{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T10:43:59Z","timestamp":1785235439039,"version":"3.55.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004375","name":"Tel Aviv University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hernia"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Active smoking is widely regarded as a risk factor for wound morbidity and adverse outcomes in abdominal wall reconstruction (AWR), often serving as a contraindication to elective repair. However, its independent impact on long-term complications remains poorly characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study utilized the prospectively maintained ACHQC registry, included patients who underwent open, elective, clean ventral hernia repair (VHR) with transversus abdominis release (TAR) and permanent synthetic mesh at a high-volume AWR center between February 2019 and December 2022. All active smokers during this period were propensity matched in a 1:3 ratio to never-smokers based on demographics, comorbidities, and operative characteristics. Outcomes were assessed at early (30-day) and long-term (\u2265\u200924 months) timepoints. Primary endpoints included wound morbidity, mesh-related complications and hernia recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 106 active smokers were propensity-matched to 295 never-smokers. Baseline demographics and operative variables were well balanced. At 30 days, there were no significant differences in surgical site infection (SSI) (9.4% vs. 9.2%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.92), surgical site occurrence (SSO) (21.5% vs. 17.6%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.48), or surgical site occurrence requiring procedural intervention (SSOPI) (9.4% vs. 9.2%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.92). At 24 months, rates of SSO (1.9% vs. 0.7%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.81), SSI (0% vs. 0.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.99), SSOPI (0% vs. 0.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.99), mesh infection (0.9% vs. 0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.99), and reoperation were low and statistically similar. Hernia recurrence at \u2265\u200924 months was 4.7% in smokers vs. 7.8% in never-smokers (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.15).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this analysis, active smoking was not associated with increased risk of clinically significant wound morbidity, mesh-related complications, SSOPI, or hernia recurrence. These findings support a patient-centered approach wherein smoking cessation is strongly encouraged but not mandated prior to surgical repair in appropriately selected individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10029-026-03625-7","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T09:56:20Z","timestamp":1772186180000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The impact of active smoking on postoperative morbidity and hernia recurrence following abdominal wall reconstruction: long-term follow-up"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4686-9583","authenticated-orcid":false,"given":"Nir","family":"Messer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adar","family":"Horowitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin T.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas R. A.","family":"Beffa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clayton C.","family":"Petro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajita S.","family":"Prabhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Ching","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliad","family":"Karin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahim","family":"Kanani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eran","family":"Nizri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Lahat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Szold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Rosen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"3625_CR1","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1016\/j.suc.2023.04.005","volume":"103","author":"N Messer","year":"2023","unstructured":"Messer N, Rosen MJ (2023) Ventral hernia repair: does mesh position matter? 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The use of data and materials was carried out with proper authorization and in compliance with all applicable laws and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical considerations"}},{"value":"As this study involved the use of existing data and did not involve direct interaction with human subjects, no patients were enrolled, and therefore, no informed consent was required. The data used in this research were anonymized and deidentified, ensuring the privacy and confidentiality of individuals in accordance with the Institutional Review Board.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent was not required"}},{"value":"In adherence to ethical standards, this chart reviews study, though devoid of direct human or animal involvement, maintained patient data confidentiality and ethical standards as required by the institutional review board.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Institutional review board"}},{"value":"I declare that there are no conflicts of interest related to this manuscript. The study was conducted impartially, and the findings presented in the manuscript are based solely on the analysis and interpretation of the data.Conflict of interest M.J.R receives salary support for his position in the leadership of the Abdominal Core Health Quality Collaborative (ACHQC), which is the data source for the present submission. A.S.P. has received funding paid to her institution from Intuitive Surgical Inc., personal fees from Medtronic, Intuitive Surgical, CMR Surgical, and Verb Surgical. L.R.B has received honorarium from Intuitive.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"108"}}