Cannabis smoking and abdominal wall reconstruction outcomes: a propensity score-matched analysis

Category	Detail
Condition	Open abdominal wall reconstruction with mesh for ventral hernia repair
Key Mechanisms	Cannabinoid receptors influence inflammatory response, intestinal motility, and gastric secretion; potential impact on wound healing and postoperative complications
Target Population	Adults undergoing clean (CDC class I) open ventral hernia repair with transversus abdominis release and retromuscular synthetic mesh
Care Setting	Surgical setting, perioperative and postoperative care

Cannabis use was not associated with increased 30-day wound morbidity (SSO, SSI, SSOPI) after abdominal wall reconstruction.
Reoperations were more frequent in cannabis users (8.3% vs 2.8%, p=0.041), mainly due to major wound complications.
No significant differences in readmission rates or overall postoperative complications between cannabis users and non-users.

Identify cannabis use via patient self-report and electronic medical record review including keywords and drug use documentation.

Consider cannabis use as a factor in surgical planning due to higher reoperation rates related to wound complications.
Continue standard perioperative care protocols as cannabis use did not increase infection or wound morbidity rates.

Monitor for wound complications and need for reoperation more closely in cannabis users postoperatively.
Use validated patient-reported outcome measures (HerQLes and PROMIS Pain Intensity) at baseline and follow-up to assess quality of life and pain.

Cannabis use may increase risk of major wound complications requiring reoperation after abdominal wall reconstruction.
No increased risk of surgical site infections or other wound morbidity was observed.

Patients undergoing open ventral hernia repair with mesh, including cannabis smokers and non-smokers matched by propensity scores.

Cannabis use did not increase wound morbidity or infections but was associated with higher reoperation rates mainly due to wound complications.

Screen patients for cannabis use preoperatively using detailed history and EMR review.
Use propensity score matching or adjustment in research to control for confounding variables when studying cannabis effects.
Employ validated quality-of-life and pain assessment tools (HerQLes, PROMIS) longitudinally to monitor patient outcomes.
Counsel patients on potential increased risk of reoperation related to wound complications if they use cannabis.
Maintain vigilance for wound complications in cannabis users despite similar infection rates.

Clinical Scorecard: Impact of Cannabis Use on Outcomes in Abdominal Wall Reconstruction: A Propensity Score-Matched Study