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Einfluss des Zigarettenrauchens auf die Hautdurchblutung der Hand

Effect of cigarette smoking on skin perfusion of the hand

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Zusammenfassung

Hintergrund

Zigarettenkonsum führt durch Beeinträchtigung der Hautdurchblutung zu postoperativen Wundheilungsstörungen.

Material und Methoden

Vierzehn Nichtraucher (Gruppe A) und 44 Raucher (Gruppe B) wurden untersucht und nach Alter (≤40 Jahre, >40 Jahre) und Dauer des Zigarettenkonsums eingeteilt. Unter Standardbedingungen wurde mittels Laser-Doppler-Imager die Durchblutung in Ruhe und während des Rauchens (Mittelfingerbeere) gemessen.

Ergebnisse

Die Hautdurchblutung verringerte sich bei Rauchern um 24% (p=0,001; junge: 39%, ältere: 11%) und bei Nichtrauchern um 30% (p=0,019; junge: 35%, ältere: 18%). Mit längerem Konsum war der Effekt schwächer (<10 Jahre: 25%, 11–30 Jahre: 18%, >30 Jahre: 15%). Kein Zusammenhang fand sich mit der Anzahl der Zigaretten/Tag.

Schlussfolgerung

Junge Menschen reagieren auf Zigarettenkonsum mit stärkerer Verminderung der Durchblutung. Bei elektiven Eingriffen bemühen wir uns besonders beim jungen Raucher um perioperative Nikotinkarenz und empfehlen den Beginn 6–8 Wochen im voraus.

Abstract

Background

Cigarette consumption leads to postoperative wound healing disturbances by impairing skin circulation.

Materials and Methods

Fourteen nonsmokers and 44 smokers were investigated and classified according to age (<40 and >40 years) and duration of cigarette consumption. Circulation at the tip of the middle finger was measured in both groups under standard conditions with laser Doppler imaging.

Results

There was a reduction in skin blood circulation of 24% in smokers (young 39%, older 11%, P=0.001) and 30% in nonsmokers (young 35%, older 18%, P=0.019). With longer duration of cigarette consumption, the effect grew weaker (<10 years 25%, 11–30 years 18%, >30 years 15%). There was no correlation between the number of cigarettes consumed per day and impaired circulation.

Conclusion

Younger subjects react to cigarette consumption with a stronger reduction in circulation. In elective surgery, especially in young smokers we recommend a 6- to 8-week nicotine abstinence prior to surgical intervention.

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Literatur

  1. Astrup P (1973) Carbon monoxide, smoking and cardiovascular disease. Circulation 48: 1167–1168

    PubMed  Google Scholar 

  2. Auerbach O, Hammond EC, Garfinkel L (1968) Thickening of walls of arterioles and small arteries in relation to age and smoking habits. N Engl J Med 2: 980–984

    Google Scholar 

  3. Bornmyr S, Svensson H, Lilja B, Sundkvist G (1997) Skin temperature changes and changes in skin blood flow monitored with laser Doppler flowmetry and imaging: a methodological study in normal humans. Clin Physiol 17: 71–81

    Article  PubMed  Google Scholar 

  4. Choi CM, Bennett RG (2003) Laser Doppler to determine cutaneous blood flow. Dermatol Surg 29: 272–280

    Article  PubMed  Google Scholar 

  5. Dalla Vecchia L, Palombo C, Ciardetti M et al. (2004) Contrasting effects of acute and chronic cigarette smoking on skin microcirculation in young healthy subjects. J Hypertens 22: 129–136

    PubMed  Google Scholar 

  6. Goodwin SJ, McCarthy CM, Pusic AL et al. (2005) Complications in smokers after postmastectomy tissue expander/implant breast reconstruction. Ann Plast Surg 55: 16–20

    Article  PubMed  Google Scholar 

  7. Heden P, Jurell G, Arnander C (1986) Prediction of skin flap necrosis: a comparative study between laser Doppler flowmetry and fluorescein test in a rat model. Ann Plast Surg 17: 485–488

    PubMed  Google Scholar 

  8. Hunt TK, Pai MP (1972) Effect of varying ambient oxygen tensions on wound metabolism and collagen synthesis. Surg Gynecol Obstet 135: 561–567

    PubMed  Google Scholar 

  9. Ijzerman RG, Serne EH, van Weissenbruch MM et al. (2003) Cigarette smoking is associated with an acute impairment of microvascular function in humans. Clin Sci (London) 104: 247–252

    Google Scholar 

  10. Jensen JA, Goodson WH, Hopf HW, Hunt TK (1991) Cigarette smoking decreases tissue oxygen. Arch Surg 126: 1131–1134

    PubMed  Google Scholar 

  11. Ludbrook J, Vincent AH, Walsh JA (1974) The effects of sham smoking and tobacco smoking on hand blood flow. Aust J Exp Biol Med Sci 52: 285–290

    PubMed  Google Scholar 

  12. Mahmud A, Feely J (2003) Effect of smoking on arterial stiffness and pulse pressure amplification. Hypertension 41: 183–187

