Smoking, a major problem in plastic surgery

Dec 6 2004

Smoking is known to cause heart disease and cancer, but most patients do not know that smoking can harm the chances of having successful plastic surgery operations. A new test to determine whether people undergoing plastic surgery are continuing to smoke has been devised by scientists at the University of Birmingham, England.

Smoking is known to affect the body's ability to heal itself especially after surgery. Just one cigarette can reduce the blood flow to a wound which can affect the way it heals. Patients who smoke also have more complications both during and after operations.

Concerned plastic surgeons at Pinderfields Hospital, Wakefield are advising people to stop smoking before their operation. Despite the warnings many patients still smoke and frequently deny it when questioned by a surgeon. The surgical team is now using a simple urine test to find out whether their patients are continuing to smoke.

One hundred patients attending a range of surgical operations were asked about their smoking habit and a sample of their urine was tested for nicotine chemicals using a simple five minute test called Smokescreen. The urine turns pink if the sample is from a smoker and the heavier the smoker the darker the colour.

The majority of patients were non-smokers (44%), 30 reported smoking and the test confirmed this, however 26 patients denied smoking and the test result was positive. Further analysis showed that 65% of those who denied smoking were women. It was found that where patients admitted to smoking, they had significantly under-reported the number of cigarettes they smoked.

Patients undergoing operations are increasing their chances of slower and poorer recovery and of picking up post-operative infections. Dr Graham Cope, who developed the smoking test at the University of Birmingham, says, 'The test is easy to use and gives a quick result in a few minutes. I hope the test will be used as part of the education in plastic surgery to get more people to stop smoking, hopefully for good.'

Caroline Payne, who carried out the study and is presenting the data today at the British Association of Plastic Surgeons, says, 'Smoking has an adverse effect on surgical outcome. It is necessary to advise and educate patients about the dangers of smoking and operative morbidity. Our aim is to reduce these complications by introducing a simple, effective bedside test to show smoking status and the quantity smoked. This will help us make a decision about when, or if, to electively operate on a patient knowing exactly their cigarette consumption'.

http://www.bham.ac.uk