Smoking increases facial skin flap complications.
This study was undertaken to determine whether smokers have a higher risk of complications after reconstruction of facial skin defects. Ninety-one patients with facial skin defects reconstructed with local flaps were reviewed retrospectively. Thirty-eight (42%) were active smokers, 12 (13%) had not smoked for at least 1 year prior to surgery, and the rest were nonsmokers. Complications occurred in 23 patients (25%; 37% in smokers, 17% in ex-smokers, and 17% in nonsmokers; p < .03). All full-thickness skin losses and all cellulitis occurred in active smokers. We conclude that active smokers are at a higher risk for complications in facial skin flap surgery. That ex-smokers had a complication rate similar to that of nonsmokers suggests that part of smoking's adverse effect on skin flaps may be an acute phenomenon, and that smoking cessation for shorter (<1 year) periods of time before surgery may have a beneficial effect.
Department of Otolaryngology, University of Texas Medical Branch, Galveston 77555-0521, USA.
J B
JB
Kinsella
C H
CH
Rassekh
Z D
ZD
Wassmuth
J A
JA
Hokanson
K H
KH
Calhoun
D016022:Case-Control Studies; D005153:Facial Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000601:surgery; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D013524:Surgical Flaps / Q000098:blood supply