Abstract
Nicotine, a key component of tobacco products, significantly impacts wound healing through its effects on vascular response, inflammation, and cellular functions critical to tissue repair. The introduction of alternative nicotine delivery systems, such as e-cigarettes and transdermal patches, has raised questions about their relative safety compared to traditional cigarettes. This review explores the effects of nicotine delivery methods on wound healing, focusing on the mechanisms of nicotine-induced vasoconstriction, oxidative stress, angiogenesis, and immune modulation.
Cigarettes impair wound healing due to the combined effects of nicotine, carbon monoxide, and tar, which disrupt oxygen delivery, increase inflammation, and weaken collagen remodeling. E-cigarettes, while combustion-free, still hinder wound repair through nicotine's effects on keratinocyte migration and mitochondrial function. Nicotine patches, though safer than smoking, have complex effects depending on dose and duration. While preoperative smoking cessation significantly improves surgical outcomes, careful management of nicotine replacement therapies is critical to minimizing adverse effects. This review highlights the need for further research into the long-term impact of vaping and strategies to optimize nicotine cessation in surgical care.