Smoking before surgery can be a fire hazard, warned doctors at the Munich Surgery Congress.
There is a risk of complications from anesthesia and wound healing.
"One last cigarette on the way to the hospital won't be so bad," many smokers think.
But that can turn out to be a fatal misconception, surgeons warn: "Smoking right after an operation can lead to serious problems, among other things, with anesthesia and wound healing." The connections and backgrounds are explained by Prof. Tim Vilz, Prof. Andreas Seekamp and Prof. Thomas Schmitz-Rixen in a conversation with Münchner Merkur and tz on the occasion of the German Surgery Congress 2023 in Munich.
Surgery professors: Smoking increases blood pressure and heart rate
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Professor Thomas Schmitz-Rixen is Secretary General of the German Society for Surgery.
© private
When inhaling cigarette smoke, carbon monoxide enters the blood through the lungs.
“As a result, oxygen is displaced from the blood and the tissue can be undersupplied with oxygen.
This has a negative effect on wound healing,” the experts explain.
Nicotine also increases blood pressure and heart rate.
This effect - in combination with the lack of oxygen - can in some cases cause complications during anesthesia and sometimes also impede healing in the days and weeks after the procedure.
Study shows: Stopping smoking at least four weeks before the operation has advantages
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Professor Andreas Seekamp is President of the German Society for Surgery.
© German Society for Surgery
A scientific study by the international research network "Cochrane Collaboration" has shown how great the influence of smoking is.
It examined the medical histories of patients who smoked their last cigarette at least four weeks before an operation.
"These patients had fewer wound healing disorders," report Professors Vilz, Seekamp and Schmitz-Rixen.
This is often of crucial importance, especially for cancer patients undergoing tumor surgery.
"In their cases, wound healing disorders can delay any necessary chemotherapy after the operation or worsen the prognosis."
Avoid alcohol before the operation and exercise in moderation
In addition to stopping smoking, it also makes sense to avoid alcohol before an operation.
"Like nicotine, alcohol is a cytotoxin that damages the body and increases the risk around surgery," warn the surgeons.
Exercise is part of good preparation for an operation.
Walking or cycling is advisable.
Light endurance training combined with strength and stretching exercises is optimal.
"However, patients should definitely discuss with their doctor how much training makes sense with a view to possible previous illnesses."
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Surgeon Professor Tim Vilz from the Bonn University Hospital.
© Saba, Johann F. - UKB
Surgeons advise: Work through a checklist with important questions before the operation
Before an operation, the patient should discuss the planned procedure with his family doctor, advise the surgery professors.
"The crucial questions are: Is the surgery necessary in the form suggested by the surgeon, and is it carried out often enough in the hospital?" The background: Studies show that the complication rate is lower in experienced and practiced surgeons and hospitals with a corresponding focus than in houses where the interventions in question are carried out comparatively rarely.
Six criteria for more safety and high quality in surgery
According to Prof. Vilz, Prof. Seekamp and Prof. Schmitz-Rixen, important criteria for a high level of safety and quality are the following six points: a personal interview with the surgeon, information about possible alternatives to surgery (including conservative treatments) , unembellished information about the risks of the procedure, discussion of the probable course after the operation, timely advice on how the patient can improve their fitness up to the day of the operation and, if in doubt, obtaining a second opinion.
