When patients are scheduled for surgery they are advised to quit smoking by their surgeons. Many patients feel this is unnecessary and do not take their doctor's advice. But surgeons have seen the complications that occur in smokers after surgery and they know these complications are preventable. Patients who continue to smoke prior to having surgery are at greater risk for wound infection, longer stays in the hospital and lung problems. In the March 2003 "Journal of Bone and Joint Surgery" researchers from Bispebjerg Hospital, Copenhagen, Denmark note that cigarette smoking "is the single greatest risk factor for developing complications" after surgery."
Wound Infections
Wounds need oxygen and nutrition to heal. In smokers, oxygen transport is compromised by carbon monoxide and nicotine. Smokers inhale carbon monoxide into their lungs from the cigarettes. Carbon monoxide binds to the hemoglobin in the blood and displaces oxygen. Thus smokers' blood is not thoroughly oxygenated and less oxygen is transported to the wound. Carbon monoxide makes the heart pump poorly, according to the Anesthesiology Info website and blood delivery from the heart is reduced.
Nicotine vasoconstricts, or shrinks, blood vessels. This constriction slows down blood flow and the wound is deprived of the nutrients and oxygen that blood carries. Interestingly, nicotine increases the need for oxygen while at the same time decreasing the supply of oxygen.
Breathing Difficulties
Smokers who smoke prior to surgery have a higher incidence of postoperative lung problems. Smoking increases the amount of mucus that is present in the lungs and at the same time impedes the smoker's ability to clear this mucus. Smoking also causes the small air sacs to collapse and the mucus becomes trapped in these small air sacs. This is how pneumonia develops. A smoker's airways are narrow and overly sensitive to irritation. Because of these factors the Anesthesiology Info website notes that a smoker's risk of bronchospasm and other life-threatening pulmonary problems is six times higher than that of a non-smoker.
Length of Stay
Smoker's who have wound infections stay in the hospital an average of four days longer than a non-smoker according to the researchers in Denmark. Other reasons smokers have prolonged hospital stays are pneumonia, longer stays in the Intensive Care Unit and impaired immune systems. This increased length of stay puts the patient at greater risk for hospital-acquired infections.
