Abstinence from smoking reduces incisional wound infection: a randomized controlled trial.
OBJECTIVE
Clinical studies show that the incidence of postoperative wound complications is higher in smokers than nonsmokers. In this study, we evaluated the effect of abstinence from smoking on incisional wound infection.


METHODS
Seventy-eight healthy subjects (48 smokers and 30 never-smokers) were included in the study and followed for 15 weeks. In the first week of the study, the smokers smoked 20 cigarettes per day. Subsequently, they were randomized to continuous smoking, abstinence with transdermal nicotine patch (25 mg per day), or abstinence with placebo patch. At the end of the first week and 4, 8, and 12 weeks after randomization, incisional wounds were made lateral to the sacrum to excise punch biopsy wounds. At the same time identical wounds were made in 6 never-smokers. In 24 never-smokers a wound was made once. All wounds were followed for 2 weeks for development of wound complications.


RESULTS
A total of 228 wounds were evaluated. In smokers the wound infection rate was 12% (11 of 93 wounds) compared with 2% (1 of 48 wounds) in never-smokers (P <0.05). Wound infections were significantly fewer in abstinent smokers compared with continuous smokers after 4, 8, and 12 weeks after randomization. No difference between transdermal nicotine patch and placebo was found.


CONCLUSIONS
Smokers have a higher wound infection rate than never-smokers and 4 weeks of abstinence from smoking reduces the incidence of wound infections.
Sorensen
Lars Tue
LT
Copenhagen Wound Healing Center, Bispebjerg University Hospital, Copenhagen Hospital Corporation, DK-2400 Copenhagen NV, Denmark. lts@dadlnet.dk
Karlsmark
Tonny
T
Gottrup
Finn
F
D000328:Adult; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000378:metabolism; D015994:Incidence; D008297:Male; D012907:Smoking / Q000503:physiopathology*; D016540:Smoking Cessation; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control*; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology*