title: Use of herbal supplements and vitamins in plastic surgery: a practical review.
abstract: OBJECTIVE
  After studying this article, the participant should be able to: 1. Explain what governmental regulations control the labeling and distribution of herbal supplements. 2. List the more commonly used supplements and their reported benefits. 3. List the possible postoperative complications from consumption of the more commonly used herbal supplements. 4. Explain the preoperative management of patients using herbal supplements. 5. Know additional resources to consult when unanswered questions arise.
  
  
  BACKGROUND
  The American public spends over $5 billion per year on herbal supplements, and approximately 20 percent of all Americans use prescription medications concurrently with herbal supplements. As the number of people who take alternative medicines rises, there is growing awareness among health care providers of the need to become educated and to educate their patients on the effects that such supplementation may have on their health. As plastic surgeons, we have an added responsibility to become informed because of potential adverse interactions with other medications and anesthesia in the elective surgical patient.
  
  
  METHODS
  Literature regarding commonly encountered herbal supplements and vitamins was reviewed and summarized to include reported indications for use and potential adverse effects and interactions specific to the perioperative patient.
  
  
  RESULTS
  Abundant literature exists regarding herbal supplementation, but very little scientific evidence exists to advocate the use of the majority of supplements available on the market. In addition, little is known about the positive and negative interactions that these supplements are capable of producing, and those interactions that are known are based on case reports.
  
  
  CONCLUSIONS
  With the lack of quality scientific studies to support the efficacy of most herbal products available and the limited regulation of these products by the government, health care providers are faced with a significant public health dilemma. This article provides a brief overview of information published on commonly encountered herbal supplements and vitamins taken by plastic surgery patients.
authors.affiliation: Department of Plastic Surgery, Nancy L & Perry Bass Advanced Wound Healing Laboratory, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9132, USA.
authors.forename: George
authors.initials: G
authors.lastname: Broughton
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Crosby
authors.forename: Jayne
authors.initials: J
authors.lastname: Coleman
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Rohrich
mesh_terms: D019587:Dietary Supplements / Q000009:adverse effects; D041743:Herb-Drug Interactions; D006801:Humans; D008517:Phytotherapy / Q000009:adverse effects; D028321:Plant Preparations / Q000009:adverse effects; D011183:Postoperative Complications / Q000139:chemically induced*; D013518:Surgery, Plastic; D014815:Vitamins / Q000009:adverse effects
chemical_list: D028321:Plant Preparations; D014815:Vitamins