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J Reconstr Microsurg 2018; 34(07): 492-498
DOI: 10.1055/s-0038-1639377
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Does Cigarette Smoking Harm Microsurgical Free Flap Reconstruction?

Denis Ehrl
1   Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Germany
2   Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Teaching Hospital, Munich, Germany
,
Paul I. Heidekrueger
2   Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Teaching Hospital, Munich, Germany
3   Department of Plastic, Hand, and Reconstructive Surgery, University Medical Center Regensburg, Germany
,
Elisabeth M. Haas
1   Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Germany
,
Michaela Coenen
4   Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University Munich, Germany
,
Riccardo Giunta
1   Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Germany
,
Milomir Ninkovic
2   Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Teaching Hospital, Munich, Germany
,
P. Niclas Broer
2   Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Teaching Hospital, Munich, Germany
› Author Affiliations Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Further Information

Publication History

19 September 2017

30 January 2018

Publication Date:
01 April 2018 (online)

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Abstract

Background Free tissue transfers can successfully address a wide range of reconstructive requirements. While the negative influence of cigarette smoking is well documented, its effects in the setting of microsurgical free flap reconstruction remain debated. This study evaluates the impact of cigarette smoking on microsurgical reconstructions.

Methods Over a 7-year period, 897 patients underwent 969 microvascular free flap reconstructions at a single surgical center. The cases were divided into “smoker” (S) and “nonsmoker” (NS) groups according to their cigarette smoking status. The data were retrospectively screened for patients' demographics, perioperative details, surgical complications, free flap types, recipient sites, flap survival, and overall outcomes.

Results Both groups were comparable regarding comorbidities including hypertension, peripheral artery disease, diabetes, American Society of Anesthesiologists scores, types of performed free flaps, and recipient sites. While patients in the NS group were significantly older and had a higher prevalence of obesity (p < 0.05), there were no significant differences regarding the rate of major or minor complications during our 3-month follow-up period (p > 0.05).

Conclusion While minor and major complications were increased regarding virtually all examined parameters, cigarette smoking did not have significant effects on the overall outcomes of microsurgical free flap reconstructions.

Keywords

cigarette smoking - nicotine - free flap reconstruction
 

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