Analysis of Complications in Patients With a History of Cannabis Use and Tobacco Use Undergoing Implant-Based Breast Reconstruction

Aesthet Surg J. 2023 Sep 14:sjad296. doi: 10.1093/asj/sjad296. Online ahead of print.

ABSTRACT

BACKGROUND: There is limited information regarding the perioperative effects of marijuana in breast reconstructive surgeries.

OBJECTIVES: The objective of this study was to explore the association between history of cannabis use and post-operative complications in the setting of implant-based breast reconstruction.

METHODS: Two databases, TriNetX (TriNetX, LLC; Cambridge, MA) and PearlDiver (Colorado Springs, CO) were queried for patients undergoing implant-based breast reconstruction. Patients were divided into four groups based on active ICD-10 diagnostic codes: 1) cannabis use only 2) tobacco use only 3) cannabis and tobacco use 4) neither cannabis or tobacco use. Associations with post-operative complications were analyzed with a logistic regression test.

RESULTS: TriNetX: 327 patients had an active diagnosis of cannabis use only and 1118 had an active diagnosis of tobacco use only. Patients in the Cannabis Only cohort had a significantly increased risk of developing surgical site infection. Patients in the Tobacco Only cohort had significantly increased risk of developing wound dehiscence, need for debridement, and surgical site infection. PearlDiver: 472 patients had an active diagnosis of both cannabis and tobacco use and 17,361 patients had a diagnosis of tobacco use only. Patients with a diagnosis of cannabis and tobacco use had a significantly increased risk of developing postoperative complications including surgical site infection, wound dehiscence, need for incision and drainage, and debridement.

CONCLUSIONS: Patients undergoing implant-based breast reconstruction with an active diagnosis of cannabis with or without tobacco use were at increased risk of developing post-operative complications, and the risk was even higher in patients using both tobacco and cannabis.

PMID:37706275 | DOI:10.1093/asj/sjad296