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Tabacco smoking and complications in elective microsurgery [Article de Revue]

 
[Tabagisme et complications en chirurgie réglée]
REUS W ; COLEN L ; STRAKER D
Plastic and reconstructive surgery. 1992/03; 89(3) : 490-494
Summary: Ce travail étudie les risques de complications parmi des patients présentant un tabagisme chronique, mais qui ont arrêté en période pré-opératoire d'une chirurgie réglée et les compare à ceux des patients non fumeurs. Entre juillet 1983 et mars 1990, une étude rétrospective a été conduite dans une unité de chirurgie réparatrice aux Etats-Unis. Les résultats montrent que les patients fumeurs présentent un risque augmenté de complications, non au site de l'anastomose mais plutôt à l'interface entre le lambeau de peau (greffon) et son site. Cette complication est dûe aux effets du tabagisme sur la microcirculation périphérique ou la cicatrisation.

This study assesses the risk for complications in patients who chronically smoke but who have quit in the perioperative period of an elective free-tissue transfer as compared with patients who do not smoke. A retrospective review identified 104 free-tissue transfers in 93 smokers and 58 transfers in 51 nonsmokers. The demographics, wound etiology, and recipient sites were similar in the two populations. With the exception of a higher incidence of chronic obstructive pulmonary disease (COPD) among smokers, preexisting comorbid factors also were similar. Postoperative medical complications were comparable between populations. When comparing smokers with nonsmokers, we found that anastomotic patency and flap survival were not different (95 versus 94 percent, respectively), that delayed wound healing at the recipient site was different (35 versus 24 percent), and that smokers require an additional procedure to achieve final wound closure more frequently (27 versus 12 percent, p = 0.03). These findings suggest that cigarette smokers are at increased risk for complications, not at the site of the anastomosis in free-tissue transfer, but rather at the flap's interface with the wound or overlying skin graft.(RESUME D'AUTEUR)
Publication
1992/03

Pages
490-494

Language
Anglais

Number of ref
17

ID notice
319083

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http://cclin-sudest.chu-lyon.fr/
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33076 Bordeaux
Tél : 05.56.79.60.58
cclin.so@chu-bordeaux.fr
http://www.cclin-sudouest.com/

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