Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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The Surgical Impact of E-Cigarettes: A Case Report and Review of the Current Literature

  • Fracol, Megan (Division of Plastic Surgery, Northwestern Memorial Hospital) ;
  • Dorfman, Robert (Division of Plastic Surgery, Northwestern Memorial Hospital) ;
  • Janes, Lindsay (Division of Plastic Surgery, Northwestern Memorial Hospital) ;
  • Kulkarni, Swati (Lynn Sage Comprehensive Breast Center, Northwestern Memorial Hospital) ;
  • Bethke, Kevin (Lynn Sage Comprehensive Breast Center, Northwestern Memorial Hospital) ;
  • Hansen, Nora (Lynn Sage Comprehensive Breast Center, Northwestern Memorial Hospital) ;
  • Kim, John (Division of Plastic Surgery, Northwestern Memorial Hospital)
  • Received : 2017.01.18
  • Accepted : 2017.08.08
  • Published : 2017.11.18
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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.

Keywords

References

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