Does Cigarette Smoking Harm Microsurgical Free Flap Reconstruction?

Denis Ehrl; Paul I. Heidekrueger; Elisabeth M. Haas; Michaela Coenen; Riccardo Giunta; Milomir Ninkovic; P. Niclas Broer

doi:10.1055/s-0038-1639377

Journal of Reconstructive Microsurgery, Table of Contents

J Reconstr Microsurg 2018; 34(07): 492-498
DOI: 10.1055/s-0038-1639377

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Does Cigarette Smoking Harm Microsurgical Free Flap Reconstruction?

Denis Ehrl

¹Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Germany

²Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Teaching Hospital, Munich, Germany

,

Paul I. Heidekrueger

²Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Teaching Hospital, Munich, Germany

³Department of Plastic, Hand, and Reconstructive Surgery, University Medical Center Regensburg, Germany

,

Elisabeth M. Haas

¹Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Germany

,

Michaela Coenen

⁴Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University Munich, Germany

,

Riccardo Giunta

¹Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Germany

,

Milomir Ninkovic

²Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Teaching Hospital, Munich, Germany

,

P. Niclas Broer

²Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Teaching Hospital, Munich, Germany

› Author Affiliations

Abstract

Background Free tissue transfers can successfully address a wide range of reconstructive requirements. While the negative influence of cigarette smoking is well documented, its effects in the setting of microsurgical free flap reconstruction remain debated. This study evaluates the impact of cigarette smoking on microsurgical reconstructions.

Methods Over a 7-year period, 897 patients underwent 969 microvascular free flap reconstructions at a single surgical center. The cases were divided into “smoker” (S) and “nonsmoker” (NS) groups according to their cigarette smoking status. The data were retrospectively screened for patients' demographics, perioperative details, surgical complications, free flap types, recipient sites, flap survival, and overall outcomes.

Results Both groups were comparable regarding comorbidities including hypertension, peripheral artery disease, diabetes, American Society of Anesthesiologists scores, types of performed free flaps, and recipient sites. While patients in the NS group were significantly older and had a higher prevalence of obesity (p < 0.05), there were no significant differences regarding the rate of major or minor complications during our 3-month follow-up period (p > 0.05).

Conclusion While minor and major complications were increased regarding virtually all examined parameters, cigarette smoking did not have significant effects on the overall outcomes of microsurgical free flap reconstructions.

Keywords

cigarette smoking - nicotine - free flap reconstruction

Full Text

References

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