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Invited Commentary
February 15, 2017

Smoking and Postoperative Surgical Site InfectionWhere There’s Smoke, There’s Fire

Author Affiliations
  • 1Department of Surgery, University of Chicago, Chicago, Illinois
JAMA Surg. Published online February 15, 2017. doi:10.1001/jamasurg.2016.5706

From the article “Association Between Smoking Status, Preoperative Exhaled Carbon Monoxide Levels, and Postoperative Surgical Site Infection in Patients Undergoing Elective Surgery,” by Nolan and colleagues,1 in this issue of JAMA Surgery, comes a powerful message: among smokers, smoking on the day of elective surgery is associated with an increased rate of surgical site infection (SSI). Therefore, refraining from smoking on the day of surgery might decrease the risk of an SSI. Indeed, the data are compelling: the risk of an SSI almost doubles if the patient smokes on the day of surgery. The key question, which remains unanswered, is whether this increased risk is sufficient cause to cancel an operation.

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