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Mini Lecture 1 Module: Tobacco and Sensory Organs

TOBACCO AND SKIN. Mini Lecture 1 Module: Tobacco and Sensory Organs. Objectives of the Mini Lecture. GOAL OF MINI LECTURE: Provide students with knowledge about the r elationship between tobacco use and changes in the skin. LEARNING OBJECTIVES Students will be able to:

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Mini Lecture 1 Module: Tobacco and Sensory Organs

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  1. TOBACCO AND SKIN Mini Lecture 1 Module: Tobacco and Sensory Organs

  2. Objectives of the Mini Lecture GOAL OF MINI LECTURE: Provide students with knowledge about the relationship between tobacco use and changes in the skin. LEARNING OBJECTIVES Students will be able to: • Identify how tobacco use is a risk factor for changes in the skin. • Understand how tobacco causes aging and acts detrimentally on wound healing. • Understand the value of cessation in the prevention of premature aging and poor wound healing.

  3. Contents Core slides • Tobacco and Premature Aging of Skin • Tobacco and Premature Aging: Mechanisms • Cessation and Premature Aging • Tobacco and Wound Healing • Tobacco and Wound Healing: Mechanism • Cessation and Wound Healing Optional slides • Host Factors that Affect Wound Healing

  4. CORE SLIDES Tobacco and Skin Mini Lecture 1 Module: Tobacco and Sensory Organs

  5. Tobacco and Premature Aging of Skin • Tobacco smoke and UVA cause wrinkle formation independently of each other.1,2 • Unquestionable sequelae of cigarette smoking are: • Occurrence of yellow fingers • Enhanced wrinkling, especially in the faces of females • Vasospasms and obliterations of large arteries as well as of small skin vessels. 1. Yin et al. 2001; 2. Partsch et al. 1994

  6. Tobacco and Premature Aging: Mechanisms • Thickening and fragmentation of the elastic fibers of skin and decrease in collagen formation that maintains a healthy and supple skin.1,4 • Enhanced elastase activity, and the degradation of elastin in the dermis.2 • More MMP-1 mRNA in the skin of smokers than non-smoker.3 • Oxygen supply and the water content of skin is also reduced.4 http://review.surreyhealth.nhs.uk/article.aspx?id_Content=5279 • Yin et al. 2000; 2. Sela 2002; 3. Lahmann et al. 2003; • 4. http://www.medindia.net/patients/patientinfo/smoking_hazards_skin.htm#ixzz0lLMlfkaB

  7. Cessation and Premature Aging • Smoking and facial wrinkling is important evidence for convincing youngpeople not to begin smoking and older smokers to quit.1 • Dermatologists can play an integral role in promoting smoking cessation by providing expert opinion and educating the public on the harmful effects of smoking on the skin.2 • Grady et al. 1992; 2. Freiman et al. 2004

  8. Tobacco and Wound Healing • Smokers are at increased risk for complications at surgery sites or following skin grafts.1 • In patients with intraoral bone grafts, wound healing was impaired in 33% of patients, of whom 80% were smokers.2 http://www.surgeryencyclopedia.com/images/gesu_01_img0009.jpg • Second hand smoke can inhibit cell migration that may result in abnormal repair and remodeling and/or lead to excess scarring.3 • Reus et al. 1992; 2. Jones and Triplett 1992; 3. Wong et al.2004

  9. Tobacco and WoundHealing Mechanism • Changes in the rheologic characteristics of the blood, increased vasoconstriction, and damage to the epithelial layer of the vessel. • Interactions with collagen metabolism. • Induction of an inflammation reaction by nicotine. • Immunosuppression caused by nicotine may also contribute. Krug et al. 2004 http://www.my-varicose-veins.com/venous-stasis-ulcers.html

  10. Cessation and Wound Healing Smoking cessation: • Three months or more before surgery, cessation reduces risk of wound complication.1 • Several weeks before surgery, cessation resulted in a substantial benefit in the rate of wound-related complications in orthopedic surgery.2 • If preoperative smoking interventions can reduce complications, the savings in personal suffering and financial expense would be substantial.3 1. Ahn et al. 2002; 2. Warner 2005; 3. Møller et al. 2002

  11. OPTIONAL SLIDES Tobacco and Skin Mini lecture 1 Module: Tobacco and Sensory Organs

  12. Host Factors ThatAffect Wound Healing Local Factors: • Chronic edema • Vascular diseases • Extensive scarring • Previous radiation • Tissue loss Systemic Factors • Malnutrition • Immune deficiencies • Organ failures • Diabetes • Old age • Cancers • Obesity • Use of Tobacco Products • Steroids, other medications http://www.osteomyelitis.com/images/classification2-big.jpg

  13. The most important health message a doctor can give to patients is to quit smoking.

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