What is the dermatologic preoperative evaluation and management of nicotine?

Updated: Mar 16, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Answer

Answer

Nicotine is a potent vasoconstrictor that has been shown to have a detrimental effect on wound healing. Nicotine can be an important cause of flap necrosis, especially where extensive surgical undermining is needed. A history of cigarette smoking is important to elicit in elderly persons, in whom slow wound healing is already a risk. Patients should be urged to discontinue smoking before and after surgery. In general, persons who smoke should be strongly encouraged to stop smoking for at least 1 week preoperatively and 2 days postoperatively to minimize adverse reactions.


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