Surgical complications for smokers

Harvey Woehlck, MD, Professor of Anesthesiology at the Medical College of Wisconsin, recently led a study regarding people who smoked within 24 hours of having surgery.

The study found that people who considered themselves smokers, and who smoked within 24 hours of surgery, had more markers of restricted blood flow to the heart than those who considered themselves nonsmokers, prior smokers, or chronic smokers, who did not smoke before their surgery.

Patients who received general anesthesia had a higher occurrence of EKG abnormalities usually associated with restricted blood flow to the heart than did those who did not smoke prior to surgery. In this case, the study could not distinguish between actual changes in blood flow, or the additional combined effect of carbon monoxide and cyanide absorption from cigarette smoke.
http://healthlink.mcw.edu/article/1031002485.html

Recommendations by a plastic surgeon: http://www.prplastic.com/smoking

smoking and secondary smoke affect wound healing in potentially a very devastating way. Any exposure to smoke either directly or indirectly can result in poor wound healing, delayed wound healing, skin loss necessitating skin grafting, increased risk in wound infection and loss of skin and deeper tissues, all resulting from decreased blood supply to those areas. The diminished blood flow to skin wound edges can cause the breakdown of skin and scabbing.

Also, there are well-known increased risks with anesthesia such as increased chance of developing pneumonia. Again, remember that slow wound healing (months instead of weeks), skin loss resulting in scabbing and prolonged need for dressing changes, and infection usually involving the need for antibiotics (but sometimes another surgery to drain the infection) all are complications that can occur at a much higher risk if you smoke or are exposed to smoke (Instead of less than 5%, it can be as high as 60% ). To lower the risk of postoperative complications, smoking cessation should occur at least 4 weeks before lung surgery.
Chest 2001;120:705-710