Give Us a Break: Fracture Surgery Patients Who Quit Smoking Heal Better

Smokers who receive emergency surgery for acute fractures and quit smoking for 6 weeks afterward heal faster and better than similar patients who go on smoking during the healing period. This was reported in a study published in 2010 in The Journal of Bone and Joint Surgery.

Dr. Hans Nåsell, MD, senior surgical consultant, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden, explained that the results showed that quitting smoking during the six weeks after surgery decreased the likelihood of postoperative complications by almost 50 percent.

This study, conducted at three Stockholm hospitals, was the first one to specifically examine the post-operative effects of quitting. Earlier studies have established a clear healing advantage for staying off tobacco before surgery. As Dr. Nasell explained, “Tobacco smoking is a major health and economic concern and also is known to have a significant negative effect on surgical outcomes… Our aim was to assess whether a smoking cessation program, started soon after hospitalization and continuing for six weeks following surgery, could reduce the number of postoperative complications.”

The smoking cessation program involved 1 to 2 in-person consultations, along with regular telephone support from a nurse specially trained in the program. Free nicotine substitutes were provided for those who requested them.

The study is surprising, said Dr. Nasell. “Up until this point, the belief was that you needed to stop smoking prior to surgery to gain any benefit.” In addition, he said that the program “requires only about two to three hours of support from the nursing staff, which is significantly less time than would be required for the treatment of side effects such as poor wound healing which can occur as a side effect of smoking.” It is especially encouraging that quitting after surgery can help so dramatically, since emergency operations of the kind followed in this study obviously offer the patient no chance to quit smoking beforehand.

Smoking gets in the way of both short-term and long-term healing by lowering the oxygen level of the blood and interfering with circulation.

This can lead to:

  • poor or failed healing of skin, soft tissues, and bone, or
  • wound site infections

Dr. Nasell stated that he hoped these study results would encourage hospitals to offer nicotine cessation programs as part of all emergency surgical treatments, in addition to those offered to planned surgery patients.

Morover, he said, “Other studies have shown that most individuals who smoke would like to quit. Having a smoking cessation program available to all patients pre-surgery can serve as a motivator to get them to quit. Even though this intervention lasts for six weeks, it may be all that is needed to help patients quit for good.”

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