Melbourne Hand Surgery 

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Latest news: Elective hospital surgeries are now unrestricted and we have options to book prior to Christmas. You no longer need to have a COVID test prior to hospital admission. Dr Tomlinson is operating at The Avenue and Glenferrie Private; Epworth Cliveden is indefinitely closed at this time. Our offices will be closed from 21 December 2020 until 10 January 2021 inclusive.

All suitable consultations at Melbourne Hand Surgery are currently conducted via telehealth at our dedicated virtual clinic to maximise patient and staff safety. We have implemented enhanced hygiene measures in our rooms including acrylic screens, masks, hand sanitiser, face shields and physical distancing-related changes. We require that all patients provide a referral prior to booking an appointment so that urgent and emergency conditions can be identified and managed in a timely manner, and so that our surgeons can assess your suitability for a telehealth appointment and identify any further information or tests that might be required before your consultation.

Victorians are in this together and together we will get through this. Thank you for your understanding as our community works through these unprecedented times together (last updated: 24 November 2020).

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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