Smoking-the Bane of Wound Healing

Ahn, Chulhyun; Mulligan, Peter; Salcido, Richard

doi:10.1097/01.asw.0000305440.62402.43

Cited by 70 publications

(29 citation statements)

References 53 publications

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“…Inducers of chronic inflammatory states such as smoking have long been established as a risk factor for wound healing. 19 however, our sensitivity analyses reveal that it is unlikely that these are playing a significant role in the observed outcomes. Furthermore, it is important to note that the lower rates of postoperative complications in pre-emptive DD group in this investigation, as mentioned previously, is likely a finding secondary to low sample size in this group.…”

Section: Discussionmentioning

confidence: 73%

“…Again, this may in part be explained by the chronic inflammatory state related to ESRD etiology and dialysis may also contribute to higher rates of urine leak observed in the post‐dialysis LD and DD groups. Inducers of chronic inflammatory states such as smoking have long been established as a risk factor for wound healing . Similarly, patients with chronic kidney disease have also been identified as a player in wound healing through variety of mechanisms including keratinization kinetics, delayed rate of granulation, large epithelial gaps, and underlying chronic inflammatory states .…”

Section: Discussionmentioning

confidence: 99%

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Assessment of perioperative surgical complications in pediatric kidney transplantation: A comparison of pre‐emptive and post‐dialysis recipients

Kim

Lorenzo

Farhat

et al. 2018

Clinical Transplantation

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Purpose To determine whether there is a benefit to pre‐emptive kidney transplantation in reducing surgical complications in pediatric population. Methods A retrospective review of kidney transplantations in our institution from 2000 to 2015 was performed. Intra‐ and postoperative complication rates and one‐year graft survival were compared in their respective donor type groups (pre‐emptive DD vs post‐dialysis DD; pre‐emptive LD vs post‐dialysis LD). Results A total of 318 patients were identified (pre‐emptive DD, n = 21; post‐dialysis DD, n = 145; pre‐emptive LD, n = 54; post‐dialysis LD, n = 98). Between the DD groups, post‐dialysis DD group was more likely to be female (P = 0.017). There was no difference in rates of intraoperative complications or graft loss (P = 0.365 and 1.000, respectively). Post‐dialysis DD groups were more likely to have postoperative complications (9.5% vs 35.1%, P = 0.023), but no difference in complications with Clavien‐Dindo grade 3 or higher was found (P = 0.130). Between the LD groups, post‐dialysis LD group was more likely to be females (P = 0.017) and with intrinsic renal (non‐urological/structural) ESRD etiology (P = 0.003). There was no difference in rates of intra‐and postoperative complications or graft loss (P = 0.353, P = 0.605, and P = 0.616, respectively). Conclusions Overall, there are similar perioperative complication rates between pediatric pre‐emptive and post–dialysis kidney transplant recipients.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Assessment of perioperative surgical complications in pediatric kidney transplantation: A comparison of pre‐emptive and post‐dialysis recipients

Kim

Lorenzo

Farhat

et al. 2018

Clinical Transplantation

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“…The primary toxins associated with impaired wound healing are nicotine and the gases carbon monoxide and hydrogen cyanide. 46 The definitive mechanisms through delay healing are not understood, but all have been shown to impair oxygen supply to tissues. 42,47,48 …”

Section: Smoking and Wound Healingmentioning

confidence: 99%

“…Carbon monoxide has a 200 times greater affinity to bind hemoglobin than oxygen. 46,47 As a result of a shift to the left in the oxygen dissociation curve, oxygenated hemoglobin in the bloodstream is reduced resulting in impaired tissue profusion and cellular hypoxia. 52,57 Hydrogen cyanide also affects tissue oxygenation by impeding cellular oxygen metabolism via inhibition of the enzyme system necessary for this metabolic process.…”

