Impact of Cannabis Use on Outcomes in Abdominal Wall Reconstruction
Overview
This propensity score-matched study evaluated the effect of cannabis use on postoperative outcomes following open abdominal wall reconstruction with mesh. Cannabis use was not associated with increased 30-day wound morbidity, infections, or readmissions but was linked to a higher rate of reoperations, primarily due to major wound complications.
Background
Cannabis use has risen significantly in the United States, with increasing legalization and accessibility. Cannabinoid receptors influence inflammatory responses and gastrointestinal functions, but the impact of cannabis on surgical outcomes remains unclear. Open abdominal wall reconstruction is a complex procedure with risks of wound and medical complications, making it important to understand if cannabis use affects perioperative outcomes. This study aimed to assess whether cannabis use influences wound morbidity and reoperation rates after clean abdominal wall reconstruction with mesh.
Data Highlights
Outcome
Cannabis-Smokers (n=72)
Non-Smokers (n=216)
p-value
SSO Rate
18%
17%
0.86
SSI Rate
11.1%
9.3%
0.65
SSOPI Rate
12%
12%
0.92
Readmission
12.5%
9.3%
0.43
Any Postoperative Complication
46%
43%
0.63
Reoperations
8.3%
2.8%
0.041
Key Findings
Cannabis use was not associated with increased 30-day surgical site occurrences (18% vs 17%, p=0.86).
Surgical site infection rates were similar between cannabis users and non-users (11.1% vs 9.3%, p=0.65).
Rates of surgical site occurrences requiring procedural intervention were equivalent (12% vs 12%, p=0.92).
Readmission rates did not differ significantly (12.5% vs 9.3%, p=0.43).
Reoperations were significantly more frequent in cannabis users (8.3% vs 2.8%, p=0.041), mainly due to major wound complications.
No mesh excisions occurred in either group.
Clinical Implications
Surgeons should be aware that while cannabis use does not appear to increase common wound complications or infections after abdominal wall reconstruction, it may be associated with a higher likelihood of reoperation related to major wound issues. This information is important for preoperative counseling and surgical planning. Further research is needed to clarify mechanisms and optimize perioperative management in cannabis users.
Conclusion
Cannabis use does not increase most postoperative wound morbidity or infection rates following abdominal wall reconstruction but is linked to a higher rate of reoperations due to major wound complications. These findings highlight the need for careful monitoring of cannabis users in the postoperative period.
References
National Survey on Drug Use and Health 2020 -- Cannabis Use Statistics
State Marijuana Laws in 2023 -- Legalization Status
Cannabinoid Receptors and Inflammation -- Animal Model Studies
Cannabinoids and Intestinal Motility -- Physiological Effects
Cannabinoids and Gastric Secretion -- Experimental Data
Surgical Outcomes and Cannabis Use -- Current Knowledge Gaps
Abdominal Core Health Quality Collaborative (ACHQC) Database -- Data Source
Surgical Site Occurrences Definitions -- Standardized Outcomes
Hernia-Related Quality-of-Life (HerQLes) Survey -- Validation and Use
Minimal Clinically Important Difference for HerQLes -- Clinical Relevance
by S. Maskal, J. M. Foreman, R. C. Ellis, S. Phillips, N. Messer, M. Melland-Smith, L. R. A. Beffa, C. C. Petro, A. S. Prabhu, M. J. Rosen, B. T. Miller
