The effect of smoking on 30-day complications following primary repair of Achilles tendon ruptures

Authors

Anna M. Ifarraguerri, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA.
Theodore Quan, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA.
Benjamin Farley, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA.
Emile-Victor Kuyl, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA. emilekuyl@gwu.edu.
John Koch, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA.
Philip M. Parel, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA.
Alisa Malyavko, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA.
Sean Tabaie, Department of Orthopaedic Surgery, Children's National Hospital, Washington, DC, USA.

Document Type

Journal Article

Publication Date

9-26-2023

Journal

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie

DOI

10.1007/s00590-023-03730-8

Keywords

Achilles tendon rupture; Complications; Smoking; Surgical repair; Urinary tract infection; Wound dehiscence

Abstract

PURPOSE: There exists a gap in the knowledge of the impact of smoking on Achilles tendon rupture repair. This study evaluates perioperative and postoperative complications associated with smoking to allow for a more informed evaluation and discussion with the patients when considering the surgical management of Achilles tendon repair in this patient population. METHODS: The National Surgical Quality Improvement Program database was queried for patients undergoing Achilles tendon rupture repair from 2006 to 2019. Two patient cohorts were defined in this retrospective study: smokers and patients who did not smoke. The various patient demographics, medical comorbidities, and postoperative outcomes were compared using bivariate and multivariate analyses between the smoking and non-smoking groups. RESULTS: Of 4209 patients who underwent Achilles tendon repair, 3662 patients (87%) did not smoke, whereas 547 patients (13%) were smokers. Patients who were smokers were more likely to be younger and have a higher body mass index. Following multivariate analyses, those who smoked had an increased risk of experiencing wound dehiscence (OR 3.57; p = 0.013) and urinary tract infections (OR 1.21; p = 0.033) compared to non-smoking patients. CONCLUSION: Despite the rate of complications being relatively low in the short-term perioperative period, individuals who smoke should be counseled on the surgical risks they may experience following Achilles tendon repair, including wound dehiscence and urinary tract infections. Discussion preoperatively between the physician and patient who smoke can include ways in which postoperative care will be done to minimize the risk of adverse events, ultimately reducing costs for both the patient and the hospital.

APA Citation

Ifarraguerri, Anna M.; Quan, Theodore; Farley, Benjamin; Kuyl, Emile-Victor; Koch, John; Parel, Philip M.; Malyavko, Alisa; and Tabaie, Sean, "The effect of smoking on 30-day complications following primary repair of Achilles tendon ruptures" (2023). GW Authored Works. Paper 3347.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3347

Department

Orthopaedic Surgery