The surgical impact of E-Cigarettes: A case report and review of the current literature

Megan Fracol, Robert Dorfman, Lindsay Janes, Swati Kulkarni, Kevin Bethke, Nora Hansen, John Kim*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations


We report a case of a 51 years old female with a 25 pack year smoking history who underwent bilateral mastectomy and immediate tissue expander reconstruction for newly diagnosed right breast cancer. The patient reported herself as a non-smoker despite significant e-cigarette use, with resulting significant mastectomy skin flap necrosis and breast reconstruction failure. Little is known about the physiologic effect of e-cigarettes on wound healing and tissue perfusion. To this end, we provide an updated review of the impact of e-cigarettes on surgical outcomes. PubMed, Ovid MEDLINE, and PRS GO were searched for the terms “e-cigarette”, “electronic cigarette”, “e-cig”, “electronic nicotine delivery system”, “vaping”, “surgery”, “surgical”, “peri-operative”, “operate”, “operative”, and “wound healing”. Abstract review of all articles was performed. 123 articles returned that contained both variants of e-cigarettes and surgery as keywords. Of those, manual assessment returned three articles which were found to be relevant to e-cigarette use in the surgical patient. No articles were found that compared perioperative complications in e-cigarette versus traditional cigarette users in humans. In conclusion, our case report depicts the potential dangers associated with e-cigarette use in the surgical patient. There is a public misconception that e-cigarettes are healthier than traditional cigarettes and as such their use may go unreported by patients. Early evidence suggests e-cigarettes may induce some of the same physiologic changes as traditional cigarettes, and may have a significant deleterious effect on wound healing.

Original languageEnglish (US)
Pages (from-to)477-481
Number of pages5
JournalArchives of Plastic Surgery
Issue number6
StatePublished - Nov 2017


  • Electronic cigarettes
  • Nicotine
  • Plastic
  • Surgery
  • Vaping
  • Wound healing

ASJC Scopus subject areas

  • Surgery


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