Tobacco smoking: impairment of experimental flap survival.

The survival rate of experimental flaps as affected by exposure to inhaled tobacco smoke has been investigated in rats subjected to different smoking regimens. A distally based dorsal flap was raised and reattached in each animal. Evaluation of the flaps on postoperative day 8 showed a mean rate of necrosis of 28.5% in 25 control animals, 32.2% in 21 rats postoperatively smoking for 7 days, 41.3% in 18 rats preoperatively smoking for 7 days, and 45.7% in 21 rats smoking for 7 days both before and after the surgical procedure. Histological sections from the lungs of the smoking animals revealed a pattern compatible with mild smoke inhalation injury. Arterial oxygen tensions were lower in the tobacco smoking animals. It is assumed that the multiple effects of tobacco smoking contributed to the impairment of experimental flap survival.