The Surgical Impact of E-Cigarettes: A Case Report and Review of the Current Literature.

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The Surgical Impact of E-Cigarettes: A Case Report and Review of the Current Literature.

Arch Plast Surg. 2017 Oct 26;:

Authors: Fracol M, Dorfman R, Janes L, Kulkarni S, Bethke K, Hansen N, Kim J

Abstract
We report a case of a 51 year old female with a 25 pack year smoking history who underwent bilateral mastectomy and immediate tissue expander reconstruction for newly diagnosed right breast cancer. The patient reported herself as a non-smoker despite significant e-cigarette use, with resulting significant mastectomy skin flap necrosis and breast reconstruction failure. Little is known about the physiologic effect of e-cigarettes on wound healing and tissue perfusion. To this end, we provide an updated review of the impact of e-cigarettes on surgical outcomes. PubMed, Ovid MEDLINE, and PRS GO were searched for the terms "e-cigarette", "electronic cigarette", "e-cig", "electronic nicotine delivery system", "vaping", "surgery", "surgical", "peri-operative", "operate", "operative" and "wound healing". Abstract review of all articles was performed. 123 articles returned that contained both variants of e-cigarettes and surgery as keywords. Of those, manual assessment returned three articles which were found to be relevant to e-cigarette use in the surgical patient. No articles were found that compared perioperative complications in e-cigarette versus traditional cigarette users in humans. In conclusion, our case report depicts the potential dangers associated with e-cigarette use in the surgical patient. There is a public misconception that e-cigarettes are healthier than traditional cigarettes and as such their use may go unreported by patients. Early evidence suggests e-cigarettes may induce some of the same physiologic changes as traditional cigarettes, and may have a significant deleterious effect on wound healing.

PMID: 29069879 [PubMed - as supplied by publisher]