Is e-Cigarette Vaping a New Clinical Challenge to Wound Healing?

Desai, Shaun C.

doi:10.1001/jamafacial.2018.1280

Cited by 8 publications

(1 citation statement)

References 7 publications

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“…44 Anecdotal experiences and the existing literature suggests a detrimental effect of e-cigarette use perioperatively. 40,43,50 Although there is a relative paucity of evidence, it is important to differentiate ENDS from other forms of NRT when counseling patients and when conducting future research.…”

Section: Electronic Nicotine Delivery Systems Basic Science (Evidence...mentioning

confidence: 99%

Is There a Smoking Gun for Nicotine? A Review of the Role of Nicotine in Dermatologic Surgery

2022

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BACKGROUND Dermatologic surgeons are faced with a dilemma when counseling actively smoking patients who require dermatologic surgery: recommend total cessation of all nicotine that is associated with extremely high rates of cessation failure or recommend nicotine replacement therapy (NRT). OBJECTIVE To determine the safety of NRT in dermatologic surgery. MATERIALS AND METHODS PubMed was queried: [(nicotine OR electronic cigarettes) AND (flap OR wound healing)]. RESULTS Smoking tobacco is detrimental to wound healing, supported by ample evidence (1A). Perioperative smoking cessation reduces risk (1B). Basic science demonstrates both a benefit and detriment of nicotine depending on the factor studied (2A). Human studies suggest no detrimental effect of nicotine on perioperative complications (1B). Nicotine may be detrimental to flaps, but evidence is limited to basic science (2A). CONCLUSION Dermatologists should consider recommending nicotine replacement for smokers in the perioperative period. Evidence is lacking to determine safety in flaps. It is presumed based on animal studies that nicotine has a negative effect on flaps; however, it is likely less than tobacco. Weighing the risk of cessation failure without nicotine replacement versus nicotine replacement after flap is challenging. Electronic cigarettes should be discouraged as a means of NRT.

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