Abstinence from smoking reduces incisional wound infection: A randomized controlled trial
Abstinence from smoking reduces incisional wound infection: A randomized controlled trial
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DOI：
10.1097/01.sla.0000074980.39700.31
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发表时间：
2003-07-01
影响因子：
9
通讯作者：
Gottrup, F
中科院分区：
文献类型：
--
作者：
Sorensen, LT;Karlsmark, T;Gottrup, F
目的：临床研究表明，吸烟者术后伤口并发症的发生率高于非吸烟者。方法：对78例健康受试者(吸烟者48例，非吸烟者30例)进行为期15周的随访。在研究的第一周，吸烟者每天抽20支烟。随后，他们被随机分为持续吸烟、尼古丁透皮贴片戒烟(每天25毫克)或安慰剂贴片戒烟。在随机化后的第一周、第4周、第8周和第12周，在骶骨外侧制作切开创面，切除穿孔活检创面。与此同时，6名从不吸烟的人也被造成了相同的伤口。在24名从不吸烟的人中，有一次留下了伤口。所有创面随访2周，观察创面并发症的发生情况。结果：共有228个创面被评估。吸烟者的伤口感染率为12%(93个伤口中有11个)，而不吸烟者为2%(48个伤口中有1个)(P<；0.05)。在随机分组后的4、8和12周后，戒烟者与持续吸烟者相比，伤口感染显著减少。结论：吸烟者创面感染率高于不吸烟者，戒烟4周可降低创面感染率。
Objective: Clinical studies show that the incidence of postoperative wound complications is higher in smokers than nonsmokers. In this study, we evaluated the effect of abstinence from smoking on incisional wound infection.Methods: Seventy-eight healthy subjects (48 smokers and 30 never-smokers) were included in the study and followed for 15 weeks. In the first week of the study, the smokers smoked 20 cigarettes per day. Subsequently, they were randomized to continuous smoking, abstinence with transdermal nicotine patch (25 mg per day), or abstinence with placebo patch. At the end of the first week and 4, 8, and 12 weeks after randomization, incisional wounds were made lateral to the sacrum to excise punch biopsy wounds. At the same time identical wounds were made in 6 never-smokers. In 24 never-smokers a wound was made once. All wounds were followed for 2 weeks for development of wound complications.Results: A total of 228 wounds were evaluated. In smokers the wound infection rate was 12% (11 of 93 wounds) compared with 2% (1 of 48 wounds) in never-smokers (P < 0.05). Wound infections were significantly fewer in abstinent smokers compared with continuous smokers after 4, 8, and 12 weeks after randomization. No difference between transdermal nicotine patch and placebo was found.Conclusions: Smokers have a higher wound infection rate than never-smokers and 4 weeks of abstinence from smoking reduces the incidence of wound infections.