Document Detail


Plastic surgery and smoking: a prospective analysis of incidence, compliance, and complications.
MedLine Citation:
PMID:  23358000     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Tobacco use remains a persistent risk factor in elective plastic surgery. Although nicotine is thought to increase complications, which procedures are affected and the reliability of patient-provided histories remain poorly defined. The authors sought to examine nicotine use and its impact on outcomes.
METHODS: All patients in a single-surgeon practice undergoing surgery with general anesthesia during a 2-year period were enrolled. Preoperative evaluation included a thorough smoking history. All patients had urine samples taken on the day of surgery to assess for nicotine metabolites. Patients were followed for a minimum of 3 months after surgery and monitored for complications.
RESULTS: Four hundred fifteen patients were enrolled. Of these, 139 (33.5 percent) stated that they had quit smoking and 39 (9.4 percent) were admitted active smokers. For the 362 patients with urine nicotine analysis available, 54 showed active smoking. Fifteen of these (4.1 percent) had denied current tobacco use. Patients stating that they had quit smoking were more likely to be deceitful than those stating they had never smoked (p < 0.001). Smokers had significantly higher overall complication rates (OR, 3.7; p < 0.001) and tissue necrosis rates (OR, 4.3; p = 0.02) and were likelier to require reoperation (OR, 3.7; p < 0.001).
CONCLUSIONS: In a large cohort study examining the prevalence and impact of nicotine in the general plastic surgery population, substantial rates of deception regarding smoking status were found. Furthermore, active smoking was strongly correlated with complications. A methodologic approach to the detection and management of patients using tobacco products can help to optimize outcomes.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.
Authors:
Devin Coon; Sami Tuffaha; Joani Christensen; Steven C Bonawitz
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  131     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-29     Completed Date:  2013-04-01     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  385-91     Citation Subset:  AIM; IM    
Affiliation:
Department of Plastic and Reconstructive Surgery, The Johns Hopkins Medical Institutions, Baltimore, Md 21287, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Humans
Incidence
Nicotine / urine
Patient Compliance / statistics & numerical data*
Postoperative Complications / epidemiology*,  etiology*,  urine
Predictive Value of Tests
Prospective Studies
Reconstructive Surgical Procedures*
Smoking / adverse effects*,  urine
Smoking Cessation*
Chemical
Reg. No./Substance:
54-11-5/Nicotine
Comments/Corrections
Comment In:
Plast Reconstr Surg. 2013 Oct;132(4):687e   [PMID:  24076734 ]
Plast Reconstr Surg. 2013 Oct;132(4):686e-687e   [PMID:  24076733 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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