Zucker Isaac, Bouz Antoun, Castro Grettel, Rodriguez de la Vega Pura, Barengo Noel C
Department of Translational Medicine, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.
Department of Public Health, University of Helsinki, Helsinki, FIN.
Cureus. 2021 Oct 18;13(10):e18876. doi: 10.7759/cureus.18876. eCollection 2021 Oct.
Background Smoking is a cause of many postoperative complications, including delayed wound healing, tissue necrosis, and reconstructive flap loss. However, there is a paucity of evidence-based guidelines for smoking cessation in patients undergoing implant-based breast surgery. Objective The objective of this study was to determine if smoking is associated with wound dehiscence or superficial/deep surgical site infection (SSI) in women undergoing implant-based breast surgery. Methods Using theAmerican College of Surgeons National Surgical Quality Improvement Program, data was obtained of U.S. adult females (n=10,077) between the ages of 18 and 70 who underwent insertion of a breast prosthesis from 2014 to 2016. The patient's preoperative smoking status, demographics, and comorbidities were analyzed to determine association with wound dehiscence, superficial SSI, and deep SSI. Unadjusted and adjusted logistic regression analyses were used to calculate odds ratios (OR) and 95% confidence intervals (95% CI). Results Patients who smoked had a statistically significant higher proportion of wound complications (2.4%) compared to non-smokers (1.3%; p<0.01). Adjusted analysis demonstrated a significantly higher odds of wound complications in smoking patients compared to those who did not smoke (OR 2.0; 95% CI 1.3-3.2). Conclusions Our study suggests that smoking is an independent risk factor for postoperative complications in patients undergoing implant-based breast surgery. These results have significant clinical implications, as increased precautions can be taken in smokers undergoing breast surgery to minimize postoperative wound complications. Future studies may determine the optimal amount of time that patients should abstain from smoking prior to implant-based breast surgery.
吸烟是许多术后并发症的一个原因，包括伤口愈合延迟、组织坏死和重建皮瓣丢失。然而，对于接受植入式乳房手术的患者，缺乏基于证据的戒烟指南。
本研究的目的是确定吸烟是否与接受植入式乳房手术的女性的伤口裂开或浅表/深部手术部位感染（SSI）相关。
利用美国外科医师学会国家外科质量改进计划，获取了2014年至2016年期间年龄在18岁至70岁之间接受乳房假体植入的美国成年女性（n = 10,077）的数据。分析患者的术前吸烟状况、人口统计学特征和合并症，以确定与伤口裂开、浅表SSI和深部SSI的相关性。使用未调整和调整后的逻辑回归分析来计算比值比（OR）和95%置信区间（95%CI）。
与不吸烟者（1.3%）相比，吸烟者的伤口并发症比例在统计学上显著更高（2.4%；p<0.01）。调整分析显示，与不吸烟的患者相比，吸烟患者发生伤口并发症的几率显著更高（OR 2.0；95%CI 1.3 - 3.2）。
我们的研究表明，吸烟是接受植入式乳房手术患者术后并发症的独立危险因素。这些结果具有重要的临床意义，因为可以对接受乳房手术的吸烟者采取更多预防措施，以尽量减少术后伤口并发症。未来的研究可能会确定患者在接受植入式乳房手术前应戒烟的最佳时间。
