Use Of Nicotine Replacement Therapy In Active Smokers Is Associated With Increased Complication Rate In Breast Surgery
Sifon Ndon, Zhenzhen Xu, B.A., Rance JT Fujiwara, B.S., Lisa Fucito, Ph.D., Steven Bernstein, Ph.D., Henry C. Hsia, MD.
Yale School of Medicine, New Haven, CT, USA.
This study aims to determine the effect of nicotine replacement therapy (NRT) on surgical outcomes such as rates of complications in patients undergoing breast surgery. METHODS:
A retrospective chart review of female smokers undergoing breast surgery between January 2014 and April 2017 within the Yale New Haven Health System spanning across four hospitals was performed. Active smoking was defined as cigarette use within one month before or after surgery. Statistical analyses were performed using Stata software.
254 patients were identified, 34 of whom had documented NRT use six months within their breast surgery. See Table 1 for patient demographics. 52.9% of those with NRT use developed complications-such as infections, wound dehiscence, seromas, hematomas, tissue necrosis, fat necrosis, and lymphedema-compared to 30.5% of their non-NRT counterparts. Multivariate logistic regression accounting for covariates including age, race, BMI, Charlson comorbidity index, insurance type, race, and presence of multiple procedures resulted in a statistically increased risk of complication development in smokers with NRT use [OR 2.42 (1.10-5.33), p=0.027].
In our experience, concurrent NRT use in active smokers undergoing breast surgery was associated with an increased risk of postoperative complications compared to those not using NRT. We advise caution regarding prescribing NRT to active smokers in preparation for surgery, and recommend prospective studies to better elucidate the relationship between NRT use and postoperative outcomes.
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