A team of researchers examined outcomes after 'Mohs reconstruction,' a procedure to remove a skin cancer lesion. Once the cancer is removed, usually from the head or neck, surgeons may close the site using a flap made from surrounding tissue or a graft of skin taken from another area of the body.
For the study, the research team analyzed outcomes for 1,008 patients who had Mohs reconstruction with flaps or grafts, including 128 current smokers and 385 former smokers.
Compared to people who never smoked, current smokers were more than nine times as likely to have acute complications such as infections, clots (hematomas), uncontrolled bleeding, or dead skin tissue. Ex-smokers were more than three times as likely to have these complications.
"Smoking having an adverse effect on healing and outcomes ... has been documented for other procedures, but not previously for the repair of wounds with flaps and grafts after skin cancer removal,"
said Dr. Ian Maher, a professor of dermatology at the University of Minnesota in Minneapolis and senior author of the study.
On the other hand, good circulation is necessary for good healing, said Maher by email. "Smoking damages small blood vessels in many organs, including the skin. Having worse circulation slows healing and sets patients up for complications such as infection."
However, the research team says that smoking status did not appear to impact long-term outcomes. The findings of the study are published in the journal JAMA Facial Plastic Surgery.
One limitation of the study is that the research team lacked data on how much people smoked or for how long, and how recently any ex-smokers might have quit smoking.
However, current and former smokers should be aware that they have a higher risk for acute complications and do what they can to reduce their risk, said James Dinulos, founder of Seacoast Dermatology in Portsmouth, New Hampshire, and a clinical associate professor of surgery at the Geisel School of Medicine at Dartmouth in Hanover.