Impact of smoking cessation on healing after foot and ankle surgery

Rozinthe, Anouk; Ode, Quentin; Subtil, Fabien; Fessy, Michel‐Henri; Besse, Jean-Luc

doi:10.1016/j.otsr.2022.103338

Cited by 6 publications

(1 citation statement)

References 26 publications

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“… 5 Tobacco smoking has been associated with massively increased rates of wound complications, with one retrospective cohort reporting a wound complication rate of 36.4% in smokers undergoing forefoot surgery compared to a rate of 8.5% for nonsmokers. 17 Cessation of smoking 6 weeks prior to surgery and for at least 3 months after surgery diminishes a patient’s risk for postoperative wound complications. 19 These modifiable and nonmodifiable host risk factors were evident in the current study as 4 of the 5 patients who had wound complications had comorbidities (2 smokers and 2 diabetes patients).…”

Section: Discussionmentioning

confidence: 99%

A Prospective Evaluation for a Possible Safe Skin Bridge in Elective Foot Surgery

Moore,

Saragas,

Ferrao

2024

Foot & Ankle Orthopaedics

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Background: In foot and ankle surgery, adequate surgical exposure often requires multiple incisions to be used near one another, thus creating a skin bridge. As the skin bridge becomes narrower, the wound edge vitality is potentially compromised and therefore the wound’s ability to heal. The impact of local, host, and surgical factors on wound healing are well documented in the literature; however, little is known about the role of the skin bridge. The aim of this study is to determine if there is a recommendable safe skin bridge in elective foot and ankle surgery. Methods: A prospective study was performed on 56 patients with 60 feet who had elective foot surgery. The length of each incision and distance between the incisions were recorded. The wounds were assessed for complications at 2, 4, and 6 weeks after surgery. Patient demographics and host risk factors were documented. Results: The average incision length was 5.5 (range: 3-8.5) cm. The average skin bridge was 3.9 (range: 2-6.8) cm. Five (8.3%) of the 60 feet developed a wound complication. Four (80%) of these patients had a known comorbidity. Two patients had diabetes and 2 were smokers. The incidence of relevant comorbidities was 5.5% (n = 3) for patients without a wound complication ( P < .001). Age did not differ significantly between patients with and without a wound complication. Patients with a wound complication had significantly longer incision lengths ( P = .047). There was no significant independent association between skin bridge width and risk of wound complications ( P > .05) with skin bridge widths of 2 cm or larger. Conclusion: In this relatively small cohort of 60 elective operative foot surgeries, we did not find increased wound complications in skin bridges 2 cm or larger, when meticulous surgical technique is practiced and host risk factors are optimized. Level of Evidence: Level III, prospective case control study.

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Section: Discussionmentioning

confidence: 99%