The acute effect of cigarette smoking on the microcirculation of a replanted digit.

Thirty-one patients who had undergone digital replantation or revascularization volunteered to participate in a study of the acute effect of smoking on the microcirculation of the skin of replanted fingers. Fourteen were smokers and 17 were nonsmokers at the time of the study. Blood flow was assessed by means of the laser Doppler flowmeter under standard conditions. Each smoker inhaled 2 cigarettes. During smoking of the first and second cigarettes a mean decrease in laser Doppler flow of 8% and 19%, respectively, was found, whereas the nonsmokers showed a slight increase of 4% and 4%, respectively. Ten minutes after the last cigarette almost no recovery could be detected. The negative effect of smoking on the microcirculation in replanted digits proved to be more pronounced in the patients operated on more recently. This experiment confirms that smoking after replantation surgery should be prohibited to guarantee optimal circulation.