EFFECT OF SMOKING ON AUTOGRAFT TAKE IN BURN WOUNDS

Early wound excision and grafting of burn wounds is regarded not only as the method of choice in speeding up the healing process in deep burns, but also limits contracture and infection, On the other hand, smoking has generally been implicated in the delay of the healing process in a variety of surgical procedures, In this study we report the outcome of a cross-sectional study of all the 395 medical records of adult patients who underwent split-thickness auto grafting during a six month period (Sep, 1999 to March 2000) in Taleghani Burn Center, Ahwaz. The subjects, both male and female, who underwent auto grafting for deep burns, were allocated into smoker and nonsmoker groups, The results showed that rejection of the auto grafts was significantly more widespread and more common among cigarette smokers. The extent of rejection was 6.7±0.5% of the graft area as compared to 2,9+0,3% in the control group (p<0,01), The incidence of rejection and successful take was 66.6 and 28.7% respectively among the cigarette smoking group (O.R. 4.95). The reason for the increase in rejection may be due to the toxic constituents in cigarette smoke. We recommend that smokers be encouraged to abstain from smoking prior to and post-burn grafting surgical procedures, which may be a useful preventive measure, Further research in this field is undergoing in order to assess the effectiveness of this recommendation in reducing the incidence of graft rejection.