Google Answers Logo
View Question
Q: Healing lungs ( Answered 5 out of 5 stars,   2 Comments )
Subject: Healing lungs
Category: Health > Conditions and Diseases
Asked by: archae0pteryx-ga
List Price: $15.50
Posted: 11 Dec 2005 18:29 PST
Expires: 10 Jan 2006 18:29 PST
Question ID: 604592
What are the consequences to the recovery process, if any, of smoking
while recuperating from lung surgery?  I am interested in both
short-term and long-term effects:  is healing retarded? is there
increased pain? is there a difference in incidence of recurrence?

We are talking about a long-time smoker who is recovering from recent
removal of a tumor in the lung.

I am not referring to myself, and I don't smoke, so please spare me
comments about smoking, addictions, and stupidity.  I am interested in
facts and well-supported opinions specifically about healing while
smoking, and it is not necessary to be gentle.

Thank you,
Subject: Re: Healing lungs
Answered By: crabcakes-ga on 11 Dec 2005 21:07 PST
Rated:5 out of 5 stars
Hello Archae0pteryx

    Please tell your friend that post-surgical healing IS delayed in
patients who resume smoking following lung surgery. Nicotine is known
to increase blood pressure, which narrows blood vessels, so less blood
gets to tissues that need it to heal. The blood that DOES get to
tissues is not fully oxygenated. Nicotine also greatly increases risk
of blood clots, which are a risk during surgery in all patients, but
clots are an even greater risk in smokers. Nerve pain can continue
because of less oxygenated blood getting to the nerve to heal.
Nicotine decreases production of white blood cells as well, cells
needed to fight off infection-causing organisms. Long term effects are
another tumor or terminal lung cancer.

    One step to healing after lung surgery is to be able to cough up
secretions, being able to inhale and exhale volumes of air. Smokers
have diminished lung capacity, restricting air movement needed for
coughing, increasing the chance of an infection, and slowing the
healing process.

?Lasting pain after surgery can be due to damaged nerves. It is not
possible for a surgeon to operate on someone without damaging nerves
as soon as the first cut is made. Nerves grow very slowly. They can
take many months to repair themselves and some never do. During this
time, you may have a nagging ache or burning pain in the area.
Sometimes this is there all the time. Sometimes it can come and go.
Eventually, when the damaged nerves are healed, the pain will go.

This type of pain is particularly associated with a type of operation
called thoracotomy. This just means opening the chest (thorax) through
the rib cage. The pain often runs along the operation scar. It will
go, but can last up to 2 years after your surgery.?

?Deep Breathing and Coughing: These exercises help prevent a lung
infection after surgery. Deep breathing opens the tubes going to your
lungs. Coughing helps to bring up sputum from your lungs and keep them
clear. You should deep breathe and cough every hour while you are
awake, including any time you spend awake during the night.?

?Incentive Spirometer (spy-ROM-uh-tur): This piece of equipment helps
you take deeper breaths. Put the plastic nozzle into your mouth, take
a very deep breath, and hold it as long as possible. Then blow as hard
as you can into the mouthpiece. Take 10 deep breaths in a row every
hour while awake. Remember to follow each deep breath with a cough.?

?To keep your lungs free of infection, continue your deep breathing
exercises. You may also be asked to keep on using an incentive
 If you are on oxygen at home, a nurse will teach you how to set the
controls on the tank. Smoking around oxygen can cause a fire. For
safety, you must not smoke or let anyone smoke around you. If your
nose becomes dry and sore, use Vaseline® ointment on it.?

?A new study outlines the way that cigarette smoke may delay the
formation of healing tissue on wounds. Previous research demonstrated
that cigarette smoke slows wound healing and increases the risk of

In this new study, researchers at the University of California,
Riverside, used mice and human cell cultures to examine the effect of
cigarette smoke on fibroblasts -- cells that migrate to wounds to
create healing tissue.

Fibroblasts play a vital role in tissue repair and remodeling. The
study found that while cigarette smoke doesn't kill fibroblasts, it
damages them and impairs their ability to move into the wound area.
Instead, the fibroblasts build up on the margins of the wound.?

