Smoking, Smoking Cessation, and Wound Complications After Lumbar Spine Surgery

1225 patients who had undergone lumbar surgery were retrospectively studied. Smoking history and cessation prior to surgery was recorded. The outcome measure of wound complication included: wound infection, seroma or hematoma, breakdown requiring wound care, and persistent drainage (greater than 7 days) requiring oral antibiotics. Stepwise logistic regression analysis (correcting for confounding factors) demonstrated that positive smoking history was a risk factor for wound infection. The risk increased dramatically for patients who smoked 2 or more packs per day. Patients who had ceased smoking for at least 3 months were not at significantly higher risk for wound complications than nonsmokers.