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Cited by 551Surgical site infection preventionWound Healing and TreatmentsSmoking Behavior and Cessation

Abstinence From Smoking Reduces Incisional Wound Infection: A Randomized Controlled Trial

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Sorensen, Lars Tue, Karlsmark, Tonny, Gottrup, Finn·2003·Annals of Surgery
DOI 10.1097/01.sla.0000074980.39700.31PMC PMC1422652
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Abstract

OBJECTIVE: Clinical studies show that the incidence of postoperative wound complications is higher in smokers than nonsmokers. In this study, we evaluated the effect of abstinence from smoking on incisional wound infection. METHODS: Seventy-eight healthy subjects (48 smokers and 30 never-smokers) were included in the study and followed for 15 weeks. In the first week of the study, the smokers smoked 20 cigarettes per day. Subsequently, they were randomized to continuous smoking, abstinence with transdermal nicotine patch (25 mg per day), or abstinence with placebo patch. At the end of the first week and 4, 8, and 12 weeks after randomization, incisional wounds were made lateral to the sacrum to excise punch biopsy wounds. At the same time identical wounds were made in 6 never-smokers. In 24 never-smokers a wound was made once. All wounds were followed for 2 weeks for development of wound complications. RESULTS: A total of 228 wounds were evaluated. In smokers the wound infection rate was 12% (11 of 93 wounds) compared with 2% (1 of 48 wounds) in never-smokers (P <0.05). Wound infections were significantly fewer in abstinent smokers compared with continuous smokers after 4, 8, and 12 weeks after randomization. No difference between transdermal nicotine patch and placebo was found. CONCLUSIONS: Smokers have a higher wound infection rate than never-smokers and 4 weeks of abstinence from smoking reduces the incidence of wound infections.

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  • Doctors avoid performing surgery on patients who smoke due to known complications in clot formation, healing times and the quality of healing.

    “Doctors avoid performing surgery on patients who smoke due to known complications in clot formation, healing times and the quality of healing [12,38].”

    From Tobacco toxins deposited on surfaces (third hand smoke) impair wound healing (2016) · cites this paper as [12]

    The Discussion (page unavailable) reports more incisional wound infections and ruptures in smokers than in never-smokers, supporting the claim that smoking compromises surgical wound healing. The paper does not establish that doctors avoid operating on smokers, or report complications in clot formation or healing times. (LLM, conf=0.86)

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Research works printed but not linked: 25

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Cited by

Sorted by citations

Authors
Sorensen, L. T., Karlsmark, T., & Gottrup, F.
Corresponding author
  • Karlsmark, Tonny
  • Gottrup, Finn
Venue
Annals of Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2003-07
Volume
238
Issue
1
Pages
1-5
ISSN
0003-4932 (ISSN-L)
DOI
10.1097/01.sla.0000074980.39700.31
PMC
PMC1422652
OpenAlex
W1998522796
Cited by
551
References
1
Citations by year
2026: 16 · 2025: 16 · 2024: 15 · 2023: 21 · 2022: 31 · 2021: 25 · 2020: 24 · 2019: 33 · 2018: 38 · 2017: 25 · 2016: 32 · 2015: 26 · 2014: 36 · 2013: 35 · 2012: 34
FWCI
15.38
Type
journal article
Language
en
Open access
Locations
  • Annals of Surgery (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (n01dk002400-003)
  • National Institute of Diabetes and Digestive and Kidney Diseases (N01 DK002400)
Topics
  • Health Sciences › Medicine › Surgery › Surgical site infection prevention
  • Health Sciences › Medicine › Rehabilitation › Wound Healing and Treatments
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Keywords
smoking abstinence, incisional infection, postoperative wound complications, smokers, nicotine patch, wound healing
MeSH terms
Adult, Hypoxia, Female, Humans, Male, Smoking, Surgical Wound Infection, Time Factors, Wound Healing, Incidence, Smoking Cessation

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