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Friday, March 2, 2001

Another reason why people should give up smoking

Add to the list of reasons why people should not smoke a study presented Thursday in scientific paper 175, which found smokers had a significantly higher percentage of poor outcomes, following Ilizarov reconstruction. The result, say the investigators, is that smokers are no longer offered elective Ilizarov reconstruction at St. Michael's Hospital and Sunnybrook Health Sciences Centre, Toronto, Canada.

The investigators performed a retrospective review of 110 adult patients (112 limbs) who underwent treatment using the Ilizarov technique. There were 52 limbs in nonsmokers and 60 limbs in active smokers. Preoperatively, there were no significant differences with respect to age, operative indications, application site or active infection.

There were 39 major complications including 12 nonunions, three malunions, seven refractures, 10 persisting infections, five amputations and two "others." All five amputations were in smokers (p = 0.041).

Outcome was measured using the Association for the Study and Application of the Method of Ilizarov Group outcome scale. In smokers (n = 60) there were 29 excellent, 12 good, one fair, and 18 poor results. In nonsmokers (n = 52) there were 40 excellent, eight good, and four poor results.

There were significantly more poor results in the smoking group than in the nonsmoking group (18 of 60, 30 percent vs. four of 52, 8 percent, p = 0.003). Eight of 10 patients with persisting infection were smokers (p = 0.075). There was a higher incidence of nonunion in the smoking group (p = 0.027).

The investigators are Dennis J. DiPasquale; MD; Michael D. McKee, MD; Lisa M. Wild, BScN; David J. Stephen, MD; Hans J. Kreder, MD; and Emil H. Schemitsch, MD, all of Toronto, Ont. Canada.

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Last modified 15/February/2001 by IS