Cigarettes, people must smoke them.

[George12]

I was thinking about everyone here talking about not smoking, and how many people smoke. People have to smoke after their surgeries, many people are very addicted and couldn't stop for more than 3-4 days.

I am 5 days post op and I smoked 3 cigarettes today. I do smoke and told my surgeon, he didn't he tell me I needed to stop before or after. I didn't smoke for 4 days after the surgery and I smoked a cigarette I had left and the 3 today. Am I going to get necrosis and my skin will eat away and die? I refuse to believe that and was wondering a doctors opinion.

If I get necrosis what will happen? Are there any signs?

Thank you.

[George12]

Could any doctor help?

[Dr. Elliot Jacobs]

It is rare that smoking will interfere to the extent that you have described.  But you must understand that it is the nicotine in the smoke which is the offender -- and nicotine constricts and tightens blood vessels so that there is diminished blood flow to your skin.  Diminished blood flow means slower healing and wounds that heal poorly.

A word to the wise!  Don't smoke!

Dr Jacobs

[DrBermant]

I was thinking about everyone here talking about not smoking, and how many people smoke. People have to smoke after their surgeries, many people are very addicted and couldn't stop for more than 3-4 days.

I am 5 days post op and I smoked 3 cigarettes today. I do smoke and told my surgeon, he didn't he tell me I needed to stop before or after. I didn't smoke for 4 days after the surgery and I smoked a cigarette I had left and the 3 today. Am I going to get necrosis and my skin will eat away and die? I refuse to believe that and was wondering a doctors opinion.

If I get necrosis what will happen? Are there any signs?

Thank you.

Actually the nicotine and the carbon monoxide from cigarettes can compromise blood supply to tissue.  The more precarious the blood supply, the more extensive the risk.  The effect is almost instantaneous for the constriction of the blood supply.  While I was at NYU, we used to have doppler detectors attached to the blood vessels of our microvascular flaps that would monitor the vascular supply constantly.  The alarms would sound and on entering the room you could still smell the sulfur from the match the patient had lit their cigarette.  Yes tissues can die with such compromise. I have seen replanted extremities, flaps, and extended tissue transfers compromised by such exposure.  Diminished blood supply can slow healing and tissue that might have survived, can die. Signs of compromised tissue can vary from pale, to white, to blue, to black. 

I caution all of my patients that they need to be off of all forms of Nicotine before and after surgery.  This is elective surgery, why take unnecessary risks?  If you are concerned about your own specific risks, check with your surgeon.

Hope this helps,

Michael Bermant, MD
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[Dr. Elliot Jacobs]

Oh, and by the way if you haven't heard -- smoking is really bad for your lungs too!

Dr Jacobs

[George12]

Ok thank you, I have quit smoking but wanted to know what was so terribly horrible about smoking them after surgery.