Biomedical Research

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.

Research Article - Biomedical Research (2017) Volume 28, Issue 4

The effects of preoperative smoking cessation on the healing of fractures and postoperative complications: A systematic review and meta-analysis

Introduction: Smoking is a known risk factor for fracture healing and postoperative complications. However, most evidence upon the association between bone healing and smoking was investigated in retrospective studies or laboratory-based animal studies. This meta-analysis evaluated the clinical efficacy of preoperative smoking cessation on the healing of fractures and postoperative complications.

Evidence Acquisition: MEDLINE, EMBASE, CNKI and the Cochrane Database were retrieved for identifying relevant study. Four studies, including three Randomized Controlled Clinical Trials (RCTs) and one Non-Randomized Concurrent Controlled Trial (NRCCTs), involving a total of 510 patients, were included.

Evidence Synthesis: In the patients with preoperative smoking cessation, the risk of overall postoperative complications was lower (Risk Ratio (RR) 0.37; 95% Confidence Interval (CI) 0.26 to 0.52; P=0.49) when compared with the patient without smoking cessation. Preoperative smoking cessation reduced the risk of wound-related complications ((RR) 0.21; 95% (CI) 0.11 to 0.39; P=0.42), recurrent surgery ((RR) 0.23; 95% (CI) 0.08 to 0.67; P=0.42) and additional complications ((RR) 0.41; 95% (CI) 0.25 to 0.67; P=0.85). One NRCCT showed that the risks of fracture non-union (P=0.03) and osteomyelitis (P=0.49) in the patients with preoperative smoking cessation were reduced.

Conclusion: Our study supports the role of preoperative smoking cessation on orthopaedic surgery outcomes.

Author(s): Wei Min, Rongze An, Songjun Li, Jiaying Feng, Jin Yang, Zhiming Huang

Abstract Full Text PDF