Risk of Respiratory Complications and Wound Infection in Patients Undergoing Ambulatory Surgery

Abstract

Smoking was associated with an increased risk of respiratory complications and postoperative wound infection in ambulatory surgery patients. These findings warrant increased efforts at promoting smoking avoidance and cessation.

Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis

“…42,43 There were 14 studies from North America, 12,21,23,26,[30][31][32][33][34][35]37,[39][40][41] six from Europe, 22,27,28,38,42,43 four from Asia, 20,25,29,36 and one from Australia. 24 There were more male than female smokers, and smokers were younger than non-smokers or ex-smokers in many of the studies. The type of surgery, definition of complications, duration of smoking cessation, and the definition of ''nonsmokers'', ''ex-smokers'', and ''current smokers'' reported in the individual studies varied between studies.…”

“…1). There were seven prospective cohort studies, 12,[20][21][22][23][24][25] 16 retrospective cohort studies, [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] and two RCTs (Table 1). 42,43 Both RCTs offered nicotine replacement therapy.…”

“…Four studies used biochemical methods, including exhaled carbon monoxide and urinary cotinine concentrations, to validate the smoking status of the patients. 12,24,42 Four studies had comparable groups among smokers, ex-smokers, and non-smokers. 43 Six of the observational studies adjusted for potential confounders ( Table 1).…”

“…12,20,22,[27][28][29][30][33][34][35][36][37][38]40 The outcome assessor for postoperative complications was blinded to the smoking status of the patients in only five of the studies. 12,29,36,42,43 All five studies reporting the source of funding received public funding, 21,24,36,42,43 and the nicotine replacement products were provided by the manufacturers (Table 1). 42,43 Respiratory complications Fifteen studies involving 19,323 patients reported respiratory complications (Table 2, available as electronic supplemental material [ESM]).…”

Smoking cessation interventions in the pre-admission clinic: assessing two approaches

“…Smokers have a higher incidence of postoperative pulmonary complications than non-smokers, 1 and smoking is associated with impaired wound healing and increased incidence of infection. 2,3 Hospitalization and the period of forced cessation it entails is often characterized as a ''window of opportunity'' for delivering cessation interventions. 4,5 Hospital-based smoking cessation interventions are effective, and even brief advice delivered by a health professional can enhance quit rates.…”