Smokers may not understand the habit's adverse effect on wounds.

Exposure to smoke from just one cigarette decreases blood flow to chronic wounds such as pressure ulcers, venous leg ulcers and diabetic foot ulcers. A new study shows the habit’s impact on healing is rarely discussed with patients. 

Researchers from The Ohio State University School of Nursing examined how smoking affects the wound healing process and found chronic wounds share common characteristics of inflammation and reduced blood flow that make them particularly susceptible to the approximately 4,000 toxic chemicals found in cigarette smoke.

“The deep skin wrinkling associated with chronic smoking is caused by chemicals that impact the production of collagen, a protein that is also critical to the wound repair process,” said Jodi McDaniel, Ph.D., CNP, a study co-author. “Chemicals like carbon monoxide also reduce blood flow to the wound and prevent skin’s natural anti-inflammatory and anti-bacterial mechanisms — so it’s a perfect chemical storm which makes wounds more likely to get infected, and less likely to heal.”

These data highlight the importance of delivering a consistent message about quitting to a chronic wound sufferer, the authors say. Still, that’s not typically part of the conversation, likely because physicians are unsure about when or how to bring up smoking cessation.

Researchers advise adding smoking cessation to existing guidelines for wound care.