Section: Smoking and Wound Healingmentioning

confidence: 99%

Smoking, Chronic Wound Healing, and Implications for Evidence-Based Practice

McDaniel

Browning

2014

Journal of Wound, Ostomy &Amp; Continence Nursing

133

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Chronic wounds are rising in prevalence and creating significant socioeconomic burdens for patients and healthcare systems worldwide. Therefore, it is now more important than ever that clinicians follow evidence-based guidelines for wound care when developing personalized treatment plans for their patients with chronic wounds. Evidence-based guidelines for treating venous leg ulcers, diabetic foot ulcers, and pressure ulcers, the 3 main categories of chronic wounds, focus primarily on biologic therapies. However, there are also evidence-based guidelines for treating behavioral risks to poor healing, such as smoking, which should be incorporated into treatment plans when appropriate. The purpose of this article was to review the mechanisms through which smoking adversely impacts the wound healing process, and propose strategies for incorporating evidence-based guidelines for treating tobacco dependence into treatment plans for patients with chronic wounds who smoke.

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“…Continued tobacco use can have devastating effects on recovery from surgery, such as increased risk of postoperative infection [32-34], wound and flap necrosis [35], and a decrease in the tensile strength of wounds [36]. The benefits of abstinence after surgery are clear, with a review of 20 studies finding significantly fewer complications in former smokers when compared to current smokers postoperation [32].…”

Section: Introductionmentioning

confidence: 99%

Who is More Likely to Use the Internet for Health Behavior Change? A Cross-Sectional Survey of Internet Use Among Smokers and Nonsmokers Who Are Orthopedic Trauma Patients

et al. 2017

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BackgroundeHealth presents opportunities to provide population groups with accessible health interventions, although knowledge about Internet access, peoples’ interest in using the Internet for health, and users’ characteristics are required prior to eHealth program development.ObjectiveThis study surveyed hospital patients to examine rates of Internet use, interest in using the Internet for health, and respondent characteristics related to Internet use and interest in using the Internet for health. For patients who smoke, preferences for types of smoking cessation programs for use at home and while in hospital were also examined.MethodsAn online cross-sectional survey was used to survey 819 orthopedic trauma patients (response rate: 72.61%, 819/1128) from two public hospitals in New South Wales, Australia. Logistic regressions were used to examine associations between variables.ResultsA total of 72.7% (574/790) of respondents had at least weekly Internet access and more than half (56.6%, 357/631) reported interest in using the Internet for health. Odds of at least weekly Internet usage were higher if the individual was born overseas (OR 2.21, 95% CI 1.27-3.82, P=.005), had a tertiary education (OR 3.75, 95% CI 2.41-5.84, P<.001), or was a nonsmoker (OR 3.75, 95% CI 2.41-5.84, P<.001). Interest in using the Internet for health increased with high school (OR 1.85, 95% CI 1.09-3.15, P=.02) or tertiary education (OR 2.48, 95% CI 1.66-3.70, P<.001), and if household incomes were more than AUS $100,000 (OR 2.5, 95% CI 1.25-4.97, P=.009). Older individuals were less interested in using the Internet for health (OR 0.98, 95% CI 0.97-0.99, P<.001).ConclusionsOnline interventions may be a potential tool for health care in this hospitalized population.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614001147673; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366829&isReview=true (Archived by WebCite at http://www.webcitation.org/6qg26u3En)

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Smoking-the Bane of Wound Healing

Abstract: After reading this article and taking this test, the reader should be able to: 1. Describe the physiologic relationship between smoking and wound healing. 2. Discuss the phenomenon of smoking addiction and both pharmacologic and behavioral approaches to smoking cessation.

Cited by 70 publications

References 53 publications

Assessment of perioperative surgical complications in pediatric kidney transplantation: A comparison of pre‐emptive and post‐dialysis recipients

Assessment of perioperative surgical complications in pediatric kidney transplantation: A comparison of pre‐emptive and post‐dialysis recipients

Smoking, Chronic Wound Healing, and Implications for Evidence-Based Practice

Who is More Likely to Use the Internet for Health Behavior Change? A Cross-Sectional Survey of Internet Use Among Smokers and Nonsmokers Who Are Orthopedic Trauma Patients

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