Al-Saghir Tala, Hall Jamie, Diffley Michael, Tang Amy, Teitelbaum Abigail, Tepper Donna G, Darian Vigen, Evangelista Maristella, Atisha Dunya
From the Division of Otolaryngology, Henry Ford Health System, Detroit, Mich.
Division of Plastic Surgery, Henry Ford Health System, Detroit, Mich.
Plast Reconstr Surg Glob Open. 2024 Aug 21;12(8):e6082. doi: 10.1097/GOX.0000000000006082. eCollection 2024 Aug.
Studies have shown that chronic marijuana use is associated with increased vascular inflammation, endothelial damage, myocardial infarctions, strokes, arteritis, and cardiomyopathies; however, cannabis's effect on wound healing in immediate direct-to-implant (DTI) breast reconstruction is unknown. With the increasing prevalence of marijuana use, it is imperative to understand its effects on surgical outcomes.
We performed a retrospective cohort study of consecutive patients in a quaternary-care breast cancer center undergoing immediate DTI reconstruction. Patient demographics, operative details, and surgical complications were extracted through chart review. Active cannabis use was defined as use within 12 weeks of operation. Univariate and multivariable analyses were performed.
In total, 243 consecutive patients underwent immediate DTI reconstruction, and 12 reported active cannabis use. There were no significant differences in patient demographics, cancer treatment, or operative details. Active marijuana users demonstrated higher rates of cellulitis treated with IV antibiotics ( = 0.004), explantation for infection ( = 0.004), emergency department visits ( = 0.028), readmission ( = 0.037), takeback to the operating room in 90 days ( < 0.001), and overall major complications ( < 0.001). Multivariable analysis demonstrated that active marijuana users were more likely to experience cellulitis treated with IV antibiotics [odds ratio (OR) = 3.55, = 0.024], takeback to the OR within 90 days of operation (OR = 4.75, = 0.001), and major complications (OR = 2.26, = 0.048).
The consumption of cannabis in the perioperative setting is associated with increased rates of complications in patients undergoing immediate DTI reconstruction; however, an analysis with a larger patient population is needed to conclude that abstinence from its use should be highly encouraged.
研究表明，长期使用大麻与血管炎症增加、内皮损伤、心肌梗死、中风、动脉炎和心肌病有关；然而，大麻对即刻直接植入式（DTI）乳房重建中伤口愈合的影响尚不清楚。随着大麻使用的日益普遍，了解其对手术结果的影响势在必行。
我们对一家四级医疗乳腺癌中心连续接受即刻DTI重建的患者进行了一项回顾性队列研究。通过病历审查提取患者人口统计学资料、手术细节和手术并发症。近期使用大麻定义为在手术12周内使用。进行了单变量和多变量分析。
共有243例连续患者接受了即刻DTI重建，12例报告近期使用大麻。患者人口统计学资料、癌症治疗或手术细节方面无显著差异。近期使用大麻者静脉注射抗生素治疗蜂窝织炎的发生率较高（P = 0.004）、因感染取出植入物的发生率较高（P = 0.004）、急诊就诊率较高（P = 0.028）、再入院率较高（P = 0.037）、90天内返回手术室的发生率较高（P < 0.001）以及总体主要并发症发生率较高（P < 0.001）。多变量分析表明，近期使用大麻者更有可能接受静脉注射抗生素治疗蜂窝织炎[比值比（OR）= 3.
