Peer-reviewed veterinary case report
How smoking affects hernia surgery recovery and recurrence
By Messer N et al.·2026·Department of Surgery·View original on Europe PMC →
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Original publication title: The impact of active smoking on postoperative morbidity and hernia recurrence following abdominal wall reconstruction: long-term follow-up.
Plain-English summary
This study looked at how smoking affects recovery after surgery to fix hernias in the abdominal wall. Researchers compared 106 active smokers to 295 people who had never smoked, checking for complications both 30 days and 24 months after surgery. They found that, at both time points, there were no significant differences in issues like infections or the need for additional procedures between the two groups. Additionally, the rate of hernia recurrence after two years was slightly lower in smokers compared to non-smokers, but the difference wasn't significant. Overall, the study suggests that while quitting smoking is encouraged for better health, it may not be necessary for everyone before this type of surgery.
Abstract
<h4>Introduction</h4>Active smoking is widely regarded as a risk factor for wound morbidity and adverse outcomes in abdominal wall reconstruction (AWR), often serving as a contraindication to elective repair. However, its independent impact on long-term complications remains poorly characterized.<h4>Methods</h4>This study utilized the prospectively maintained ACHQC registry, included patients who underwent open, elective, clean ventral hernia repair (VHR) with transversus abdominis release (TAR) and permanent synthetic mesh at a high-volume AWR center between February 2019 and December 2022. All active smokers during this period were propensity matched in a 1:3 ratio to never-smokers based on demographics, comorbidities, and operative characteristics. Outcomes were assessed at early (30-day) and long-term (≥ 24 months) timepoints. Primary endpoints included wound morbidity, mesh-related complications and hernia recurrence.<h4>Results</h4>A total of 106 active smokers were propensity-matched to 295 never-smokers. Baseline demographics and operative variables were well balanced. At 30 days, there were no significant differences in surgical site infection (SSI) (9.4% vs. 9.2%, p = 0.92), surgical site occurrence (SSO) (21.5% vs. 17.6%, p = 0.48), or surgical site occurrence requiring procedural intervention (SSOPI) (9.4% vs. 9.2%, p = 0.92). At 24 months, rates of SSO (1.9% vs. 0.7%, p = 0.81), SSI (0% vs. 0.3%, p > 0.99), SSOPI (0% vs. 0.7%, p > 0.99), mesh infection (0.9% vs. 0%, p > 0.99), and reoperation were low and statistically similar. Hernia recurrence at ≥ 24 months was 4.7% in smokers vs. 7.8% in never-smokers (p = 0.15).<h4>Conclusion</h4>In this analysis, active smoking was not associated with increased risk of clinically significant wound morbidity, mesh-related complications, SSOPI, or hernia recurrence. These findings support a patient-centered approach wherein smoking cessation is strongly encouraged but not mandated prior to surgical repair in appropriately selected individuals.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41758246