CIGARETTE-SMOKING, PLASTIC-SURGERY, AND MICROSURGERY

Although tobacco smoking is known to result in coronary heart disease, chronic obstructive pulmonary disease, peripheral vascular disease, c erebrovascular disease, lung cancer, and other smoking cancers, many s urgeons believe that smoking also results in impaired wound healing an d poor surgical results. Large clinical experiences in several areas o f plastic surgery reinforce this suspicion. Procedures that have been noted to be adversely affected by cigarette smoking include rhytidecto my, abdominoplasty, breast reconstruction, free-tissue transfer, and d igital replantation. This article reviews the available data, introduc es new clinical data, and hypothesizes about the ways in which some pr ocedures are more affected than others.