Performing Surgery On Smokers: What You Should Know

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Lawrence Fallat, DPM, FACFAS, and Ruby Chahal, DPM

   Postoperatively, the patient wore a non-weightbearing slipper cast after three weeks and a partial weightbearing cast for an additional three weeks. Radiographs revealed early consolidation at six weeks and the patient wore a surgical shoe. The patient transitioned to shoe gear after eight weeks postoperatively and he returned to full activity after 12 weeks.

   The additional fixation helped achieve greater stability of the fracture and offset the detrimental effects of smoking. This resulted in fracture consolidation within a reasonable time and early weightbearing without complications.

In Conclusion

The risks and complications associated with cigarette smoking are well documented. Ideally, the patient will start a smoking cessation program prior to elective surgery. The surgeon must be aware of the complications and make an effort to educate the patient of these risks.

   Dr. Fallat is the Program Director of the Podiatric Surgery Residency at the Oakwood Annapolis Hospital within the Oakwood Healthcare System in Wayne, Mich. He is a Fellow of the American College of Foot and Ankle Surgeons.

   Dr. Chahal is a second-year podiatric surgery resident with the Oakwood Annapolis Hospital within the Oakwood Healthcare System in Wayne, Mich.

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c cernaksays: April 5, 2013 at 10:36 am

I believe a few years ago I read in one of the major journals that you never do elective surgery on a smoker. I've abided by that rule for over 20 years. If they were in enough pain that they needed to consider foot surgery, they were referred back to their primary care doctor to get help to stop smoking before the surgery was scheduled. If there were ever doubts they had quit, a nicotine level was run a day or so before the case was to be scheduled.

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