Authors / Timing of Smoking
Cessation / Population breakdown (N) / Wound healing complications
% (n/N) / Additional Explanation
Copyright© 2012, Canadian Journal of Anesthesia
Lindström et al.,2008 (42) / ≥3 wk / Ex-smokers N=20 / 10% 2/20 / NS difference in wound complications between ex-smokers who quit ≥3 wk or 1-2 wk before surgery and current smokers, P0.05.
1-2 wk / Ex-smokers N=9 / 0/9
Continued to smoke / Current smokers N=73 / 25% 18/73
Taber et al., 2009 (41) / Non-smokers N=140 / 2.9% 4/140 / NS difference in current, ex-smokers who quit >2 wk before surgery, and non-smokers.
>2 wks / Ex-smoker N=39 / 7.7% 3/39
Current Smokers N=42 / 4.8% 2/42
Padubidri et al.,
2001 (34) / - / Non-smoker N= 517 / 25.9% 134/517 / Increased complications in ex-smokers who quit <3 wk vs ≥ 3 wk before surgery and non-smokers, P=0.002.
≥ 3 wk / Ex-smokers N= 76 / 25% 19/76
< 3 wk / Ex-smokers N= 155 / 39.4% 61/155
Kuri et al.,
2005 (36) / - / Non-smokers N=40 / 47.5% 19/40 / Increased complications in current smokers vs. early (>6 wk) or intermediate (3-6 wk) cessation and non-smokers, P0.05. NS difference between late cessation (1-3 wk) and smokers.
- / Ex-smokers / -
1-3 wk / Late Cessation N=34 / 67.7% 23/34
3-6 wk / Intermediate Cessation N=20 / 55% 11/20
> 6 wk / Early Cessation N=66 / 59.1% 39/66
- / Current Smokers N=28 / 85.7% 24/28
Araco et al.,
2008 (22) / - / Non-smokers N=42 / 1.2% 1/42 / Increased complications in ex-smokers who quit ≥ 4 wk before surgery vs non-smokers, P0.001.
≥ 4 wk / Ex-smokers N=42 / 14.3% 12/42
Chan et al.,
2006 (38) / - / Non-smokers N=104 / 33.7% 35/104 / Increased complications in current smokers vs. non-smokers, P =0.02. Increased complications in ex-smokers who quit > 4 wk vs <4 wk before surgery, P = 0.028.
- / Ex-smokers
> 4 wk / N=15 / 33.3% 5/15
< 4 wk / N=19 / 52.6% 10/19
Continued to smoke / Current Smokers N=31 / 67.7% 21/31
Chang et al.,
1999 (33) / - / Non-smokers N=478 / 14.2% 68/478 / Increased donor site complications in ex- smokers who quit <4 wk vs≥ 4wk before surgery and non-smokers, P=0.001 and P=0.007, respectively.NS difference in flap complications.
> 4 wk / Ex-smokers N=150 / 10.0% 15/150
< 4 wk / Ex-smokers N=90 / 25.6% 23/90
Goodwin et al.,
2005 (35) / - / Non-smokers N=383 / 15.1% 58/383 / Increased complications in ex-smokers who quit >4 wk or <4 wk before surgery vs. non-smokers, P=0.0001. NS difference in ex-smokers who quit >4 wk or <4 wk before surgery.
< 4 wk / Ex-smokers N= 54 / 37.0% 20/54
> 4 wk / Ex-smokers N= 78 / 39.7% 31/78
Spear et al.,
2005 (37) / - / Non-smoker N=134 / 7.5% 10/134‡ / Increased multiple TRAM flap complications in current smokers vs. non-smokers, and ex-smokers vs. non-smokers, P=0.0023 and P=0.0018, respectively.NS difference in overall donor complications among current, ex- and non-smokers.
> 4 wk / Ex-smokers N=35 / 28.6% 10/35‡
- / Current Smokers N=31 / 29.0% 9/31‡
Al-Sarraf et al., 2008 (28) / - / Non-smokers N=748 / 7.6% 57/748 / NS difference among smokers who quit
≤4 wk or >4 wk before surgery.
> 4 wk / Ex-smokers N=1364 / 8.9% 122/1364
≤ 4 wk / Ex-Smokers N=475 / 9.5% 45/475
Glassman et al.,
2000 (39) / - / Non-smokers
N=169 / 14.2% 24/169 / NS difference in non-union rate among ex- smokers who quit <4 wk or >4 wk before surgery and current smokers.
< 4 wk / Ex-smokers
N=74 / 20.2% 15/74
> 4 wk / Ex-smokers
N=51 / 19.6% 10/51
Continued to smoke / Current Smokers
N=63 / 22.2% 14/63
Myles et al., 2002 (24) / - / Non-smokers N=173 / 0.6% 1/173 / NS difference in complications among current smokers, ex-smokers who quit >4 wk before surgery and non-smokers.
> 4 wk / Ex-smokers N=116 / 2.6% 3/116
- / Current Smokers N=200 / 3.7% /200
Moore et al.,
2005 (40) / Non-smokers N=654 / 6.9% 45/654 / NS difference in complications among ex-smokers who quit ≥4 wk before surgery and non-smokers.
≥ 4 wk / Ex-smokers N=233 / 5.6% 13/233
Møller et al.,
2002 (43) / 6-8 wk / Ex-smokers / 0 / Increased complications in current smokers vs. ex-smokers who quit 6-8 wk before surgery, P=0.0004
Current smokers / 26% 12
Ngaage et al., 2002 (27) / - / Non-smokers N=881
Sternal wound infection
Mediastinitis / 15%
1% / NS difference in complications among smokers who quit >12 wk or ≤ 12 wk before surgery and non-smokers.
> 12 wk / Ex-smokers N=1075
Sternal wound infection
Mediastinitis / 11%
1.4%
≤ 12 wk / Ex-Smokers N=207
Sternal wound infection
Mediastinitis / 15%
2.4%
NS= not significant, wk= weeks.