Abstract
BackgroundThe effect of intensive smoking cessation programs on postoperative complications has never before been assessed in soft tissue surgery when smoking cessation is initiated on the day of surgery.MethodsA single-blinded randomized clinical trial conducted at two vascular surgery departments in Denmark. The intervention group was offered the Gold Standard Program (GSP) for smoking cessation intervention. The control group was offered the departments’ standard care. Inclusion criteria were patients with planned open peripheral vascular surgery and who were daily smokers. According to the power calculation a total of 144 patients were needed in the trial.ResultsDue to slow patient inclusion, the trial was terminated prior to fulfilling the power calculation. Thirty-two patients were included in the trial from March 2011 to September 2012. Of these, 11 were randomized to the GSP intervention and 21 as controls. There was no difference in 30-day complication rates or 6-week abstinence rates between the two groups.ConclusionsA trial assessing the effect of smoking cessation on postoperative complications on the day of soft tissue surgery is still needed. If another trial is to be planned it must be more pragmatic with less extended inclusion criteria and conducted nationally or internationally to ensure enough patients for the trial.Trial registrationClinicalTrials.gov (NCT01469091). Registration date: 27 October 2011.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-015-0965-x) contains supplementary material, which is available to authorized users.
Highlights
The effect of intensive smoking cessation programs on postoperative complications has never before been assessed in soft tissue surgery when smoking cessation is initiated on the day of surgery
We offered free nicotine replacement and individual meetings to all participants randomized for the Gold Standard Program (GSP) corresponding to the previous studies on GSP for surgical patients [8,9,10]
The following had to be excluded according to the criteria: surgery performed as an elective procedure (20 patients, during phase 1), readmitted and operated upon in the same vascular segment within the previous 90 days (17 + 76 patients), drinking more than 5 units/day (26 + 56 patients), and six patients in whom data were missing (Fig. 1)
Summary
The effect of intensive smoking cessation programs on postoperative complications has never before been assessed in soft tissue surgery when smoking cessation is initiated on the day of surgery. Smoking is a well-known risk factor for developing complications after surgery. The reason that smoking tobacco is a risk factor for developing postoperative complications is multifactorial. The tobacco and the additives affect most cells and tissues in the body. Wound healing is slower due to diminished oxygenation of the tissues, impaired microcirculation and release of vasoactive components [1, 2]. Electrocardiograms studied during surgery in smokers have shown signs of heart muscle ischemia [3, 4].
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