Cannabis use disorder was linked to more postoperative pain and skin complications after tummy tuck surgery

In a propensity-matched analysis of 1,596 panniculectomy patients, those with cannabis use disorder had 82% more postoperative pain and 48% more wound complications, but no difference in other major complications.

Mokhtar, Jonathan et al.·BMC plastic and reconstructive surgery·2026·Moderate EvidenceRetrospective Cohort
RTHC-08499Retrospective CohortModerate Evidence2026RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

After propensity score matching on age, sex, BMI, race/ethnicity, and comorbidities, patients with CUD had significantly higher rates of postprocedural pain (RR 1.82, 95% CI 1.32-2.46, p < 0.001) and skin complications (RR 1.48, 95% CI 1.05-2.09, p = 0.019). No significant differences were found for sepsis, hematoma/seroma, venous thromboembolism, pulmonary embolism, or hospital readmission.

Key Numbers

1,596 matched patients (798 CUD, 798 controls). Mean age 43.2, 80.3% female. Postprocedural pain RR 1.82 (95% CI 1.32-2.46, p < 0.001). Skin complications RR 1.48 (95% CI 1.05-2.09, p = 0.019). No significant differences in sepsis, hematoma/seroma, VTE, PE, or readmission.

How They Did This

Retrospective cohort study using the TriNetX federated database (100+ healthcare organizations). Adult panniculectomy patients (2010-2025) with CUD documented within 6 months preoperatively were propensity-matched 1:1 to controls. Risk ratios were calculated for 90-day postoperative complications.

Why This Research Matters

Surgeons often lack evidence-based guidance on how cannabis use affects surgical outcomes. This large matched analysis provides specific risk estimates for a common procedure, supporting the case for routine cannabis use screening in preoperative assessments.

The Bigger Picture

As cannabis use becomes more common, understanding its impact on surgical outcomes becomes increasingly important. The specific pattern here, more pain and wound issues but not systemic complications, suggests cannabis may affect local healing and pain processing rather than causing broad surgical risk.

What This Study Doesn't Tell Us

ICD coding for CUD may undercount cannabis users. No data on route, dose, or frequency of cannabis use. Concurrent nicotine use is a potential confounder. Retrospective design with inherent limitations. TriNetX database may have documentation biases.

Questions This Raises

  • ?Is the increased pain due to cannabinoid receptor changes affecting pain processing, or to tolerance to analgesics?
  • ?Would preoperative cannabis cessation reduce these risks?
  • ?Do these patterns apply to other surgical procedures?

Trust & Context

Key Stat:
RR 1.82 for postoperative pain in patients with cannabis use disorder vs. matched controls
Evidence Grade:
Large propensity-matched study from a multi-institutional database, but retrospective design and reliance on ICD coding for CUD identification introduce potential for misclassification.
Study Age:
2026 publication using 2010-2025 data
Original Title:
Association of cannabis use disorder with postoperative complications following panniculectomy: a multicenter propensity-matched analysis.
Published In:
BMC plastic and reconstructive surgery, 2(1), 1 (2026)
Database ID:
RTHC-08499

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 cannabis users avoid surgery?

This study does not suggest avoiding surgery, but rather that surgeons should screen for cannabis use and anticipate potentially higher pain management needs and wound monitoring requirements.

Why might cannabis users have more pain after surgery?

Possible explanations include altered pain processing from chronic cannabinoid receptor stimulation, cross-tolerance with anesthetic agents, or differences in pain reporting. The study identified the association but did not test mechanisms.

Read More on RethinkTHC

Cite This Study

RTHC-08499·https://rethinkthc.com/research/RTHC-08499

APA

Mokhtar, Jonathan; Ha, John Y; Almeida, Victor F A; Lellouch, Alexandre G; Vyas, Krishna S; Doh, Susan J; Duraes, Eliana F R. (2026). Association of cannabis use disorder with postoperative complications following panniculectomy: a multicenter propensity-matched analysis.. BMC plastic and reconstructive surgery, 2(1), 1. https://doi.org/10.1186/s44452-026-00013-z

MLA

Mokhtar, Jonathan, et al. "Association of cannabis use disorder with postoperative complications following panniculectomy: a multicenter propensity-matched analysis.." BMC plastic and reconstructive surgery, 2026. https://doi.org/10.1186/s44452-026-00013-z

RethinkTHC

RethinkTHC Research Database. "Association of cannabis use disorder with postoperative comp..." RTHC-08499. Retrieved from https://rethinkthc.com/research/mokhtar-2026-association-of-cannabis-use

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.