Does cigarette smoking affect muscle flap survival? an 8 year experience over 261 consecutive cases in southern Iran

ABSTRACT

Smoking has been shown to be a complicating factor in normal wound healing. Both nicotine and carbon monoxide adversely affect multiple stages of the healing process. From 1991 to 1999, 407 muscle flap procedures were performed on 374 patients in a single surgical unit. A retrospective review of 261 patients was completed. Patients were divided into three groups Group A, no smoking history; group B, smokers for at least one year, and group C, active smokers up to the time of surgery. Patients were excluded who had diabetes, had a recurrent malignancy, or used steroids. A total of 261 patients were included in the study. The age, sex, number of patients and primary operative indications were matched in the 3 groups. Active smokers were shown to have a complication rate significantly higher in the immediate post-operative period compared with non-smokers and smokers who had quit. The most common complications were partial muscle necrosis and partial skin graft loss. This series suggests that active smoking at the time of muscle transposition significantly increases the rate of post-operative complications