The implications of vaping on surgical wound healing: A systematic review

Surgery. 2023 Jun;173(6):1452-1462. doi: 10.1016/j.surg.2023.02.017. Epub 2023 Mar 29.


Background: E-cigarette use is rapidly growing, and little is known about the postoperative complications. Cigarette smoking has been well-established to be associated with delayed wound healing and increased complications in surgical patients. Due to the intricate and harmonious nature of the wound-healing process, vaping may impair tissue regeneration, posing a risk for patients undergoing surgery. This systematic review aimed to review the evidence on the implications of vaping on wound healing.

Methods: A systematic search of PubMed and Scopus databases was conducted on October 2022 per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following keywords were used to conduct the search: vaping, vape, e-cigarettes, electronic cigarettes, wound healing, tissue regeneration, postoperative complications, wound infection, and blood flow.

Results: Of 5,265 screened articles, only 37 were eligible for qualitative synthesis. A total of 18 articles studied the effect of e-cigarettes on human volunteers, 14 investigated e-cigarette extract on human cell lines, and 5 used animal rat models.

Conclusion: Despite limited objective data, the recommendation is that e-cigarettes be treated as tobacco cigarettes; hence, vaping should be stopped in the perioperative period to decrease the incidence of wound healing complications. Clinical trials are required to understand the health hazards of e-cigarettes further and maximize patient safety and clinical outcomes.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Animals
  • Electronic Nicotine Delivery Systems*
  • Humans
  • Perioperative Period
  • Postoperative Complications / etiology
  • Rats
  • Surgical Wound*
  • Vaping* / adverse effects
  • Vaping* / epidemiology