ArticleThe Laryngoscope2025
Non-Tobacco Nicotine Use and Complications in Free Flap Repair in Head and Neck Cancer.
Article in The Laryngoscope, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Impact of Non-Tobacco Nicotine Products on Postoperative Outcomes in Soft Tissue Hand Surgery.Journal of hand surgery global online · 2027Article
- Nontobacco Nicotine Dependence Is Associated with Increased Postoperative Complications Following Breast Reconstruction.Plastic and reconstructive surgery. Global open · 2026Article
- Inhalant exposure and outcomes after inguinal hernia repair: cigarette, cannabis, and vaping effects by surgical approach.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Short-Term Nicotine Improves Experimental Flap Survival: Implications for Different Findings in Experimental Flap Models.Medicina (Kaunas, Lithuania) · 2026Article
- Failure of salvage therapies in radiation-induced necrosis of a free fibula flap: a case report.Annals of medicine and surgery (2012) · 2026Article
- Non-tobacco nicotine use and complications in single-level posterior lumbar and transforaminal lumbar interbody fusion.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Non-Tobacco Nicotine Use and Complications in Free Flap Repair in Head and Neck Cancer.The Laryngoscope · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveAssess associations between non-tobacco nicotine usage and free flap repair complications in head and neck cancer (HNC) patients. STUDY
designPropensity-matched retrospective cohort study.
methodsThe TriNetX database was queried for HNC patients who underwent free flap procedures from 2010 to 2024. Among these patients, the NIC cohort was defined as those with dependence on nicotine prior to surgery, but without the use of cigarettes, chewing tobacco, or other tobacco products. The non-NIC cohort was defined as patients with no nicotine dependence, cigarettes, chewing tobacco, or other tobacco product use prior to surgery. Cohorts were propensity-matched based on demographics and comorbidities. Primary outcomes included free flap failure, blood vessel repair, and other revisionary procedures (associated with wound disruption or repair) within 30 days of the primary reconstruction. Secondary outcomes included infection, pneumonia, cardiopulmonary complications, and hematoma within 30 days.
resultsFollowing propensity matching, 1324 patients were included in each cohort. Across all free flaps, non-tobacco nicotine use was associated with a significantly increased risk of other revision procedures (RR: 1.230 [95% CI: 1.013, 1.493], p = 0.036), sepsis (RR: 1.563 [95% CI: 1.009, 2.419], p = 0.045), fistula (RR: 1.588 [95% CI: 1.041, 2.423], p = 0.032), cardiovascular complications (RR: 1.420 [95% CI: 1.054, 1.914], p = 0.021), pneumonia (RR: 2.055 [95% CI: 1.570, 2.689], p < 0.001), and pulmonary embolism (RR: 2.220 [95% CI: 1.217, 3.933], p = 0.008).
conclusionsNon-tobacco nicotine use is associated with an increased risk of postoperative complications in HNC patients following free flap reconstruction. Screening for non-tobacco nicotine use in surgical candidates may better inform clinical management and counseling. LEVEL OF EVIDENCE: III.
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