Smoking and postoperative complications

Authors: J. Zajak 1;  E. Králíková 2,3;  P. Pafko 1;  Z. Bortlíček 4
Authors‘ workplace: III. chirurgická klinika 1. LF UK a FN Motol, přednosta: Prof. MUDr. R. Lischke, PhD 1;  Ústav hygieny a epidemiologie 1. LF UK a VFN, přednosta: Doc. MUDr. M. Tuček, CSc. 2;  Centrum pro závislé na tabáku III. interní kliniky – kliniky endokrinologie a metabolismu 1. LF UK a VFN, přednosta: prof. MUDr. Š. Svačina, DrSc., MBA 3;  Institut biostatistiky a analýz, Masarykova univerzita, Brno, ředitel: Doc. RNDr. L. Dušek, Ph. D. 4
Published in: Rozhl. Chir., 2013, roč. 92, č. 9, s. 501-505.
Category: Original articles


Smoking has a negative impact on the outcome of surgical procedures. Smoking leads to higher risk of postoperative complications and it delays wound healing.

Materials and methods:
We observed pulmonary complications, wound healing complications, and the length of the postoperative hospitalization period of 877 patients admitted for elective surgery.. Patients were divided according to their smoking status in to 3 groups: the current smokers were 32% (279/877), the former smokers 31% (274/877) and the non-smokers 37% (324/877).

Pulmonary complications occurred more frequently in the smoking group (3.9%) compared to the non-smoking group (0.9%), p<0,001. The incidence of wound infections was 7.5% in the smoking group compared to 4.6% in the non-smoking group. Wound dehiscence occurred in 3.6% patients in the smoking group, respectively 2.8% in the non-smoking group, without statistical significance. The number of postoperative hospitalisation days was 3 days for both smokers and non-smokers, but it decreased inversely to number of smoke-free days before the surgery for those who stopped smoking: those abstinent for 31–90 days were hospitalized for 7.0 days, those abstinent for 91–183 were hospitalized for 5.5 days, and for those abstinent over 184 days the postoperative hospitalization was, again, 3 days. Among the current smokers, 93% preferred to stay smoke-free after the surgery.

Our results support better surgery outcomes for non-smokers. However, our sample was not large enough to assess the impact of the number of preoperative smoke-free days. An elective surgery seems to be an unused occasion to motivate smokers to stop smoking, preferably, as soon as possible before the surgery date.

Key words:
Elective surgery – smoking, pulmonary complications – wound healing, infection.


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Surgery Orthopaedics Trauma surgery
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