Unlike other forms of complementary and alternative medicine (CAM), herbal medi cine (phytomedicine) employs remedies possessing significant pharmacological activ ity and consequently potential adverse effects and drug interactions. The explosion in sales of herbal therapies has brought many products to the marketplace that do not conform to the standards of safety and efficacy that physicians and patients expect. Unfortunately, few surgeons question patients regarding their use of herbal medicines, and 70% of patients do not reveal their use of herbal medicines to their physicians and pharmacists (Eisenberg et al., 1993). All surgeons should question patients regarding the use of the following common herbal remedies, which may increase the risk of bleeding during surgical procedures: feverfew, garlic, ginger, gingko, Asian ginseng. Conversely, surgeons may employ herbal medicines such as aloe vera gel to aid in wound healing. When prescribing herbal medicines, practitioners are advised to select manufacturers who adhere to the code of pharmaceutical Good Manufacturing Process.
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