    Article  PubMed  Google Scholar 

  13. Moller AM, Villebro N, Pedersen T, Tonnesen H (2002) Effect of preoperative smoking intervention on postoperative complications: a randomised trial. Lancet 359: 114–117

    Article  PubMed  Google Scholar 

  14. Monfrecola G, Riccio G, Savarese C et al. (1998) The acute effect of smoking on cutaneous microcirculation blood flow in habitual smokers and nonsmokers. Dermatology 197: 115–118

    Article  PubMed  Google Scholar 

  15. Morecraft R, Blair WF, Brown TD, Gable RH (1994) Acute effects of smoking on digital artery blood flow in humans. J Hand Surg [AM] 19: 1–7

    Google Scholar 

  16. Mosely LH, Finseth F (1977) Cigarette smoking: impairment of digital blood flow and wound healing in the hand. Hand 9: 97–101

    Article  PubMed  Google Scholar 

  17. Mosely LH, Finseth F, Goody M (1978) Nicotine and its effect on wound healing. Plast Reconstr Surg 61: 570–574

    PubMed  Google Scholar 

  18. Padubidri AN, Yetman R, Browne E et al. (2001) Complications of postmastectomy breast reconstructions in smokers, ex-smokers and nonsmokers. Plast Reconstr Surg 107: 342–349

    Article  PubMed  Google Scholar 

  19. Powers EW 3rd, Frayer WW (1978) Laser Doppler measurement of blood flow in the microcirculation. Plast Reconstr Surg 61: 250–255

    PubMed  Google Scholar 

  20. Reus WF, Robson MC, Zachary L, Heggers JP (1984) Acute effects of tobacco smoking on blood flow in the cutaneous micro-circulation. Br J Plast Surg 37: 213–215

    Article  PubMed  Google Scholar 

  21. Richardson D (1987) Effects of tobacco smoke inhalation on capillary blood flow in human skin. Arch Environ Health 42: 19–25

    PubMed  Google Scholar 

  22. Riefkohl R, Wolfe JA, Cox EB, McCarty KS Jr (1986) Association between cutaneous occlusive vascular disease, cigarette smoking, and skin slough after rhytidectomy. Plast Reconstr Surg 77: 592–595

    PubMed  Google Scholar 

  23. Sarin CL, Austin JC, Nickel WO (1974) Effects of smoking on digital blood-flow velocity. JAMA 229: 1327–1328

    Article  PubMed  Google Scholar 

  24. Seifalian AM, Stansby G, Jackson A, Howell K, Hamilton G (1994) Comparison of laser Doppler perfusion imaging, laser Doppler flowmetry and thermographic imaging for assessment of blood flow in human skin. Eur J Vasc Surg 8: 65–69

    Article  PubMed  Google Scholar 

  25. Siana JE, Rex S, Gottrup F (1989) The effect of cigarette smoking on wound healing. Scand J Plast Reconstr Surg Hand Surg 23: 207–209

    PubMed  Google Scholar 

  26. Silverstein P (1992) Smoking and wound healing. Am J Med 93: 22–24

    Article  Google Scholar 

  27. Tur E, Yosipovitch G, Oren-Vulfs S (1992) Chronic and acute effects of cigarette smoking on skin blood flow. Angiology 43: 328–335

    PubMed  Google Scholar 

  28. Van Adrichem LN, Hovius SE, van Strik R, van der Meulen JC (1992) Acute effects of cigarette smoking on microcirculation of the thumb. Br J Plast Surg 45: 9–11

    Article  PubMed  Google Scholar 

  29. Van Adrichem LN, Hovius SE, van Strik R, van der Meulen JC (1992) The acute effect of cigarette cigarette smoking on the microcirculation of a replanted digit. J Hand Surg [AM] 17: 230–234

    Google Scholar 

  30. Waeber B, Schaller MD, Nussberger J et al. (1984) Skin blood flow reduction induced by cigarette smoking. Role of vasopressin. Am J Physiol 247: 895–901

    Google Scholar 

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Danksagung

Wir bedanken uns bei der Firma GLOCK Ges.m.b.H. Europe für die Bereitstellung des Laser-Doppler-Imagers.

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Authors and Affiliations

  1. Universitätsklinik für Plastische und Wiederherstellungschirurgie, Anichstraße 35, 6020, Innsbruck, Österreich

    F. T. Petschke, T. O. Engelhardt &  H. Piza-Katzer

  2. Institut für Biostatistik und Dokumentation, Med. Univ. Insbruck

    H. Ulmer

Authors
  1. F. T. Petschke
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  2. T. O. Engelhardt
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  3. H. Ulmer
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  4. H. Piza-Katzer
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Correspondence to H. Piza-Katzer.

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Petschke, F.T., Engelhardt, T.O., Ulmer, H. et al. Einfluss des Zigarettenrauchens auf die Hautdurchblutung der Hand. Chirurg 77, 1022–1026 (2006). https://doi.org/10.1007/s00104-006-1216-1

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  • DOI: https://doi.org/10.1007/s00104-006-1216-1

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