Smoking and Wound Healing – Are They Linked?

Smoking and Wound HealingIt has been proven that smoking adversely impacts the wound healing process. The wound healing process comprises inflammatory, proliferative, maturation and remodeling stages. Wound care consulting involves documentation of these stages. Cigarettes contain harmful substances such as carbon monoxide, nicotine and cyanide derivatives that can negatively influence these healing stages. According to the Centers for Disease Control and Prevention (CDC), more than 16 million Americans are living with a disease caused by smoking.

Our body’s abilities to recover from wounds and injuries depend on oxygen. Supply of oxygen allows the repair and rebuilding of cells. The smoking habit reduces the supply of oxygen to the affected region. With smoking, the blood vessels become smaller and they find it difficult to carry oxygen and healing factors to the injured region, resulting in delayed wound healing. This habit also makes the blood thicker so it doesn’t flow as easily through narrowed blood vessels.

Smoking impacts wound healing by –

  • Causing infections in the wounded area
  • Reducing the levels of vitamin C that is vital for healing
  • Reducing cell proliferation and migration across the wound bed
  • Affecting macrophage activity
  • Reducing epithelialisation and wound contraction
  • Obstructing oxygenation of the wound
  • Weakening the immune system
  • Decreasing blood flow to the extremities

A recent report published in the American Journal of Respiratory and Critical Care Medicine says that smoke from cigarettes blocks self-healing processes in the lungs, consequently leading to chronic obstructive pulmonary disease (COPD). Some other researches also show that smokers may have more pain after surgery than non-smokers.

At healthcare centers, smoking cessation programs are implemented before surgical treatments to reduce post-surgical wound complications. It is highly recommended to consider quitting smoking at least during the wound healing process.

Any wound that does not heal within a few weeks should be examined by a healthcare professional as it might be infected. Accurate wound assessment is essential to ensure appropriate patient and wound management. While documenting non-healing wounds, nurses at wound clinics should also document the patient’s smoking history along with health history, current and past medications, wound size, location, infection and pain. They should also note the resources provided to aid patients with chronic wounds to quit smoking. Wound care software programs can assist clinical settings with accurate and faster documentation of patient records. Details of any counseling provided to the patient as well as outcome of counseling must be reported in the medical record.