Cannabis Dependence Linked to Double the Infection Risk After Hand Surgery
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.
Quick Facts
What This Study 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.
Key Numbers
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 They Did This
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.
Why This Research 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 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.
What This Study Doesn't 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.
Questions This Raises
- ?Would preoperative cannabis cessation reduce infection risk?
- ?Is smoked cannabis worse than other forms?
- ?How long before surgery should patients stop using cannabis?
Trust & Context
- Key Stat:
- Evidence Grade:
- Large multi-institutional database with propensity matching — strong for identifying associations though limited by coding accuracy.
- Study Age:
- Published in 2026, adding to the surgical outcomes literature on cannabis use.
- Original Title:
- Is Cannabis Dependence Associated with Postoperative Infections in Hand and Wrist Surgeries?
- Published In:
- Journal of hand surgery global online, 8(3), 100948 (2026)
- Authors:
- Dussik, Christopher M, Coombs, Jeffrey, Phan, Amy, Ghattas, Yasmine, Ferraro, Joseph, Ketonis, Constantinos
- Database ID:
- RTHC-08242
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
Should I stop using cannabis before hand surgery?
This study found cannabis-dependent patients had nearly double the infection risk after hand surgery. While it can't prove cannabis caused the infections, the strong association suggests discussing your cannabis use with your surgeon during pre-surgical planning.
Why might cannabis increase surgical infection risk?
Possible mechanisms include cannabis's immunomodulatory effects, smoking-related tissue changes, or associated behavioral factors. The study couldn't determine the specific cause, but the clinical risk pattern was consistent across multiple outcome measures.
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Cite This Study
https://rethinkthc.com/research/RTHC-08242APA
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
MLA
Dussik, Christopher M, et al. "Is Cannabis Dependence Associated with Postoperative Infections in Hand and Wrist Surgeries?." Journal of hand surgery global online, 2026. https://doi.org/10.1016/j.jhsg.2026.100948
RethinkTHC
RethinkTHC Research Database. "Is Cannabis Dependence Associated with Postoperative Infecti..." RTHC-08242. Retrieved from https://rethinkthc.com/research/dussik-2026-is-cannabis-dependence-associated
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.