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First 30 Days Postoperative Wound Related Complications in Young Smokers Following Primary Achilles Repair

Published:September 30, 2022DOI:https://doi.org/10.1053/j.jfas.2022.08.013

      Abstract

      The Achilles tendon is frequently injured in the young to middle aged population. Previous studies have shown an increased association between cigarette smoking and delayed wound healing among patients with Achilles tendon injury.
      This study utilized the American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database. We included patients between the ages of 15 and 35 years, and who underwent primary Achilles tendon repair between years 2011 and 2020. The procedures with or without graft (CPT 27650 and 27652), patient demographics, and comorbidities were included. Primary outcomes of interest were rates of 30-day readmission, minor complications, outcomes related to wound healing and reoperations within 30 days of index surgery.
      A total of 1944 patients met the inclusion criteria for this study. One thousand six hundred and fifty nine patients were nonsmokers, while two hundred and eighty five corresponded to smokers. Logistic regression showed no differences between smokers and non-smokers (reference group) for 30-day readmission, reoperation, and minor complications. However, Black non-Hispanic patients were found to be 0.3 times (95% CI: 0.1, 0.98) as likely to develop minor complications as compared to the White non-Hispanic patients.
      Wound-related complications after Achilles tendon repair remain low in younger (15-35 years) patients. When comparing differences in clinical outcomes between non-smokers and smokers, we found no statistically significant difference in this retrospective study.

      Key Words/ Level of Clinical Evidence

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