Despite century of clinical experience and tens scientific researches, only in 1977 L. Mosley and F. Finseth have scientifically proved negative influence of smoking on rate of healing of wounds. In 1978 the same authors in experimental model on animals have shown that system application of nicotine essentially worsens process of healing of wounds.
Smoking worsens postoperative healing of wounds. At inspection of women by which the laparotomy was carried out it has been established that at a longitudinal section the width of cicatrix at smoking patients averages 7,4 mm, at non-smoking – 2,7 mm, and at cross-section – 2,8 and 2,1 mm accordingly.
Retrospectively having analyzed all cosmetic operations on face executed in clinic for 6 years it has been found out 10,2 % of the complications shown in amotio of a skin of various degrees. Smoking patients have made 80 % of this group. Authors have established that at the smoking patients subjected to cosmetic operations on the person, risk of tearing away of dermal flaps in 12,46 times above, than at the non-smoking.
At lifting performance on face skin peeling is observed at 5 % of non-smoking patients, at 8,3 % before smoking and at 19,4 % of smokers.
Because of it even special updating of lifting at which very limited introduction in a skin is carried out has been developed. Results have improved at once: any case of amotio of a skin at patients, including 32 % of smokers. However even at such sparing technique it has been found out statistically authentic higher number of cases of a hair fall in the field of a surgery field in smokers, than at the non-smoking people.
Direct dependence between quantity of smoked packs of cigarettes a day and development of a necrosis of dermal grafts at reconstructive operations is established. At the patients smoking more than 1 pack of cigarettes a day, the risk of necrosis development is in 3 times higher than at non-smoking people and at smoking 2 packs the risk is in 6 times higher and necrosis more often develops.
For a long time vasoconstrictive action of a cigarette smoke is known. Though this smoke contains more than 4000 poisoning components, it has been established that the basic substance rendering vasoconstrictive effect and breaking a blood flow is nicotine effect. The true mechanism of this influence is unknown, but, probably, all the meter is in the activation of secretion of a vasopressin caused by nicotine.
Smoking activates sympathetic nervous system that, in turn, also leads to narrowing of peripheric blood vessels. Besides, the catecholamines, which emission amplifies at activation of sympathetic nervous system are formation cofactors of kaylons- the glycoproteids that braking a cuticularization.
Smoking reduces oxygenation of tissues. It also enlarges the maintenance of a carboxyhemoglobin which even greater worsens oxygenation of tissues, limiting oxygen capacity of a blood. Besides, smoking causes aggregation of thrombocytes, reduces formation of collagen adjournment and raises viscosity of a blood.
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