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.

Dussik, Christopher M et al.·Journal of hand surgery global online·2026·Moderate EvidenceRetrospective Cohort
RTHC-08242Retrospective CohortModerate Evidence2026RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
N=498,150

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)
Database ID:
RTHC-08242

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

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.

Read More on RethinkTHC

Cite This Study

RTHC-08242·https://rethinkthc.com/research/RTHC-08242

APA

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.