Cigarette smoking increases complication rate in forefoot surgery

Clayton C. Bettin, Kellen Gower, Kelly McCormick, Jim Wan, Susan N. Ishikawa, David R. Richardson, G. Andrew Murphy

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Cigarette smoking is known to increase perioperative complication rates, but no study to date has examined its effect specifically in forefoot surgery. The purpose of this study was to determine whether cigarette smoking increased complications after forefoot surgery. Methods: The records of 602 patients who had forefoot surgery between 2008 and 2010, and for whom smoking status was known, were reviewed. Patients were categorized into 3 groups based on smoking status: active smoker, smoker in the past, or nonsmoker. Medical records were reviewed for occurrence of complications, including nonunion, delayed union, delayed wound healing, infection, and persistent pain. Results: Active smokers were found to have a notably higher complication rate (36.4%) after forefoot surgery than patients who previously (16.5%) or never (8.5%) smoked. Patients who continued to smoke in the perioperative period had the highest percentage of delayed union (3.0%), infection (9.1%), delayed wound healing (10.6%), and persistent pain (15.2%). Active cigarette smokers were 4.3 times more likely to have a complication than nonsmokers. Patients who smoked at any point in the past but quit prior to surgery were 1.9 times more likely than nonsmokers to incur a complication. The average time of smoking cessation for patients who had smoked at any point in the past but had quit prior to surgery was 17 years. For active smokers, those with a complication smoked an average of 18 cigarettes daily, while those without a complication smoked 14 cigarettes daily. Conclusions: Before forefoot surgery, surgeons should educate patients who smoke about their increased risk of complications and encourage smoking cessation.

Original languageEnglish (US)
Pages (from-to)488-493
Number of pages6
JournalFoot and Ankle International
Volume36
Issue number5
DOIs
StatePublished - May 11 2015
Externally publishedYes

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Smoking
Tobacco Products
Smoking Cessation
Smoke
Wound Healing
Pain
Perioperative Period
Wound Infection
Medical Records
Infection

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Bettin, C. C., Gower, K., McCormick, K., Wan, J., Ishikawa, S. N., Richardson, D. R., & Murphy, G. A. (2015). Cigarette smoking increases complication rate in forefoot surgery. Foot and Ankle International, 36(5), 488-493. https://doi.org/10.1177/1071100714565785

Cigarette smoking increases complication rate in forefoot surgery. / Bettin, Clayton C.; Gower, Kellen; McCormick, Kelly; Wan, Jim; Ishikawa, Susan N.; Richardson, David R.; Murphy, G. Andrew.

In: Foot and Ankle International, Vol. 36, No. 5, 11.05.2015, p. 488-493.

Research output: Contribution to journalArticle

Bettin, CC, Gower, K, McCormick, K, Wan, J, Ishikawa, SN, Richardson, DR & Murphy, GA 2015, 'Cigarette smoking increases complication rate in forefoot surgery', Foot and Ankle International, vol. 36, no. 5, pp. 488-493. https://doi.org/10.1177/1071100714565785
Bettin CC, Gower K, McCormick K, Wan J, Ishikawa SN, Richardson DR et al. Cigarette smoking increases complication rate in forefoot surgery. Foot and Ankle International. 2015 May 11;36(5):488-493. https://doi.org/10.1177/1071100714565785
Bettin, Clayton C. ; Gower, Kellen ; McCormick, Kelly ; Wan, Jim ; Ishikawa, Susan N. ; Richardson, David R. ; Murphy, G. Andrew. / Cigarette smoking increases complication rate in forefoot surgery. In: Foot and Ankle International. 2015 ; Vol. 36, No. 5. pp. 488-493.
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