Delaunay F, Coquerel-Beghin D, Magalon G, Cohen S R, Casanova D, Niddam J, Milliez P-Y, Peillon C, Delpierre V, Auquit-Auckbur I
Department of plastic, reconstructive and aesthetic surgery, Le Belvédère hospital, 76130 Mont-Saint-Aignan, France.
Department of plastic and hand surgery, universitary hospital of Rouen, 76000 Rouen, France.
Ann Chir Plast Esthet. 2018 Jul;63(4):307-315. doi: 10.1016/j.anplas.2018.03.004. Epub 2018 May 31.
Smoking induces complications in plastic surgery, in particular wound healing delays. Despite a 4-weeks' abstinence asking before and after surgery, some patients denied or hid their consumption. The aim of this study was to evaluate the effectiveness of a cotininury detection test in terms of improvement in outcomes after an abdominoplasty.
This retrospective cohort study included patients who underwent an abdominoplasty with umbilical transposition and lipoaspiration. Current smokers were asked to stop smoking 4 weeks before and after surgery. After 2013, we performed a preoperative cotininury test for patients having abdominoplasty, with a cancellation of surgery in case of positive result. We analyzed the test's effectiveness on delayed healing and on other complications.
Two hundred and thirty-five patients were included; 80 were tested and 21,3% had a positive test. There was significantly less delayed healing in the "screening" group than in the "no screening": 20,3% versus 41,5% (P=0,002). Alike, complications were significantly less frequent in the "screening" group than in the "no screening": 18,1% versus 42,3% (P<0,001).
The routine use of the cotininury test in preoperative abdominoplasties significantly reduces risk of delayed healing and other serious complications. It is an objective test, which is simple, quick and non-invasive. Smoking cessation must be at least 4 weeks before and after the surgery. Following medical advice to cease smoking by the surgeon and anesthetist, referral to an appropriate tobacco-addiction specialist clinic may be helpful for the patient who has difficulty stopping smoking.
吸烟会引发整形手术并发症，尤其是伤口愈合延迟。尽管手术前后要求戒烟4周，但仍有一些患者否认或隐瞒吸烟情况。本研究旨在评估可替宁检测试验对腹部整形术后改善预后的有效性。
这项回顾性队列研究纳入了接受脐移位和抽脂腹部整形术的患者。要求现吸烟者在手术前后4周停止吸烟。2013年后，我们对接受腹部整形术的患者进行术前可替宁检测，检测结果呈阳性则取消手术。我们分析了该检测对愈合延迟和其他并发症的有效性。
纳入235例患者；80例接受检测，其中21.3%检测呈阳性。“筛查”组的愈合延迟明显少于“未筛查”组：分别为20.3%和41.5%（P = 0.002）。同样，“筛查”组的并发症明显少于“未筛查”组：分别为18.1%和42.3%（P < 0.001）。
腹部整形术前常规使用可替宁检测可显著降低愈合延迟和其他严重并发症的风险。这是一项客观检测，简单、快速且无创。手术前后必须至少戒烟4周。在外科医生和麻醉师建议戒烟后，将难以戒烟的患者转诊至合适的烟草成瘾专科诊所可能会有所帮助。
