Among nearly 500,000 hand surgery patients, those with cannabis dependence had 1.9x higher wound infection risk, 2.5x more hospital readmissions, and 2.6x more returns to the OR for deep infections.
Hand surgery patients, surgeons, anesthesiologists, and anyone planning surgery who uses cannabis.
What the researchers found
Patients with cannabis dependence showed significantly higher odds of superficial wound complications/infections (OR 1.9), postoperative admissions (OR 2.5), ED visits (OR 1.8), sepsis (OR 2.3), and return to OR for deep infections (OR 2.6) after hand and wrist soft-tissue surgery.
Why it matters
Hand surgery infections can have devastating consequences for hand function. The finding that cannabis dependence nearly doubles infection risk provides practical information for surgical risk assessment and patient counseling.
The numbers in context
498,150 total patients. 5,607 with cannabis dependence. Wound complications: OR 1.9 (1.6-2.3). Readmissions: OR 2.5 (1.7-3.6). ED visits: OR 1.8 (1.6-2.0). Sepsis: OR 2.3 (1.5-3.6). Return to OR: OR 2.6 (1.6-4.6).
How the study worked
Retrospective cohort study using the TriNetX multi-institutional database. 498,150 patients who underwent hand/wrist soft-tissue surgery; 5,607 with preoperative cannabis dependence (ICD-10 F12) vs. 492,543 without. Propensity score matching controlled for confounders. 90-day postoperative outcomes assessed.
What this study cannot tell us
Association, not causation. ICD-10 coding may under-identify cannabis use. Cannabis dependence patients may differ in other ways (compliance, comorbidities). Database study lacks clinical detail on cannabis type, amount, or cessation timing. TriNetX may not capture all complications.
How to read the evidence
Large multi-institutional database with propensity matching — strong for identifying associations though limited by coding accuracy.
When this study was published
Published in 2026, adding to the surgical outcomes literature on cannabis use.
The bigger picture
This adds to growing evidence that cannabis use status should be part of preoperative assessment. Whether the increased risk is from cannabis itself (immune modulation, smoking-related tissue effects) or associated behaviors remains unclear, but the clinical signal is strong enough to warrant counseling.
Questions still open
- Would preoperative cannabis cessation reduce infection risk? Is smoked cannabis worse than other forms? How long before surgery should patients stop using cannabis?
Common questions
Should I stop using cannabis before hand surgery?
Why might cannabis increase surgical infection risk?
Read the original research
Is Cannabis Dependence Associated with Postoperative Infections in Hand and Wrist Surgeries?
Journal of hand surgery global online, 8(3), 100948
Citation
Dussik, Christopher M; Coombs, Jeffrey; Phan, Amy; Ghattas, Yasmine; Ferraro, Joseph; Ketonis, Constantinos. (2026). Is Cannabis Dependence Associated with Postoperative Infections in Hand and Wrist Surgeries?. Journal of hand surgery global online, 8(3), 100948. https://doi.org/10.1016/j.jhsg.2026.100948
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