Making Surgery Safer

By Society for Vascular Surgery, Special for  USDR

Cigarette smokers facing surgery should quit smoking as soon as possible, according to a new statement released jointly by the Societies for Vascular Surgery and Vascular  Nursing.

The statement urges surgeons and their professional staff to make sure that as smokers are scheduling surgery they also get specific, personalized advice on how to quit. Smokers who don’t get such counseling should ask how to get  it.

An abundance of data shows that cigarette smokers have many more surgical complications and a higher risk of death if they don’t quit before the procedure. The longer a patient can be smoke-free before surgery the better the outcome, but even quitting one day ahead has  benefits.

For many surgery patients who smoke, the upcoming procedure provides them with a “teachable moment” since the results of their procedure – and often even their survival – may depend on it. However, newer research suggests that many smokers who are scheduled for surgery still need some extra help to  quit.

A pilot study called VAPOR, funded by a grant from the SVS Foundation, has found that when the surgeon’s team of nurses and nurse practitioners give the smoker personalized smoking cessation options, the patient is more likely to successfully stop smoking before  surgery.

Successful programs do much more than give the patient a quit smoking pamphlet,  however.

“We found that patients want us customize their smoking cessation program,” said SVS member and VAPOR researcher Dr. Philip P. Goodney of the Dartmouth-Hitchcock Medical Center in New Hampshire. “Patients know a lot about their own  challenges.”

For some patients, a smoking cessation telephone hotline like (800) QUITNOW will help, while others prefer a nicotine patch, a prescription medication, or a combination of  those.

Those are common options that nursing staff members tend to offer patients, said Marie Rossi, RN, president of the Society for Vascular Nursing. “We try to meet patients wherever they are on the spectrum of quitting,” she said, “and help them move  forward.”

The joint statement urges vascular surgeons and their surgical teams to assist patients who smoke, but in reality, all surgical teams, regardless of specialty, should provide patients who smoke with cessation assistance, Dr. Goodney  said.

Smokers should quit as soon as they know surgery will be scheduled, regardless of whether the surgeon or his team suggest quitting, noted Dr. R. Clement Darling, president-elect of the Society for Vascular Surgery. If smoking cessation advice is not offered, smokers should take the initiative to ask for  help.

Some people are unaware of the damaging effects on veins, arteries and blood cells and how that impacts the body during and after surgery, Darling  said.

“Cigarette smoking keeps oxygen from getting to all parts of the body,” he said. “There are dozens of reasons why smoking is bad for your vascular system on an average day, but on the day of surgery, it’s really  dangerous.”

The lingering effects of nicotine and carbon monoxide, found in cigarette smoke, make the stresses of surgery even more  dangerous.

“Quit smoking for your own health and swift recovery,” Dr. Darling said, “but also quit for those who love you, who are sitting in the waiting room, hoping the surgeon brings them good  news.”

The Society for Vascular Surgery® (SVS) is a 5,600-member, not-for-profit professional medical society, composed primarily of specialty-trained vascular surgeons, which seeks to advance excellence and innovation in vascular health through education, advocacy, research and public  awareness. 

The Society for Vascular Nursing (SVN) is a non-profit organization with nearly 600 members. Its mission is to provide a professional community for nurses focused on advancing the care of persons living with vascular disease through excellence in evidence-based practice and  education.

SOURCE Society for Vascular  Surgery

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