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Smoking found to be associated with delayed wound healing

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Smoking has been found to be linked to the delayed healing of wounds after shinbone surgery, according to researchers.

As a result, the said recommended that all fracture patients should be provided with smoking cessation support to boost recovery.

“All fracture patients should be provided with support for smoking cessation”

Hannah Daily

They analysed 1,003 tibial fracture patients over 20 years. Their findings included increased risk of arrested healing among women aged 30-49 and a significant delay in bone healing among smokers.

They noted that, in adults, tibia fractures were usually fixed through the surgical implantation of a slender metal rod called an intramedullary nail in the hollow space within the bone.

This treatment is generally effective for tibial fractures. However, in 10% to 15% of cases the bone fails to heal in a timely manner, resulting in a “non-union” or arrested healing.

Considered a serious complication in the healing of a fracture, patients who experience non-union can be significantly affected by pain, increased duration of opioid use, and depression.

The study involved researchers from Lehigh University in Pennsylvania and Scotland’s Royal Infirmary of Edinburgh.

One surprising result the researchers found was that patients in the middle decades of life, particularly women aged 30-49, seemed to be at increased risk of non-union.

In addition, another important result from the study was that smoking significantly delays bone healing, said the researchers in the Journal of Orthopaedic Trauma.

“This finding does not have a simple obvious biological explanation”

Hannah Dailey

Hannah Dailey, assistant professor in mechanical engineering and mechanics at Lehigh, said: “We are all familiar with some of the more well-known negative health effects of smoking, but the influence on bone healing is less widely known outside the medical community.

“Our study recommended that all fracture patients should be provided with support for smoking cessation to help reduce the risk of complications related to their injury,” she said.

Regarding the heightened risk among women, she said: “This finding does not have a simple obvious biological explanation.

“[It] suggests that there are other factors – such as living environment, employment, activity levels and others – that could be contributing to bone healing in a way that isn’t easy to measure,” she said.

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