Surgeons warn against smoking 6 weeks before surgery

Medical professionals in surgery have warned smokers scheduled for major operations to stop smoking for at least six weeks or more before the procedure date, to avoid poor outcomes.

Frowning at smoking before surgery, they warned that it can impair lung functions during anaesthesia, predispose an individual to lung infections, slow down the healing process of the surgery area, as well lead to slow recovery time.

The World Health Organisation has severely warned that tobacco smokers are at significantly higher risk than non-smokers for post-surgical complications, including impaired heart and lung functions, infections and delayed, or impaired wound healing.

A renowned Professor of Orthopaedics and Trauma Surgery at the  Ahmadu Bello University, Zaria, Mike Ogirima,  said smoking before surgery might expose one to bronchitis.

He said, “We advise people to stop smoking for at least six weeks before major surgery because smoking has been associated with some risks on general anaesthesia. Smoking is dangerous to health.

“The lungs have to be healthy before you undergo general anaesthesia. Also, smoking has been associated with reduced immunity. So, with these two factors, if a smoker undergoes major surgery, there will be a problem in wound healing.

“After surgery, the patient should allow the wound to heal before smoking. Due to the carbon deposit on the lung tissue under anaesthesia, oxygen intake reduces.”

For women who smoke after a caesarean section, the orthopaedic and trauma surgeon said it would expose them to infection due to lowered immunity.

Prof.Ogirima, who is a former President of the Nigerian Medical Association, also warned

“It exposes one to bronchitis and lung infection. That persistent cough will lead to a continuous increase in intra-abdominal pressure.against smoking after surgery, adding, “It is not advisable to smoke just like that after surgery.”

“That is why there is a high incidence of abdominal hernia in smokers because of the persistent increase in intra-abdominal pressure from coughing.”

According to the professor, major surgeries are those that will last more than 30 minutes and involves loss of blood.

He said they include brain surgery, hip surgery, Caesarean Section, open heart surgery, fibroid surgery and removal of the prostate.

“It is more disastrous to smoke before surgery than after surgery. If the person wants to smoke after surgery, it is at his own risk”, the surgeon added.

Also, an Associate Professor, at the Plastic Surgery Unit, College of Medicine, University Of Lagos, Bolaji Mofikoya, said for individuals meant to undergo surgical procedures, smoking poses many dangers.

He said, “The World Health Organisation has reported that smoking significantly increases the incidence of adverse outcomes and complications following virtually all types of surgery.

“They. therefore, recommended that patients who are scheduled for elective surgery should stop smoking four weeks or more before the date to minimise complications and improve outcomes.

“Among many other things, smoking has been shown to increase the risk of blood clots in the vessels, thus leading to potential life-threatening clots in the lungs.

“It has also shown conclusively that smokers have impaired lung function during anaesthesia and slower recovery following surgery.

“Smokers also tend to have impaired immune response leading to an overall increase in wound healing complications, infections and a generally poorer outcome.”

The plastic surgeon further said scientists have demonstrated that only one stick of cigarette decreases the body’s ability to deliver necessary nutrients for healing after surgery.

“Surgical operations on the brain, heart, intestines and spine have worsened outcomes in smokers including individuals with second-hand smoke exposure (people who do not smoke but are usually around smokers).

“In recent times, there has been a rise in the popularity of e-cigarettes or vaping, which is often common among teenagers and youths.

“Vaping or the use of electronic cigarettes still contains nicotine or other harmful additives and can be associated with lung injury (EVALI). This has also been associated with an increased risk of complications in patients undergoing surgery.”

Collectively, the surgeons urged patients going for major surgeries to avoid smoking and not to joke with their health.

On the risk of smoking after surgery, the WHO says smoking tobacco also damages the lungs making it difficult for the proper amount of air to flow through, increasing the risk of post-surgical complications to the lungs.

“Smoking distorts a patient’s immune system and can delay healing, increasing the risk of infection at the wound site.

“Complications after surgery present a large burden for both the health care provider and the patient”, the global health body said.

Giving further insights into why it is important to stop smoking before surgery,  the American Society of Anesthesiologists said,  “If you smoke, your heart and lungs don’t work as well as they should.

“You may have breathing problems during or after surgery, and you are at greater risk of developing pneumonia. You are also much more likely to need a ventilator, a machine that breathes for you, after surgery. In addition, smoking reduces blood flow, which slows healing, so your surgical incision is more likely to become infected.

“Because smoking is a major cause of heart disease, your chances of suffering a heart attack during or after surgery increase.”

 

 

Healthwise/S.S