Association of Nicotine Cessation Time on the Incidence of Recurrent Incisional Hernia Repair and Postoperative Surgical Site Occurrences

Am Surg. 2023 Dec;89(12):6127-6133. doi: 10.1177/00031348231192042. Epub 2023 Jul 27.

Abstract

Background: Nicotine products are believed to be associated with a higher incidence of incisional hernia (IH) recurrence and postoperative complications after IH repair.

Methods: A retrospective analysis of the Abdominal Core Health Quality Collaborative (ACHQC) database was performed. Outcomes included risk of IH recurrence, 30-day surgical site infection (SSI), and 30-day surgical site occurrence (SSO).

Results: We included 14,663 patients. Nicotine users who quit within 1 year of surgery had a 26% higher risk of IH recurrence compared to patients who quit more than a year before surgery or never users. Patients who quit using nicotine within 1 year of surgery had a 54% higher odds of SSI compared to former nicotine users who quit more than a year before surgery.

Conclusion: Former nicotine users with less than 1 year of nicotine use cessation before surgery exhibited worse outcomes than those with more than a year of cessation or no prior use.

Keywords: hernia infection; hernia recurrence; incisional hernia; nicotine use; wound healing.

MeSH terms

  • Hernia, Ventral* / complications
  • Hernia, Ventral* / epidemiology
  • Hernia, Ventral* / surgery
  • Herniorrhaphy / adverse effects
  • Humans
  • Incidence
  • Incisional Hernia* / epidemiology
  • Incisional Hernia* / etiology
  • Incisional Hernia* / surgery
  • Nicotine / adverse effects
  • Recurrence
  • Retrospective Studies
  • Surgical Mesh / adverse effects
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / surgery

Substances

  • Nicotine