Evidence map›Paper›PMID 41758246›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2026

The impact of active smoking on postoperative morbidity and hernia recurrence following abdominal wall reconstruction: long-term follow-up.

Nir Messer, Adar Horowitz, Benjamin T Miller, Lucas R A Beffa, Clayton C Petro, Ajita S Prabhu, Li-Ching Huang, Eliad Karin, Fahim Kanani, Eran Nizri and 3 more

Abstract read
In one paragraph

Article in Hernia : the journal of hernias and abdominal wall surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Nir MesserDepartment of Surgery, Gray Faculty of Medicine, Tel Aviv Sourasky Medical Center, Tel -Aviv University, Tel Aviv, Israel. masrinir@gmail.com.ORCID http://orcid.org/0000-0002-4686-9583
Adar HorowitzTel -Aviv University, Tel Aviv, Israel.
Benjamin T MillerTel -Aviv University, Tel Aviv, Israel.
Lucas R A BeffaDepartment of General Surgery, Cleveland Clinic Center for Abdominal Core Health, Cleveland Clinic Foundation, Cleveland, OH, USA.
Clayton C PetroDepartment of General Surgery, Cleveland Clinic Center for Abdominal Core Health, Cleveland Clinic Foundation, Cleveland, OH, USA.
Ajita S PrabhuDepartment of General Surgery, Cleveland Clinic Center for Abdominal Core Health, Cleveland Clinic Foundation, Cleveland, OH, USA.
Li-Ching HuangDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
Eliad KarinDepartment of Surgery, Gray Faculty of Medicine, Tel Aviv Sourasky Medical Center, Tel -Aviv University, Tel Aviv, Israel.
Fahim KananiDepartment of Surgery, Gray Faculty of Medicine, Tel Aviv Sourasky Medical Center, Tel -Aviv University, Tel Aviv, Israel.
Eran NizriDepartment of Surgery, Gray Faculty of Medicine, Tel Aviv Sourasky Medical Center, Tel -Aviv University, Tel Aviv, Israel.
Guy LahatDepartment of Surgery, Gray Faculty of Medicine, Tel Aviv Sourasky Medical Center, Tel -Aviv University, Tel Aviv, Israel.
Amir SzoldAssia Medical Group, Assuta Medical Center, Tel Aviv, Israel.
Michael J RosenDivision of GI Surgery, Northwestern University, Chicago, IL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionActive smoking is widely regarded as a risk factor for wound morbidity and adverse outcomes in abdominal wall reconstruction (AWR), often serving as a contraindication to elective repair. However, its independent impact on long-term complications remains poorly characterized.

methodsThis study utilized the prospectively maintained ACHQC registry, included patients who underwent open, elective, clean ventral hernia repair (VHR) with transversus abdominis release (TAR) and permanent synthetic mesh at a high-volume AWR center between February 2019 and December 2022. All active smokers during this period were propensity matched in a 1:3 ratio to never-smokers based on demographics, comorbidities, and operative characteristics. Outcomes were assessed at early (30-day) and long-term (≥ 24 months) timepoints. Primary endpoints included wound morbidity, mesh-related complications and hernia recurrence.

resultsA total of 106 active smokers were propensity-matched to 295 never-smokers. Baseline demographics and operative variables were well balanced. At 30 days, there were no significant differences in surgical site infection (SSI) (9.4% vs. 9.2%, p = 0.92), surgical site occurrence (SSO) (21.5% vs. 17.6%, p = 0.48), or surgical site occurrence requiring procedural intervention (SSOPI) (9.4% vs. 9.2%, p = 0.92). At 24 months, rates of SSO (1.9% vs. 0.7%, p = 0.81), SSI (0% vs. 0.3%, p > 0.99), SSOPI (0% vs. 0.7%, p > 0.99), mesh infection (0.9% vs. 0%, p > 0.99), and reoperation were low and statistically similar. Hernia recurrence at ≥ 24 months was 4.7% in smokers vs. 7.8% in never-smokers (p = 0.15).

conclusionIn this analysis, active smoking was not associated with increased risk of clinically significant wound morbidity, mesh-related complications, SSOPI, or hernia recurrence. These findings support a patient-centered approach wherein smoking cessation is strongly encouraged but not mandated prior to surgical repair in appropriately selected individuals.

Indexed as

Abdominal WallHernia, VentralHerniorrhaphyPostoperative ComplicationsSmokingAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedRecurrenceRegistriesRisk FactorsSurgical MeshSurgical Wound InfectionHernia recurrenceMesh complicationsOpen transversus abdominis releaseSurgical site infectionTobacco smokingVentral hernia

Identifiers

PMID41758246
PMCPMC12948806

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.