Assessing the impact of nicotine and non-tobacco nicotine use on postoperative complications following hallux valgus surgery

Background Nicotine use, including from non-tobacco sources, is associated with impaired wound healing and increased surgical complications. This study evaluated the impact of nicotine and non-tobacco nicotine use on postoperative outcomes in hallux valgus (HV) surgeries. Methods Using the TriNetX Global Health Research Network, we analyzed adult patients aged 18 and older undergoing HV correction. Cohorts included nicotine users, non-tobacco nicotine users, and controls, matched using propensity score matching (PSM). Postoperative complications were assessed within 90 days. Results Both nicotine and non-tobacco nicotine cohorts demonstrated increased postoperative complications compared to the control cohort, notably infections, wound disruption, stroke, pneumonia, and renal failure. Also, both nicotine and non-tobacco nicotine users showed elevated healthcare utilization, including emergency department visits and opioid-related disorders. Conclusions Nicotine and non-tobacco nicotine use significantly increase the risk of postoperative complications following HV surgery, emphasizing the importance of mitigating these risks through further research and preoperative strategies.