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Wound Infections in Aesthetic Abdominoplasties: The Role of Smoking

Araco, Antonino M.D.; Gravante, Gianpiero M.D.; Sorge, Roberto M.D.; Araco, Francesco M.D.; Delogu, Daniela; Cervelli, Valerio M.D.

Plastic and Reconstructive Surgery: May 2008 - Volume 121 - Issue 5 - p 305e-310e
doi: 10.1097/PRS.0b013e31816b13c2

Background: In this prospective study, the authors followed patients who underwent aesthetic abdominoplasty to determine the influence of smoking on the occurrence of postoperative wound infections.

Methods: Patients who underwent aesthetic abdominoplasty were considered eligible for the study. The authors excluded postbariatric patients, those with ongoing clinical infections, those receiving a recent antibiotic course, and those with systemic diseases such as arteriosclerosis and diabetes mellitus. Smokers were advised to quit smoking at least 4 weeks before surgery.

Results: Starting in February of 2004, the authors enrolled 84 patients. Postoperative infections were present in 13 patients (15.5 percent) and were superficial in 10 (77 percent). All but one occurred in smokers. These had a certain number of cigarettes smoked per day, years of smoking, and higher estimated overall number of smoked cigarettes when postoperative infections were present. The relative risk of smoking on infections was 12. A cutoff value of approximately 33,000 overall cigarettes smoked determined 3.3 percent false-positive and 0 percent false-negative rates.

Conclusions: Smoking is an important issue in aesthetic surgery that needs to be accurately addressed during the preoperative interview. In the future, the analysis of smoke-related, easy-to-gather variables such as the estimated overall number of cigarettes smoked until surgery could help stratify patients according to their risk of manifesting infections.

Birmingham, United Kingdom; and Rome, Italy

From Dolan Park Hospital; Department of General Surgery, Plastic Surgery, and Laboratory of Biometry, University of Tor Vergata; and University “La Sapienza.”

Received for publication December 30, 2006; accepted March 23, 2007.

Disclosure:None of the authors has a financial interests in any of the products, drugs, or devices mentioned in this article.

Gianpiero Gravante, M.D., Via U. Maddalena 40/a, 00043 Ciampino, Rome, Italy,

©2008American Society of Plastic Surgeons