卡梅隆·汉纳姆，药剂师.D.
Sr. 临床会计药师
What implications does tobacco use have on medical treatment and the process of healing in workers’ compensation?
Tobacco use and smoking has wide-ranging implications for health and overall individual wellbeing, including the ability to negatively impact medical treatment outcomes and wound healing processes. 在工人赔偿方面, where injured employees undergo medical treatment and rehabilitation, understanding the impact of tobacco use is of particular importance.
烟草对伤口和骨愈合的影响
Tobacco use has been shown to significantly impair the wound healing process. Even smoking one cigarette reduces the body’s ability to provide necessary nutrients for post-surgery healing. 几项研究，包括来自 美国国立卫生研究院 (NIH)和 世界卫生组织 (世卫组织), 已经证明吸烟会削弱免疫系统, 延缓和延长伤口愈合, 增加了, 伤口感染的严重程度和持续时间, and negatively impacts overall outcomes of surgical procedures and post operative complications.
虽然确切的机制还不完全清楚, 伤口愈合的过程是复杂的. 然而, 据估计，香烟烟雾中含有超过4,000种有害物质, 包括尼古丁, 氰化氢和一氧化碳. These compounds can induce inflammation and 缺氧 (low blood oxygen), 对愈合过程产生负面影响.
尼古丁, 烟草的主要成分, 有收缩血管的作用吗, 导致流向伤口部位的血流量减少. This diminishes the delivery of oxygen and nutrients required for optimal healing. 此外, nicotine inhibits the proliferation and migration of various cell types involved in wound healing, 包括成纤维细胞和内皮细胞.
通过研究，烟草也被证明会 对骨愈合有负面影响, particularly in the context of fractures and orthopedic procedures. 吸烟与骨折愈合延迟有关, 骨不连(骨头不能愈合)的几率增加, 植入失败的风险也更高.
The detrimental effects of tobacco on bone healing are attributed to multiple factors, 包括血流受损, 缺氧, 细胞活性改变, 破坏了对骨再生至关重要的信号通路. 此外, tobacco smoke has been found to have a negative impact on bone mineral density, 增加骨质疏松和随后骨折的风险.
Impact on Treatment Outcomes and Implications for Workers’ Compensation
Understanding the impact of tobacco use on medical treatment and wound healing in workers' compensation has significant implications. One area of concern in treatment relates to the use of opioids for managing pain. Tobacco users tend to present with more severe and extended chronic pain, 通常需要更高频率的阿片类药物使用. 有趣的是, current tobacco use via traditional cigarettes or e-cigarettes, is a strong predictor for the potential risk of engaging in non-medical or non-prescription opioid use.
吸烟与疼痛程度增加有关, longer hospital stays and reduced functional outcomes following surgery or medical interventions. The delayed healing and increased risk of complications associated with tobacco use can also lead to extended disability, 长时间不工作, 雇主和亚博真人官方版APP的医疗费用也会增加. Recognizing the negative effects of smoking on treatment outcomes can influence the development of comprehensive workers' compensation programs that incorporate smoking cessation support as an integral part of tailored rehabilitation and recovery plans. 通过提供戒烟干预, employers and payers can help injured employees optimize their healing process, enhance treatment outcomes and aid in an overall quicker return to work.
Research has consistently demonstrated the detrimental effects of tobacco use on medical treatment outcomes and the healing process. 吸烟会延缓伤口和骨头的愈合, increases the risk of complications following surgical procedures and interferes with the efficacy of certain medications. Understanding these effects is crucial for workers' compensation programs to develop comprehensive strategies that include smoking cessation support. 通过解决烟草使用问题, 雇主可以提高治疗效果, promote faster healing and ultimately improve the overall well-being and outcomes of injured employees within the workers' compensation system.
此信息旨在作为总体概述, and any specific questions or concerns should be more fully reviewed with your health care professional such as the prescribing doctor or dispensing pharmacist.
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引用:
http://www.who.int/news/item/20-01-2020-smoking-greatly-increases-risk-of-complications-after-surgery#:~:text=Smoking%20distorts%20a%20patient's%20immune,nutrients%20for%20healing%20after%20surgery
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241583/
http://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00459-4/fulltext
http://pubmed.ncbi.nlm.nih.gov/26375198/#:~:text=Smokers%20present%20with%20more%20severe%20and%20extended%20chronic,of%20risk%20for%20nonmedical%20use%20of%20prescription%20opioids.