In smokers undergoing surgery, which postoperative complication is of particular concern due to impaired oxygenation?

• A. Delayed wound healing due to impaired oxygenation
• B. Postoperative nausea and vomiting
• C. Hair loss
• D. Weight gain

Answer: (A)

The key idea is that wound healing after surgery relies on adequate tissue oxygenation. Oxygen is essential for several healing processes: fibroblasts need oxygen to synthesize collagen and cross-link it properly, new blood vessel formation (angiogenesis) depends on enough oxygen, and immune cells use oxygen to kill bacteria. Smokers often have impaired oxygen delivery to tissues because carbon monoxide from smoke binds to hemoglobin, reducing its oxygen-carrying capacity, and nicotine causes vasoconstriction that lowers blood flow. If oxygen delivery to the surgical site is reduced, these healing processes slow down, leading to delayed wound healing and a higher risk of infection.

Postoperative nausea and vomiting, hair loss, and weight gain are not as directly linked to impaired oxygenation in smokers, so they’re less likely to be the specific concern tied to oxygenation status.