NEW YORK (Reuters) -- The bones of smokers take longer to heal after surgery than those of nonsmokers, according to a study.
"Cigarette smoking is detrimental to bony healing," said Dr. Franklin Chen, an orthopaedics instructor at Northwestern University Medical School in Chicago, Illinois, and lead author of a report presented at the recent annual meeting of the American Academy of Orthopaedic Surgeons (AAOS), held in New Orleans, Louisiana.
He and his colleagues focused on the 13-month healing rates of 54 patients who underwent surgery to help correct a specific type of (often work-related) wrist injury called symptomatic ulnar impaction syndrome. Chen says "95% of nonsmokers healed compared to 68% of smokers; this difference is statistically significant. The mean time to healing was 5 months for nonsmokers and 7.2 months for smokers." Previous studies have shown similar slower healing rates among smokers who have undergone spine or ankle fusion surgeries.
In an interview with Reuters, Chen explained that nicotine inhaled during smoking "causes vasoconstriction of blood vessels," limiting blood flow and slowing the recovery of damaged tissue. He adds that "people who tend to smoke may not be as healthy in general," further impacting on healing rates.
In a related study, also presented at the AAOS meeting, Dr. Carlos Lavernia of the University of Miami School of Medicine in Florida and other researchers found that smoking patients who undergo hip or knee replacement operations had longer surgeries and higher hospital bills than nonsmoking patients.
In their preliminary study of 256 such patients, Lavernia said his team found that "smoker's hip and knee replacement costs averaged $28,947 compared to $22,019 for nonsmokers." And he says that "although smokers in this study were younger than nonsmokers (60 years versus 66 years), their surgery took longer (153 minutes versus 112 minutes)."
Lavernia believes further research is necessary to understand the cause of such disparities. But he speculates that the longer surgeries may be linked to the fact that smokers are usually more difficult to anesthetize than nonsmokers, and are more likely to have special respiratory concerns.
