Peri-operative risks

In peri-operative care, which one of the following interventions reduces the risk of wound infections by 80%, the risk of requiring secondary surgery by 70% and therisk of pulmonary complications by 80%.

a) Screening for and treating MRSA colonisation

b) Avoiding inadvertent peri-operative hypothermia

c) Stopping smoking eight weeks pre-operatively

d) Intraoperative goal directed therapy

e) Preoperative safety briefing

Answer: c

Explanation

Much effort is put into many activities to improve outcome in surgery, but the single

intervention that will produce the best returns for the above complications (and an

additional raft of complications including stroke and myocardial infarction) is for the

patient to stop smoking a good amount of time pre-operatively.

Reference

Møller AM, Kjellberg J, Pedersen T, Tønnesen H. Effect of preoperative smoking

intervention on postoperative complications: a randomised clinical trial. Lancet 2002;

359(9301): 114–17.