6 May 2016
A four year study of more than 300 Queensland trauma patients
has shown that smokers and patients with comorbidities are at
increased risk of developing an infection following surgery.
Post-operative infection is particularly problematic in trauma
patients requiring metal plates or prosthetics because it may
require the whole operation to be done again.
Dr Andrew Lewandowski from the Gold Coast University Hospital
says that being a smoker increases your chances of getting bone
infections if metalwork has been used to fix fractures.
"We know that smoking even one cigarette constricts your small
blood vessels, particularly at the site where a fracture is
healing, reducing blood flow and the capacity of the body to heal,"
Dr Lewandowski says.
"Smoking has been shown to drastically increase the time for all
surgical wounds to heal, and is often a reason surgery is cancelled
in an elective setting.
"Unfortunately when treating fractures in an emergency we can't
completely stop people from smoking and so we see high rates of
infections in these patients.
"Our study focused on fractures of the upper and lower limbs
where a tourniquet was used in the surgery, and we found that the
timing of antibiotic administration was also a big factor in
whether patients developed a post-operative infection.
"Antibiotics need to be circulating in the blood before surgery
begins, and in orthopaedic surgery where a tourniquet is used,
there often isn't time for the medicine to fully circulate in the
limb before blood supply is cut off.
"We found that rates of infection were reduced when antibiotics
were administered between 11 and 30 minutes before tourniquet
"It is hoped that these findings will allow us to alter clinical
practice to reduce rates of infection following trauma surgery, but
it is another reminder for people to quit smoking to avoid serious
Dr Lewandowski is presenting his findings at the Royal
Australasian College of Surgeons Annual Scientific Congress in
Brisbane this week.
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