Melbourne Hand Surgery 

Please note: Due to high demand our next new patient appointment at Melbourne Hand Surgery is in 4 months. There are no further appointments available in 2018 unless existing booked patients cancel.So we can streamline your care and ensure that urgent and emergency conditions are seen in a timely manner we require that all patients provide a referral from their general practitioner prior to seeking an appointment date. Once we have received your referral we will contact you to schedule an appointment. Referrals can be submitted by secure messaging (Argus, HealthLink, MedicalObjects), email, mail or fax.  

Melbourne Hand Surgery closes for the holiday season at 5pm on Monday 17 December 2018; we will resume consulting and operating on Monday 14 January 2019.

Smoking & hand surgery

smokinghand2 200x133Smoking increases your risk of complications after hand surgery and with hand injuries. Sarin (1974) demonstrated that smoking a single cigarette produces a 42% reduction in digital (finger) blood flow. Other investigators (Ludbrook 1974, Rottenstein 1960) found similar effects. Just one cigarette is doing you damage. Smoking impairs your recovery from all hand surgery and hand injuries. The nicotine in cigarettes not only causes blood vessels to constrict, but smoking increases carboxyhaemoglobin (which blocks the ability of the blood to transport oxygen), increases platelet aggregation, increases blood viscosity, increases fibrinogen, increases heart rate, decreases prostacyclin formation and decreases collagen deposition - all of which can reduce healing and impair outcomes in hand injuries and after hand surgery.

stubboutcigaretteStill unconvinced? Research shows smoking increases the likelihood that replanted digits will fail (die). In a meta-analysis of 1,803 replanted digits from nearly 1,300 patients, it was found that the survival of digits was significantly (p <.05) higher in nonsmokers (96.7%) compared with smokers (61.1%). Chronic regional pain syndrome has also been associated with smoking. Smoking has been shown to increase the likelihood that broken bones will fail to heal - this is especially important for patients with scaphoid fractures but does apply to all fractures.

It's not easy to give up smoking but there is help. If you have any questions please ask your hand surgeon or GP. For specialist assistance in smoking cessation, please contact the professionals at Quit Victoria on 13 78 48 and please do keep trying until you succeed! 

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References

Mosely LH, Finseth F. Cigarette Smoking: Impairment of Digital Blood Flow and Wound Healing in the Hand. Hand. 1997; 9(2):97-101.

Wei DH, Strauch RJ. Smoking and Hand Surgery. J Hand Surg 2013 38:1;176-179

FRACS

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