Arch Plast Surg.  2017 Nov;44(6):477-481. 10.5999/aps.2017.00087.

The Surgical Impact of E-Cigarettes: A Case Report and Review of the Current Literature

• Fracol M
• Dorfman R
• Janes L
• Kulkarni S
• Bethke K
• Hansen N
• Kim J

• KMID: 2403947
• DOI: http://doi.org/10.5999/aps.2017.00087

Abstract

We report a case of a 51 years old female with a 25 pack year smoking history who underwent bilateral mastectomy and immediate tissue expander reconstruction for newly diagnosed right breast cancer. The patient reported herself as a non-smoker despite significant e-cigarette use, with resulting significant mastectomy skin flap necrosis and breast reconstruction failure. Little is known about the physiologic effect of e-cigarettes on wound healing and tissue perfusion. To this end, we provide an updated review of the impact of e-cigarettes on surgical outcomes. PubMed, Ovid MEDLINE, and PRS GO were searched for the terms "e-cigarette", "electronic cigarette", "e-cig", "electronic nicotine delivery system", "vaping", "surgery", "surgical", "peri-operative", "operate", "operative", and "wound healing". Abstract review of all articles was performed. 123 articles returned that contained both variants of e-cigarettes and surgery as keywords. Of those, manual assessment returned three articles which were found to be relevant to e-cigarette use in the surgical patient. No articles were found that compared perioperative complications in e-cigarette versus traditional cigarette users in humans. In conclusion, our case report depicts the potential dangers associated with e-cigarette use in the surgical patient. There is a public misconception that e-cigarettes are healthier than traditional cigarettes and as such their use may go unreported by patients. Early evidence suggests e-cigarettes may induce some of the same physiologic changes as traditional cigarettes, and may have a significant deleterious effect on wound healing.

Keyword

Electronic cigarettes; Vaping; Nicotine; Wound healing; Surgery, plastic

MeSH Terms

Breast Neoplasms
Electronic Cigarettes*
Female
Humans
Mammaplasty
Mastectomy
Necrosis
Nicotine
Perfusion
Skin
Smoke
Smoking
Surgery, Plastic
Tissue Expansion Devices
Tobacco Products
Wound Healing
Nicotine
Smoke