First 30 Days Wound-Related Complications in Young Smokers Following Primary Achilles Repair

• Published in: The Journal of foot and ankle surgery 2024-01, Vol.63 (1), p.9-12
• Main Authors: Rodriguez-Materon, Solangel, Trynz, Samantha, Ahmed, Md Ashfaq, SanGiovanni, Thomas P., Chapman, Cary, Hodgkins, Christopher W.
• Format: Article
• Language: English
• Subjects: Achilles rupture; Achilles tendon; Achilles Tendon - injuries; Achilles Tendon - surgery; ACS-NSQIP; Adolescent; Adult; Humans; Middle Aged; Outcome studies; Postoperative Complications - epidemiology; Primary Achilles tendon repair; Retrospective Studies; Rupture - surgery; Smokers; Surgical Wound Infection - epidemiology; Surgical Wound Infection - etiology; Treatment Outcome; Young Adult
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2022.08.013

The Achilles tendon is frequently injured in the young to middle aged population. Previous studies have shown that there is an increased risk of delay in postsurgical wound healing amongst tobacco smoking patients with Achilles tendon injury. This study utilized the American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database. We included patients between the ages of 18 and 35 years who underwent primary Achilles tendon repair between years 2011 and 2020. The procedure type (with or without graft, CPT 27650 and 27652), patient demographics, and comorbidities were included. Primary outcomes of interest were 30-day readmission, minor complications, outcomes related to wound healing (wound disruption, superficial surgical site infection, deep incisional surgical site infection, organ-space site infections) and reoperations within 30 days of index surgery. A total of 1944 patients met the inclusion criteria for this study. One thousand six hundred and fifty-nine patients were nonsmokers, while 285 were smokers. Logistic regression showed no differences between smokers and nonsmokers (reference group) for 30-day readmission, reoperation, and minor complications. However, Black non-Hispanic patients were found to be 0.3 times (95% confidence interval: 0.1, 0.98) as likely to develop minor complications as compared to the White non-Hispanic patients. Wound-related complications after Achilles tendon repair remain low in younger (18-35 years) patients. When comparing clinical outcomes between nonsmokers and smokers, we found no statistically significant difference in this retrospective study.