Urinary cotinine testing as pre-operative assessment of patients undergoing free flap surgery

Reinbold, C.; Rausky, J.; Binder, J.-P.; Revol, M.

doi:10.1016/j.anplas.2014.10.002

Cited by 19 publications

(3 citation statements)

References 46 publications

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“…Because of our significant complication rate in smokers, testing patients for preoperative smoking (cotinine urine test) can be considered. 25 The surgeon must encourage abstinence of smoking for at least 6 to 8 weeks before intervention and make sure the patient fully understands the risks of smoking.…”

Section: Discussionmentioning

confidence: 99%

Complications of Lower Body Lift Surgery in Postbariatric Patients

Poodt

Dijk

Klein

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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Background:There is an exponential rise of patients with massive weight loss because of bariatric surgery or lifestyle changes. The result is an increase of patients with folds of redundant skin that may cause physical and psychological problems. The lower body lift is a procedure to correct deformities in the abdomen, mons, flanks, lateral thighs, and buttocks. Complication rates are quite high and could negatively affect the positive outcomes. The purpose of this study is to assess complication rates and to identify predictors of complications to optimize outcomes for patients after lower body lift surgery.Methods:A retrospective analysis of 100 patients who underwent a lower body lift procedure was performed. The patients were reviewed for complications, demographic data, comorbidities, smoking, highest lifetime body mass index, body mass index before lower body lift surgery, percentage of excess weight loss, and amount of tissue excised.Results:The overall complication rate was 78%. Twenty-two percent of the patients had major complications and 56% had minor complications. There is a linear relationship between body mass index before lower body lift surgery and complications (P = 0.03). The percentage of excess weight loss (odds ratio [OR] 0.97; 95% confidence interval [CI] 0.92–1.00), highest lifetime body mass index (OR 1.08; 95% CI 1.01–1.15), body mass index before lower body lift surgery (OR 1.17; 95% CI 1.02–1.33), and smoking (OR 7.74; CI 0.98–61.16) are significantly associated with the development of complications.Conclusions:This study emphasizes the importance of a good weight status before surgery and cessation of smoking to minimize the risk of complications.

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Section: Discussionmentioning

confidence: 99%

Complications of Lower Body Lift Surgery in Postbariatric Patients

Poodt

Dijk

Klein

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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“…The recommendation for 6 weeks is based on plastic surgery recommendations and includes a mandatory 6-week period of nicotine abstinence and preoperative testing of plasma or urinary cotinine, a nicotine metabolite (Reinbold et al 2015). However, for smoking as a risk factor for pulmonary complications, it is generally agreed that any period of cessation can help reduce pulmonary complications, with “the longer, the better” being preferable.…”

Section: Methodsmentioning

confidence: 99%

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on prevention of postoperative infection within an enhanced recovery pathway for elective colorectal surgery

Holubar

Hedrick²,

Gupta

et al. 2017

Perioper Med

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BackgroundColorectal surgery (CRS) patients are an at-risk population who are particularly vulnerable to postoperative infectious complications. Infectious complications range from minor infections including simple cystitis and superficial wound infections to life-threatening situations such as lobar pneumonia or anastomotic leak with fecal peritonitis. Within an enhanced recovery pathway (ERP), there are multiple approaches that can be used to reduce the risk of postoperative infections.MethodsWith input from a multidisciplinary, international group of experts and through a focused (non-systematic) review of the literature, and use of a modified Delphi method, we achieved consensus surrounding the topic of prevention of postoperative infection in the perioperative period for CRS patients.DiscussionAs a part of the first Perioperative Quality Initiative (POQI-1) workgroup meeting, we sought to develop a consensus statement describing a comprehensive, yet practical, approach for reducing postoperative infections, specifically for CRS within an ERP. Surgical site infection (SSI) is the most common postoperative infection. To reduce SSI, we recommend routine use of a combined isosmotic mechanical bowel preparation with oral antibiotics before elective CRS and that infection prevention strategies (also called bundles) be routinely implemented as part of colorectal ERPs. We recommend against routine use of abdominal drains. We also give consensus guidelines for reducing pneumonia, urinary tract infection, and central line-associated bloodstream infection (CLABSI).

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“…235 The ethics of this requirement have been questioned for nonelective procedures, 261 and it has not been reported outside of elective orthopedic and plastic surgery, where concerns for wound-or bone-related complications are especially acute. Biochemical verification of preoperative smoking status can be readily performed using exhaled carbon monoxide or urinary cotinine (a metabolite of nicotine) [262][263][264] ; evidence is mixed as to whether verification itself increases the likelihood of quitting. 238,252 Other Simple tactics can Facilitate treatment…”

Section: Advice To Quit Is Foundationalmentioning

confidence: 99%

Anesthesiologists and the Other Pandemic: Tobacco Use

Warner

2022

Anesthesiology

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Tobacco use will kill a projected 1 billion people in the 21st century in one of the deadliest pandemics in history. Tobacco use disorder is a disease with a natural history, pathophysiology, and effective treatment options. Anesthesiologists can play a unique role in fighting this pandemic, providing both immediate (reduction in perioperative risk) and long-term (reduction in tobacco-related diseases) benefits to their patients who are its victims. Receiving surgery is one of the most powerful stimuli to quit tobacco. Tobacco treatments that combine counseling and pharmacotherapy (e.g., nicotine replacement therapy) can further increase quit rates and reduce risk of morbidity such as pulmonary and wound-related complications. The perioperative setting provides a great opportunity to implement multimodal perianesthesia tobacco treatment, which combines multiple evidence-based tactics to implement the four core components of consistent ascertainment and documentation of tobacco use, advice to quit, access to pharmacotherapy, and referral to counseling resources.

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Urinary cotinine testing as pre-operative assessment of patients undergoing free flap surgery

Cited by 19 publications

References 46 publications

Complications of Lower Body Lift Surgery in Postbariatric Patients

Complications of Lower Body Lift Surgery in Postbariatric Patients

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on prevention of postoperative infection within an enhanced recovery pathway for elective colorectal surgery

Anesthesiologists and the Other Pandemic: Tobacco Use

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