Your personal health affects many aspects of your life, including your surgical outcomes!
In addition to making sure that you make informed decisions about the medical facility and the surgeons that you entrust your health to, there are other controllable factors that you should take into account when considering surgery. In this article we will have a look at one of these key surgical risk factors : smoking.
The statistics tell a story:
- Smokers are 38% more likely to die after surgery than non-smokers.
- For example if you are a smoker considering dental implants then the failure rate for your dental implants may be almost 15 times higher than for a non-smoker and you are at a greater risk of post-surgical infection
- Smoking is the most important risk factor for the development of serious post-operative complications in patients undergoing elective hip and knee replacement
- Smoking is the most important factor for the development of postoperative heart and wound-related complications in elective surgery.
Smoking is clearly linked to increased levels of surgical risks and post-surgical complications including wound healing and infections. Smoking has also been shown to be associated with not only inferior surgical outcomes but also lower patient satisfaction with the procedure. Some surgeons will not actually carry out procedures until a patient is able to abstain from smoking.
So what are the risks?
Continuing to smoke right up until the time you have surgery will mean that your heart will have less oxygen, blood clots are more likely to form in your veins, you will have more trouble breathing during and after your surgery, you will have an increased risk of infection, your healing will be delayed and importantly may impact the functioning of your anesthetic.
OK, so it’s pretty clear that these aren’t a good set of outcomes and that quitting smoking improves surgical outcomes through reducing risk and complications. So, how long before surgery should you quit?
How long before surgery should I quit?
Even stopping smoking briefly before an operation can have positive effects. While it is generally recommended that quitting smoking two months prior to surgery will give you the best chance of reducing smoking related risks and complications there are still some benefits to be had from quitting much closer to surgery.
Have a look at this timeline graphic about what happens to your body once you quit smoking (courtesy of www.health.qld.gov.au) :
So, even eight hours after you quit, your heart rate and blood pressure will begin to return to normal and at twelve hours the nicotine and carbon monoxide in your body will drop dramatically. It does take three weeks however for your body’s ability to heal to begin to improve and eight weeks for your risk of lung complications to be lower than a continuing smoker.
For smokers who are unable to quit, the Royal College of Anaesthetists (UK) advises that smokers should give up smoking for at least several weeks before surgery and certainly not to smoke on the day of an operation.
Post surgery, it is important you do not start smoking again, even if you only quit 12 hours before surgery. Allow your body time to recover and heal properly. Smoking makes recovery harder by stressing your heart, affecting your blood pressure, reducing oxygen in your blood and body tissues, and damaging your lungs.
The evidence to date has not identified any major concerns about the use of electronic cigarettes around surgery.
The Bottom Line
Your personal health affects your surgical outcomes. Managing your health before and after any surgery is just as important as making informed decisions about the professionals that will perform your surgery and the facility in which your surgery takes place.
Remember there is no need to sacrifice quality for cost (in fact, more often that not that is a disaster!) and every surgical procedure carries with it risk.