was most evident in comparison to smokers suffering from periodontitis (p = .042), followed by diabetics suffering from periodontitis (p = .09). An opposite trend was seen for blood flow. Patients suffering from periodontitis demonstrated higher blood flow values (p = .012). Five patients, which belonged to the group of smokers suffering from periodontitis, showed clinically a delayed wound healing. Conclusion Differences in SO2 and blood flow of gingival tissue could be detected in different groups of patients with existing periodontitis compared to control patients. Clinical Relevance Lower baseline SO2 values could be a warning signal for possible wound healing disorders after oral surgery.

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“…3,4 This may be more impactful on younger smokers. 5 Smoking cessation is shown to decrease incidence of postoperative complications (level 1B evidence). Successful cessation programs reduce postoperative complication rates by 19% per week, up to a 41% reduction.…”

Section: Detrimental Effect Of Tobacco On Surgerymentioning

confidence: 99%

Is There a Smoking Gun for Nicotine? A Review of the Role of Nicotine in Dermatologic Surgery

Jin

Campbell

Somani

2022

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BACKGROUND Dermatologic surgeons are faced with a dilemma when counseling actively smoking patients who require dermatologic surgery: recommend total cessation of all nicotine that is associated with extremely high rates of cessation failure or recommend nicotine replacement therapy (NRT). OBJECTIVE To determine the safety of NRT in dermatologic surgery. MATERIALS AND METHODS PubMed was queried: [(nicotine OR electronic cigarettes) AND (flap OR wound healing)]. RESULTS Smoking tobacco is detrimental to wound healing, supported by ample evidence (1A). Perioperative smoking cessation reduces risk (1B). Basic science demonstrates both a benefit and detriment of nicotine depending on the factor studied (2A). Human studies suggest no detrimental effect of nicotine on perioperative complications (1B). Nicotine may be detrimental to flaps, but evidence is limited to basic science (2A). CONCLUSION Dermatologists should consider recommending nicotine replacement for smokers in the perioperative period. Evidence is lacking to determine safety in flaps. It is presumed based on animal studies that nicotine has a negative effect on flaps; however, it is likely less than tobacco. Weighing the risk of cessation failure without nicotine replacement versus nicotine replacement after flap is challenging. Electronic cigarettes should be discouraged as a means of NRT.

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Einfluss des Zigarettenrauchens auf die Hautdurchblutung der Hand

Abstract: Younger subjects react to cigarette consumption with a stronger reduction in circulation. In elective surgery, especially in young smokers we recommend a 6- to 8-week nicotine abstinence prior to surgical intervention.

Cited by 15 publications

References 30 publications

Is There an Association between Comorbidities and the Outcome of Microvascular Free Tissue Transfer?

Is There an Association between Comorbidities and the Outcome of Microvascular Free Tissue Transfer?

Longitudinal analysis of microcirculatory parameters in gingival tissues after tooth extraction in patients with different risk profiles for wound healing disorders – a pilot study

Is There a Smoking Gun for Nicotine? A Review of the Role of Nicotine in Dermatologic Surgery

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