?Do not smoke. Sounds simple, but incredibly difficult. However, the
rewards will be worth every ounce of effort! Smoking changes blood
flow patterns, delays healing, and has been shown to increase the
length of recovery. Furthermore, a patient?s own perception of their
health, and their perception of treatment success, is negatively
impacted by smoking. No soapbox is needed here, the information is
known to everyone, but its importance cannot be overstated. If you do
smoke, there is no better time to stop.?

?Smoking can cause some serious complications for those undergoing
general anesthesia and major surgeries. Some reasons to quit smoking
before the operation:
·	Prevent pneumonia?after a general anesthetic it is very important to
cough and deep breathe to clear the lungs and prevent pneumonia.
Smokers have to cough much more often than non-smokers because they
produce more sputum due to the irritation of the smoke in the lungs.
Smokers are much more prone to post-operative pneumonia, than
non-smokers. By stopping cigarettes the chances of pneumonia are less.
It may even cause you less pain!
·	Wound healing?nicotine, which is found in tobacco, raises blood
pressure by making the blood vessels smaller. This in turns causes
problems with blood flow to a new surgical incision. An incision needs
blood rich with oxygen to heal normally. A smoker?s circulation is
slowed down so an incision will not heal as well or as quickly as
someone without nicotine in their blood.
·	Prevent blood clots after surgery?nicotine also tends to affect
platelets in the blood, which could lead to blood clots forming and
causing serious complications after surgery, such as a blood clot that
travels to the lung.

20 Minutes after Quitting:
·	Blood pressure drops to a level close to that before the last cigarette.
·	Temperature of hands and feet increases to normal.
8 Hours after Quitting:
·	Carbon monoxide level in blood drops to normal
24 Hours after Quitting:
·	Chance of heart attack decreases
2 Weeks after Quitting:
·	Circulation improves
·	Lung function increases up to 30%

?Smoking is associated with an increased risk of wound infections even
for simple wounds, according to the results of a randomized controlled
trial published in the July issue of the Annals of Surgery. However,
four weeks of abstinence from smoking reduced the risk to that of
never-smokers, irrespective of the use of nicotine patches, although
abstinence from smoking did not affect the incidence of wound

"Smokers who undergo general and orthopedic surgery have a higher
incidence of wound infections than nonsmokers," write Lars Tue
Sorensen, MD, from Bispebjerg University Hospital in Copenhagen,
Denmark, and colleagues. "The proposed mechanism is a detrimental
effect of smoking on tissue oxygen, which impairs the reparative
processes of wound healing and the neutrophil defense against surgical

?Smoking's numerous deleterious effects on health are well known, but
one negative consequence of tobacco that has gone relatively
unheralded in the popular media is the effect on postoperative
patients. Smoking is thought to retard wound healing through impairing
tissue oxygenation, and relative hypoxia may also cause a sluggish
neutrophil response to pathogens.?

?A prominent heart surgeon I know refuses to perform bypass surgery on
any patient who won't quit smoking, on grounds that smoking undoes any
good his surgery might accomplish.

That's a little farther than I'd go to make my patients quit smoking.
But it's not unjustified. In fact, there's new research that
underscores the point.?

?Postsurgical Complications Women who smoke after being treated for
cervical cancer double their risk for postsurgical complications,
including bleeding in the bowel, rectum, and bladder. Women who have
been treated for breast cancer experience lower survival rates, if
they smoke.?

Smokers simply can?t get enough oxygen into their systems.
?Summary of Evaluation of Gas Exchange Function- background facts for assessing  
 pulmonary function are as follows:  
1.  there is a large reserve in normal individuals  
2.  condition of the ventilatory muscles depends on the physical state
of the patient
3.  as lung volume falls, airways in dependent areas of the lung close  
4.  with aging and smoking, airways close at higher lung volumes  
5.  V/Q mismatch occurs with airway closure  
6.  V/Q mismatch requires increased alveolar ventilation to maintain
the same amount of gas
7.  spirometry measures the volumes of lung and the ability to move air  
8.  PaCO2 is an indicator of adequacy of ventilation  
9.  PaO2 is an indicator of adequacy of oxygenation ?

?Smoking makes it more likely that you will develop an infection at
the site of your operation. If you get this kind of infection, you
will feel sicker, you will have to take extra medicines, and you may
need to stay in the hospital for a longer time than you had expected.?

?Cigarette smoking is a known risk factor for the development of
serious postoperative complications, including delayed wound healing
and nonunion after orthopedic procedures.?

