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Sharnell S. Smith, MD
Smoking and Surgery
Fort Washington Medical Center
. http://www.fortwashingtonmc.org/

Smoking and Surgery

According to the Centers for Disease Control and Prevention, about 15 of every 100 U.S. adults aged 18 years or older currently smokes cigarettes. This means an estimated 36.5 million adults in the United States currently smoke cigarettes.

If you smoke, there is a good chance your primary care physician (PCP) has told you to stop smoking many times in the past and for good reason. If you want to maximize the quantity and quality of your remaining years, then you should eat healthier, exercise and definitely stop smoking.

However, there is another, lesser-known reason for quitting smoking. According to a study published by the American College of Surgeons, Americans undergo an average of 9.2 surgical procedures (3.4 inpatient operations, 2.6 outpatient operations, and 3.2 non-operating room invasive procedures) per lifetime. In the event you must have surgery (or choose to have an elective procedure) being a non-smoker ahead of time will increase the likelihood of your successful recovery.

Smoking wreaks havoc on every organ in the human body. Aside from the cancer-causing properties in cigarettes, they cause constriction of the smaller blood vessels throughout your body leading to decreased blood flow. One of the most important steps in healing after surgery is increased blood flow to the area of the operation. Blood carries all the cells and nutrients needed to heal the surgical area.

Decreased blood flow caused by smoking can lead to increased wound infections, delayed wound healing, non-healing wounds, and sometimes even dead tissue.

In an article from the Journal of the American College of Surgeons published in 2012, smoking related complications lead to longer hospital stays, higher rates of ICU (Intensive Care Unit) admission, greater need for repeat surgery, and higher overall costs of care.

It is recommended that you stop smoking at least eight weeks prior to surgery or, if not, at least for 24 hours before surgery. Do not smoke on the day of your surgery. It is important that your anesthesiologist knows about your smoking so he or she can take precautions to reduce your risk of having problems.

The earlier you quit, the greater your chances are of avoiding surgery-related complications. The body begins to heal within hours of quitting. Twelve hours after a person quits, his or her heart and lungs already begin to function better and in less than a day blood flow improves.

As you can see, that advice from your PCP to stop smoking has an impact on more than just your blood pressure medication, for instance. You have certainly heard this “lecture” repeatedly from your PCP.

But, this time around you are hearing it for a different reason. This is from the perspective of a general surgeon. Let's make sure you come out of any future surgeries with the best possible outcomes.

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