We recommend that adults and children over 12 wear face masks when attending our clinic, but no longer provide masks to patients and carers. Videoconsultations are conducted via telehealth at our dedicated virtual clinic. We are experiencing high demand for appointments hence require that all patients provide a referral prior to booking an appointment so that we can identify and manage urgent and emergency conditions 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. If our surgeons assess that your condition (especially recent injuries) is best managed with hand therapy rather than surgery we may recommend that you see a qualified hand therapist (physiotherapist or occupational therapist) rather than schedule an appointment with our surgeons. Dr Tomlinson does not offer consultations and surgical services where a Medicare Rebatable Item Code does not apply; this includes injections for palmar hyperhidrosis. Dr Tomlinson has scheduled sabbatical leave during much of October, November and December 2023 so will not be available for urgent or emergency referrals during that time.

Smoking & hand surgery

Created 01 January 2012, last modified 09 January 2015

smokinghand2 200x133 Smoking 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.

stubboutcigarette Still 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

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