?Fifty-one patients had one or more complications, including delayed
wound healing, pseudoarthrosis, septic arthritis, deep vein
thrombosis, nerve injury, and pin-site infection. Patients in the
smokers group required an average of 16 more days in external fixation
and had significantly more complications than patients in the
nonsmokers group (smokers: 17/34 versus nonsmokers: 34/166, P = .001).
Patients in the smokers group were two and one-half times more likely
to develop complications than patients in the nonsmokers group
(relative risk 2.5, 95% confidence interval [CI] 1.5-4.7).
Multivariate analysis revealed that cigarette smoking was the greatest
preoperative risk factor for complications (odds ratio 5.1, P = .001,
95% CI 2.2-12).?

?Does smoking or drinking interfere with any cancer treatments? There
are not a lot of good data on this subject. Standard treatments for
lung cancer include surgery, radiation and chemotherapy. All of these
treatments can be difficult to tolerate, even in patients who are in
generally excellent physical condition. There are many reasons why
smokers and drinkers would be expected to have a worse outcome with
treatment. Heavy smokers are often hypoxic, and this could increase
surgical morbidity and mortality, and decrease the effectiveness of
radiotherapy treatment. It is possible that carcinogens present in
cigarette smoke could cause the tumor cells to be resistant to
chemotherapy. Alcohol induces a number of P450 enzymes, which could
affect the metabolism of chemotherapeutic agents, and either, reduce
their effectiveness or increase their toxicity.?

?Unbelievably, soon after my brain surgery and shortly before my lung
surgery, I found myself smoking again. Over the course of several
weeks, I moved from sneaking an occasional puff to one or two
cigarettes a day, to three or four a day. And every puff felt like a
betrayal. My own health wasn't the issue. It was my family and
friends, who had closed ranks to help and provide all the support they
could. I felt blessed by their love, but I betrayed them all the same.
Cigarettes are evil that way. Still, no less than three doctors
advised me it was the wrong time to be concerned about cigarettes.
That battle was scheduled for later.
Well, later is here. Now I only have one lung and I'll never smoke again.?

?After the surgery has been completed, the surgeon will insert one or
two chest tubes (drains). These will allow air and fluid to drain out
of the chest in the days after the procedure. Once the drainage has
decreased, the surgeon will remove the drain. The epidural, if there
is one, will be removed. Most patients go home after four or five days
in the hospital. While in the hospital, it is important to work on
deep breathing and coughing. As with any procedure, there are risks
associated with every type of operation. Before having any surgery,
make sure you have discussed the potential risks and benefits of your
operation you're your surgeon.?

?Studies have shown that stopping cigarette smoking before or even
after the diagnosis of lung cancer is confirmed increases survival.
Therefore, it is essential that smokers with lung cancer stop

There you go! I hope this will help you help your friend to stop
smoking! If any part of this answer is unclear, please request an
Answer Clarification.

Sincerely, Crabcakes

Search Terms
Post-surgical smoking 
Smoking + diminished lung capacity + post-surgical
Post + lung + surgery + smoking
smoking delays  healing
smoking delays recovery + surgery
archae0pteryx-ga rated this answer:5 out of 5 stars and gave an additional tip of: $8.50
Hi there, Crabcakes.  Nice job.  Thank you.  I know he knows he should
stop, and I know that reason isn't enough to counter addiction.  But
maybe this information will tip the balance.

Subject: Re: Healing lungs
From: greatergood-ga on 27 Dec 2005 16:40 PST
Hey All,

You can read some tips and articles about this topic at:
Subject: Re: Healing lungs
From: crabcakes-ga on 27 Dec 2005 17:08 PST
Thank  you for the stars and nice tip! Both are appreciated!
Regards, Crabcakes

Important Disclaimer: Answers and comments provided on Google Answers are general information, and are not intended to substitute for informed professional medical, psychiatric, psychological, tax, legal, investment, accounting, or other professional advice. Google does not endorse, and expressly disclaims liability for any product, manufacturer, distributor, service or service provider mentioned or any opinion expressed in answers or comments. Please read carefully the Google Answers Terms of Service.

If you feel that you have found inappropriate content, please let us know by emailing us at with the question ID listed above. Thank you.
Search Google Answers for
Google Answers  

Google Home - Answers FAQ - Terms of Service - Privacy Policy