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Adverse Effects of Smoking on Wound Complications for Ankle and Calcaneus Fracture Fixation and Total Ankle Arthroplasty: A Meta-analysis
Other Title
Adverse Effects of Smoking on Wound Complications for Ankle and Calcaneus Fracture Fixation and Total Ankle Arthroplasty: A Meta-analysis
Type
thesis
Date Issued
2025-06-21
Author(s)
Tran Nguyen Anh Duy
Advisor
郭宜潔 ;陳昱斌
Subjects
系所名稱：國際醫學研究博士學位學程
Publisher
國際醫學研究博士學位學程
Description
學位別：博士
口試委員：郭宜潔; 陳昱斌; 陳加憲; 曾峰毅; 林宗瑩
關鍵字：Smoking、Tobacco、Cigarette、Ankle、Calcaneus、Fixation、Arthroplasty、Wound complications
口試委員：郭宜潔; 陳昱斌; 陳加憲; 曾峰毅; 林宗瑩
關鍵字：Smoking、Tobacco、Cigarette、Ankle、Calcaneus、Fixation、Arthroplasty、Wound complications
Abstract
Background: Cigarette smoking has been shown to cause adverse outcomes following orthopedic surgery. Although numerous studies have demonstrated this negative association in the context of ankle and calcaneus fracture fixation (ACFF) and total ankle arthroplasty (TAA), others have not. Aim: This meta-analysis was undertaken to elucidate the impact of smoking on wound complications (WCs) following these procedures.
Methods: A comprehensive search of electronic databases via PubMed, Embase, and Scopus was conducted to identify studies investigating the relationship between smoking and complications following ACFF and TAA. The quality of included studies was assessed using the Newcastle-Ottawa Scale, and random-effects models were employed to calculate odds ratios (OR) and 95% confidence intervals (CI).
Results: The analysis included data from 44 studies, encompassing a total of 72,773 participants. Results demonstrated a significantly increased risk of any WCs for both ACFF (32 studies; OR: 1.87; 95% CI: 1.57–2.24; p<0.001; I²=47%) and TAA (12 studies; OR: 1.80; 95% CI: 1.01–3.20; p=0.050; I²=74%), among smokers compared to non-smokers. Subgroup analysis showed that patients identified as current smokers had a significantly increased risk of WCs by 1.66 and 3.30 times after ACFF and TAA surgery, respectively.
Conclusions: Smoking, particularly current smoking, significantly elevates the risk of WCs after ACFF and TAA. Clinicians should consider smoking status when planning surgical interventions for these patients, with smoking cessation being a recommended preoperative measure to mitigate these risks.
Methods: A comprehensive search of electronic databases via PubMed, Embase, and Scopus was conducted to identify studies investigating the relationship between smoking and complications following ACFF and TAA. The quality of included studies was assessed using the Newcastle-Ottawa Scale, and random-effects models were employed to calculate odds ratios (OR) and 95% confidence intervals (CI).
Results: The analysis included data from 44 studies, encompassing a total of 72,773 participants. Results demonstrated a significantly increased risk of any WCs for both ACFF (32 studies; OR: 1.87; 95% CI: 1.57–2.24; p<0.001; I²=47%) and TAA (12 studies; OR: 1.80; 95% CI: 1.01–3.20; p=0.050; I²=74%), among smokers compared to non-smokers. Subgroup analysis showed that patients identified as current smokers had a significantly increased risk of WCs by 1.66 and 3.30 times after ACFF and TAA surgery, respectively.
Conclusions: Smoking, particularly current smoking, significantly elevates the risk of WCs after ACFF and TAA. Clinicians should consider smoking status when planning surgical interventions for these patients, with smoking cessation being a recommended preoperative measure to mitigate these risks.