Bikhchandani J, Varma S K, Henderson H P
Department of Plastic & Reconstructive Surgery, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK.
J Plast Reconstr Aesthet Surg. 2007;60(9):1050-4. doi: 10.1016/j.bjps.2007.01.073. Epub 2007 May 21.
There are several studies in the literature suggesting that smoking increases the complication rate in various plastic surgery operations. We did a study on 402 patients to see the effect of smoking on breast reduction. The objective was to raise the controversial issue of whether breast reduction could be refused to smokers who fail to stop smoking in the peri-operative period.
The records of patients who had undergone breast reductions between April 1999 and May 2004 at the Leicester Royal Infirmary, Leicester were reviewed retrospectively for age, body mass index, smoking habits and wound-related complications.
A total of 764 breast reductions were performed in 402 patients during this period. Twenty-eight per cent (112) of these patients were smokers. The mean age was 33.9 (range 19-68)+9.5 years in smokers and 34.4 (range 16-73)+10.6 years in non-smokers. About 90% of patients had bilateral breast reductions. Wound-related complications were seen in 35% of smokers as against 13% of non-smokers, P value<0.001. Overall, smokers had a 2.3 x higher chance of developing a complication. The probability of a smoker developing wound infection was 3.3 x more in comparison to a non-smoker. Smokers were also three times more likely to develop T-junction necrosis.
Smoking increases the complication rate of breast reduction significantly. Hence, patients must be strongly encouraged to quit smoking before surgery and abstain until the wound has completely healed. Stoppage of smoking in the peri-operative period should be adopted as an essential eligibility criterion for breast reduction.
文献中有多项研究表明，吸烟会增加各类整形手术的并发症发生率。我们对402例患者进行了一项研究，以观察吸烟对乳房缩小手术的影响。目的是提出一个有争议的问题，即对于在围手术期未能戒烟的吸烟者，是否可以拒绝为其实施乳房缩小手术。
回顾性分析了1999年4月至2004年5月在莱斯特皇家医院接受乳房缩小手术的患者的记录，内容包括年龄、体重指数、吸烟习惯和与伤口相关的并发症。
在此期间，402例患者共进行了764次乳房缩小手术。其中28%（112例）为吸烟者。吸烟者的平均年龄为33.9岁（范围19 - 68岁）±9.5岁，非吸烟者为34.4岁（范围16 - 73岁）±10.6岁。约90%的患者进行了双侧乳房缩小手术。吸烟者中35%出现了与伤口相关的并发症，而非吸烟者中这一比例为13%，P值<0.001。总体而言，吸烟者发生并发症的几率高2.3倍。吸烟者发生伤口感染的概率比非吸烟者高3.3倍。吸烟者发生T形切口坏死的可能性也高出3倍。
吸烟显著增加乳房缩小手术的并发症发生率。因此，必须强烈鼓励患者在手术前戒烟，并在伤口完全愈合前 abstain（此处英文原文有误，结合语境推测可能是“ abstain from smoking”，即“戒烟”）。围手术期戒烟应作为乳房缩小手术的一项基本合格标准。
