Acute effects of nicotine and smoking on blood flow, tissue oxygen, and aerobe metabolism of the skin and subcutis.
BACKGROUND
Nicotine released from tobacco smoke causing reduction in blood flow has been suggested as causative for postoperative wound complications in smokers, but the mechanism remains unknown.


METHODS
In eight healthy male smokers and eight ex-smokers, the cutaneous and subcutaneous blood flow (QBF, SqBF) was assessed by Laser Doppler and 133Xe clearance. Tissue oxygen tension (TO(2)) was measured by a LICOX O(2)-electrode. Tissue glucose and lactate (Tgluc, Tlact) were assessed by microdialysis. The parameters were studied after intravenous infusion of 1.0 mg nicotine, smoking of one cigarette, arterial occlusion, and reperfusion.


RESULTS
Nicotine infusion decreased SqBF from 4.2 +/- 2.0 to 3.1 +/- 1.2 mL/100 g tissue/min (P < 0.01), whereas QBF was 21.7 +/- 8.6 and 22.7 +/- 9.6 Arbitrary Units (AU), respectively (P = 0.21). TO(2) increased from 49.3 +/- 12.0 to 53.9 +/- 12.0 mm Hg (P = 0.01). Tgluc and Tlact remained unaffected. Smoking decreased SqBF from 4.2 +/- 2.0 to 2.7 +/- 1.2 mL/100 g tissue/min (P < 0.01). QBF decreased from 23.4 +/- 9.2 to 20.3 +/- 7.4 AU (P < 0.01), and TO(2) decreased from 53.9 +/- 12.0 to 48.4 +/- 11.1 mm Hg (P < 0.01). Following smoking, Tgluc decreased from 0.7 +/- 0.1 to 0.6 +/- 0.1 ng/mL (P < 0.01), and Tlact increased from 0.2 +/- 0.1 to 0.3 +/- 0.2 ng/mL (P < 0.01). The observed alterations were similar in smokers and ex-smokers.


CONCLUSIONS
Nicotine has a limited vasoactive effect in the skin and subcutis unlikely to be explained by smoking, which distinctly decreases tissue blood flow, oxygen tension, and aerobe metabolism independent of smoking status.
Sørensen
Lars Tue
LT
Copenhagen Wound Healing Center, Department of Surgery, Bispebjerg Hospital, Copenhagen, Denmark. lts@dadlnet.dk
Jørgensen
Stig
S
Petersen
Lars J
LJ
Hemmingsen
Ulla
U
Bülow
Jens
J
Loft
Steffen
S
Gottrup
Finn
F
D000328:Adult; D000332:Aerobiosis / Q000187:drug effects / Q000502:physiology*; D001158:Arteries / Q000187:drug effects / Q000502:physiology*; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology*; D003367:Cotinine / Q000097:blood; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007773:Lactates / Q000378:metabolism; D008297:Male; D009538:Nicotine / Q000097:blood / Q000494:pharmacology*; D010100:Oxygen / Q000378:metabolism*; D012867:Skin / Q000098:blood supply* / Q000187:drug effects; D012879:Skin Physiological Phenomena; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D055815:Young Adult
D007773:Lactates; D009538:Nicotine; D005947:Glucose; D003367:Cotinine; D010100:Oxygen