Effect of Smoking Cessation on Healing and Rehabilitation

Purpose: The purpose of this study is to determine the effect of cigarette smoking on wound healing and rehabilitation among service members who have a traumatic lower extremity amputation.

Design: This study uses a prospective quasi-experimental arm and a retrospective chart review arm. 

Methods: Each arm compares the difference over time between smokers and nonsmokers healing time and length of time to progress through a rehabilitation program. 

Sample: The sample included active duty service members who experienced a traumatic amputation. The prospective arm required enrollment within one month of the injury. The retrospective review included only those that were seen at the Center of the Intrepid in San Antonio, Texas and captured in the clinical database. 

Analysis: A t-test was used to compare differences in days between smokers and nonsmokers from initial amputation until the amputation was deemed healed. Rehabilitation was analyzed using a t test to compare smokers to nonsmokers to determine differences in number of days from the date of injury to each of four phases of rehabilitation. 

Findings: The overall smoking rate was 38.1%. Smokers had a significant delay in wound healing taking an average of 51.2 more days to heal when compared to nonsmokers.  No difference was found in the number of days for rehabilitation or the distance walked in a 2 minute walk test when comparing smokers to nonsmokers. 

Implications for Military Nursing: Critically injured service members who smoke are at risk for complications.  Nurses are the patient advocates to guide these patients through the entire pathway of healing and rehabilitation. Nurses are also essential personnel in the current smoking cessation programs for the military. Nurses must advocate for smoking cessation to insure the best outcomes for these war fighters.

Final Report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2015105...