Reuther William J, Hale Beverley, Matharu Jas, Blythe John N, Brennan Peter A
Maxillofacial Department, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK.
Maxillofacial Department, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK.
Br J Oral Maxillofac Surg. 2016 Apr;54(3):338-41. doi: 10.1016/j.bjoms.2015.12.001. Epub 2016 Jan 22.
The association between smoking and postoperative complications is compounded in patients who have oral and maxillofacial operations by an additional local effect, and patients often continue to smoke after operation despite advice to stop. Recent studies have suggested that nicotine may reduce inflammation and improve angiogenesis, so topical application may be beneficial for smokers. The electronic cigarette is increasing in popularity and more patients ask whether they can vape after operation. We investigated the effect of electronic cigarettes (of which half contained nicotine and half did not) on blood flow in the buccal mucosa in 10 volunteers immediately after vaping. Smokers were excluded as this was considered an additional variable in a small pilot study and our Trust has a no-smoking policy. After vaping for 5 minutes, capillary blood flow was measured in the buccal mucosa at 5-minute intervals using a laser Doppler probe, and the results were expressed as arbitrary perfusion units. There was a wide variation in results and a small but significant rise (p=0.008) as a result of nicotine vaping, but these fell to the same levels as before within 30 minutes. Electronic cigarettes may have an effect on blood flow to the oral mucosa, although further studies are needed to show whether they improve healing time after operation. Additional work is also needed to compare them with cigarettes.
吸烟与术后并发症之间的关联在接受口腔颌面手术的患者中因额外的局部影响而更加复杂，并且患者尽管被建议戒烟，但术后仍经常继续吸烟。最近的研究表明，尼古丁可能会减轻炎症并促进血管生成，因此局部应用可能对吸烟者有益。电子烟越来越受欢迎，越来越多的患者询问他们术后是否可以吸电子烟。我们调查了电子烟（其中一半含尼古丁，一半不含尼古丁）对10名志愿者吸电子烟后即刻颊黏膜血流的影响。吸烟者被排除在外，因为在这项小型试点研究中这被视为一个额外变量，而且我们的信托机构有禁烟政策。吸电子烟5分钟后，使用激光多普勒探头每隔5分钟测量一次颊黏膜的毛细血管血流，结果以任意灌注单位表示。结果差异很大，吸含尼古丁电子烟后有小幅但显著的上升（p = 0.008），但在30分钟内又降至之前的水平。电子烟可能会对口腔黏膜的血流产生影响，不过还需要进一步研究来表明它们是否能缩短术后愈合时间。还需要开展额外工作将它们与香烟进行比较。
