Smoking and wound healing
By Dr. Sergio Mazzei, General Surgeon
Smoking harms nearly every organ in the human body and it may be the cause of heart disease, stroke, lung cancer, diabetes. However, not many people know that smoking also slows down healing process. It’s important to know the dangers of smoking, especially if you are recovering from an injury, a surgery or a painful back condition.
Oxygen is the basis for wound healing, and it begins at the cellular level. Smoking deprives the body of the oxygen it needs to repair wounds and build new tissue. Chemicals found in cigarette smoke cause many changes to the way our body handles oxygen. Therefore, haemoglobin, a molecule which transports oxygen throughout the body, cannot carry as much oxygen as usual when it is exposed to cigarette smoke.
Smoking also narrows the blood vessels. This can slow the supply of blood, oxygen and nutrients to the healing wound. A wound that does not get enough oxygen and nutrients may result in a wound that does not heal.
In addition, smoking makes blood thicker, so it doesn’t flow as easily through narrowed blood vessels. Blood thickening increases the risk for the development of blood clots in the leg, which can cause heart attacks, strokes and pulmonary embolism.
Cigarette smoking is a key risk factor for poor wound healing, with a greater risk of infection and scarring. Various chemicals – such as nicotine – are detrimental to tissue oxygenation and the immune response. Moreover, there are many unknowns about the chemicals found in e-cigarette vapor. But most e-cigarettes contain nicotine and can slow down healing, just like regular cigarettes do.
The reduced capacity for wound repair is a particular concern in patients undergoing plastic or reconstructive surgery. Compared with nonsmokers, smokers have a higher rate of unsatisfactory healing after face-lift surgery, as well as a greater degree of complications following breast surgery.
Recent research shows that smoking has other far-reaching effects.
- Wounds. Smokers have more trouble recovering from surgeries. There is a greater risk for wound infections, failed skin grafts, scarring, and torn stitches.
- Bone fractures. Smoking increases your risk for spine, forearm, and hip fractures. Smokers have higher rates of bone infections and nonunions (permanent failure of healing after a fracture).
- Osteoporosis. Smoking decreases bone density, increasing the risk for osteoporosis and its complications: a hunched back, fractures of the spine/hips/wrists.
- Muscle pain is a common complaint in chronic conditions like fibromyalgia. Smoking impairs blood flow to the muscles and interferes with the removal of lactic acid, leading to prolonged muscle pain.
- Quit smoking.
- Seek help from your specialist. Smoke cessation used alongside treatments from your pain specialist can speed your recovery.
- Improve your diet. Eat foods rich in Vitamin C, Vitamin D and Calcium.
- Exercise. It improves blood flow to injured tissues.
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