Case: Mr. Zhang, a 48-year-old truck driver, caught his right hand when closing the door. Due to the force, the end of his right middle finger was instantly pinched off, and Mr. Zhang rushed to the hospital for medical treatment. Upon diagnosis, the interphalangeal joint of his right middle finger was completely severed, and the doctor then performed a broken finger replantation surgery on him. After more than four hours of surgery, his broken finger was reattached. However, during his stay in the hospital, Mr. Zhang was addicted to smoking, causing a vascular crisis, and the finger that was easily reattached eventually did not survive. It is well known that some bad habits have a negative impact on wound healing, and smoking is one of them, as it can seriously affect wound healing and increase the risk of infection and scar formation. Large amounts of tobacco-related chemicals, such as nicotine, have harmful effects on tissue oxygen saturation and immune response, affecting the function of lymphocytes and fibroblasts, resulting in decreased microbial clearance, tissue necrosis and collagen synthesis, low wound healing tension, and poor postoperative wound healing. What kind of effect does smoking have on the replantation of broken fingers? Nicotine is the main harm factor of smoking, the content of nicotine in a cigarette can reach 1.3mg, it stimulates the damage of vascular endothelial cells, and is the adsorbent of platelets, easy to form thrombus, easy to occur after smoking arterial spasm, and stubborn finger artery spasm makes it difficult to spasm drugs, leading to low remission rate of vascular crisis, and replantation of finger necrosis. 2, female finger arteries tend to be thinner than male diameter, thin wall, anastomosis patency rate is low, the patient may face the disability of trauma is not enough thought preparation, systemic stress response is strong, easy to endocrine disorders, emotional instability, such as women smoke less, high sensitivity to nicotine, especially young women are more prominent, so after smoking, especially passive smoking is more likely to occur after arterial crisis. 3, patients without smoking history and passive smokers have a higher rate of vascular crisis than active smokers, the earlier the time of smoking or passive smoking after surgery, the more likely to occur vascular crisis; the longer the time of quitting smoking after surgery, the lower the incidence of vascular crisis, arterial crisis after smoking is mostly seen within 10-30 minutes, the fastest only 30 seconds, manifested as reimplantation of finger skin pallor, low skin temperature, poor tension, capillary reaction disappears. Nicotine in cigarette can cause vasospasm and lead to impaired blood flow in the finger, especially in the replanted finger, therefore, smoking should be prohibited in the hand surgery and microsurgery wards, and smoking cessation should be included in the routine for patients after finger replantation or microsurgery, and patients should be warned not to enter the smoking area and not to copolymerize with smokers. There have been a lot of cases of necrosis of replanted fingers due to smoking, and the lesson is profound. In addition, if there are visiting family members who have just smoked, they should stay outside for a while to wait for the smell of smoke to dissipate before entering the ward to avoid inattentiveness and causing harm to the patient. In addition to the smoking ban after finger replantation, we also need to pay attention to the following measures: keep the room temperature 23℃-25℃, relative humidity 50%-60%, keep the ward quiet, comfortable and tidy, and irradiate with 60W baking lamp at 30-40cm above the finger for 24h continuously to make the local blood vessels expand. Also encourage patients to eat more high-energy, high-protein, high-vitamin diet to promote wound healing; drink more water, eat more coarse fiber food to prevent constipation, if necessary, give some laxatives to ensure smooth defecation; forbid drinking caffeinated liquids, such as coffee, tea, cola, etc., avoid spicy and stimulating food; forbid lighting mosquito incense to prevent vasospasm.