NEW YORK (Reuters Health) - Quitting smoking for as little as 4 weeks can dramatically reduce the odds of wound infection after surgery, according to a new report.

Surgery patients are routinely advised to quit smoking before their operation, and previous research has shown that abstinence from smoking can reduce post-op complications, including wound infection. However, exactly how long abstinence must be maintained to produce a benefit has been unclear. To investigate, Dr. Lars Tue Sorensen and colleagues, from Bispebjerg University Hospital in Copenhagen, studied the healing of small incisions in 78 volunteers. Some were habitual smokers and some had never smoked. Half the smokers were allowed to continue smoking while the others abstained from smoking using a nicotine or placebo patch. After 1 week and again at 4, 8, and 12 weeks later, small suture-closed incisions were made on the smokers. For comparison, among most of the never-smokers an incision was made at only one of those time points. Wounds became infected in 12 percent of smokers, significantly more than the 2 percent of never-smokers, the investigators report in the Annals of Surgery. In addition, wounds broke open in 12 percent of smokers, while no ruptures were seen among never-smokers. After 4 weeks and again at 8 and 12 weeks, abstinent smokers were significantly less likely to develop a wound infection than continuous smokers. Moreover, this benefit did not depend on whether they quit using a nicotine or placebo patch. No difference in wound rupture rates was seen between abstainers and continuous smokers. Just 4 weeks of abstinence from smoking "reduces wound infections to a level similar to never-smokers," Sorensen's team concludes. Two Stanford University physicians point out in a commentary that these results "suggest that surgeons need to be even more active in recommending smoking cessation programs to their patients because the impact of smoking on even minor incisions can be significant."

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