Nicotine, CO and HCN: the detrimental effects of smoking on wound healing.

During the 1960s, the Royal College of Physicians published its first report on smoking and health, concentrating on the association between smoking and long cancer, chronic obstructive pulmonary disease and heart disease (RCP, 2000). It was not until a decade later that the effects of smoking on wound healing were first reported (Mosely and Finseth, 1977). Although it is now widely accepted that smoking impairs wound healing, extensive studies have yet to be performed. Clinical practitioners have a role to deliver evidence-based care and provide smoking cessation programmes for patients with wounds. This article discusses three key toxins in cigarette smoke and research studies that have examined the effect of smoking on healing of acute wounds.