Lucky break: Quit smoking after fracture surgery for better healing

Jun 01, 2010

Smokers who refrain from using tobacco during the six-week period following emergency surgery for an acute fracture heal more quickly and experience fewer complications than patients who continue to smoke during the healing process, according to a study published in the June 2010 issue of The Journal of Bone and Joint Surgery (JBJS).

"Our results indicate that a intervention program during the first six weeks after acute fracture surgery decreases the risk of by nearly half," said Hans Nľsell, MD, senior surgical consultant, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.

While earlier research has clearly indicated refraining from smoking prior to surgery results in better healing and fewer postoperative complications, this multi-center, randomized study was the first to examine the effects of smoking cessation following surgery.

" smoking is a major health and economic concern and also is known to have a significant negative effect on surgical outcomes," Dr. Nľsell said. "The benefits of a smoking cessation program prior to elective surgery are well known, but there have not been any studies about the benefit of smoking cessation following emergency surgery. Our aim was to assess whether a smoking cessation program, started soon after hospitalization and continuing for six weeks following surgery, could reduce the number of postoperative complications."

In the study, conducted at three hospitals in Stockholm, daily smokers who underwent emergency surgery for an acute fracture were offered a smoking cessation program within two days of surgery, and then followed for six weeks.

Patients included in the program were offered one or two in-person meetings, in addition to regular telephone contact with a nurse trained in the cessation program. During the six-week follow-up, patients were encouraged not to smoke and free nicotine substitution was offered to those who needed it.

Up until this point, the belief was that you needed to stop smoking prior to surgery to gain any benefit," Dr. Nľsell said. "It was surprising, and encouraging, to see that even stopping smoking following surgery for a period of time can offer significant benefits, including nearly a 50 percent reduction in wound complications.

"The smoking cessation program requires only about two to three hours of support from the nursing staff, which is significantly less time than would be required for the treatment of side effects such as poor wound healing which can occur as a side effect of smoking," he added.

Smoking inhibits circulation and lowers blood oxygen levels, which can affect short-term and long-term healing in several ways, including:

  • failure or delayed healing of bone, skin and other soft tissues; or
  • causing wound site infections.
"In elective surgery, smoking cessation can become part of a plan preoperatively to reduce risks during and after surgery," noted Dr. Nľsell. "But with emergency surgery, such as acute fracture surgery, stopping smoking before surgery is not an option. Therefore, it's very encouraging to see that stopping smoking following surgery offers some of the same benefits as preoperative smoking cessation."

Dr. Nľsell said he hopes the results of the study will encourage hospitals and clinics to begin offering smoking cessation programs routinely to patients undergoing emergency surgery. He also added that in Sweden, hospitals are required by The National Board of Health and Welfare to offer a smoking cessation program as an option to any patient undergoing surgery, whether planned or emergency.

"Other studies have shown that most individuals who smoke would like to quit," he noted. "Having a smoking cessation program available to all patients pre-surgery can serve as a motivator to get them to quit. Even though this intervention lasts for six weeks, it may be all that is needed to help patients quit for good."

Explore further: A new approach to cut death toll of young people in road accidents

add to favorites email to friend print save as pdf

Related Stories

It pays to quit smoking before surgery

Sep 03, 2009

People who start nicotine replacement therapy at least four weeks before surgery can halve their risk of poor wound healing. This is what the German Institute for Quality and Efficiency in Health Care (IQWiG) concludes in ...

Recommended for you

Sensors may keep hospitalized patients from falling

8 hours ago

(Medical Xpress)—To keep hospitalized patients safer, University of Arizona researchers are working on new technology that involves a small, wearable sensor that measures a patient's activity, heart rate, ...

Rising role seen for health education specialists

10 hours ago

(HealthDay)—A health education specialist can help family practices implement quality improvement projects with limited additional financial resources, according to an article published in the March/April ...

User comments : 0

More news stories

Autism Genome Project delivers genetic discovery

A new study from investigators with the Autism Genome Project, the world's largest research project on identifying genes associated with risk for autism, has found that the comprehensive use of copy number variant (CNV) genetic ...

Team reprograms blood cells into blood stem cells in mice

Researchers at Boston Children's Hospital have reprogrammed mature blood cells from mice into blood-forming hematopoietic stem cells (HSCs), using a cocktail of eight genetic switches called transcription factors. The reprogrammed ...

Study links California drought to global warming

While researchers have sometimes connected weather extremes to man-made global warming, usually it is not done in real time. Now a study is asserting a link between climate change and both the intensifying California drought ...