Henderson Daily Dispatch

Role of Vitamins In Surgery Cases

By LOGAN CLENDENING, M. D.

The trend of experimental work in surgery of late is not so much to improve operative technique or to invent new operations as it is to safeguard the patient from the general stress of surgical operations.

I recently visited the medical school of a great state university and found that the head of the department of surgery seldom did any routine operations. I found that he was working in food and water, on the iodine supply its relation to goiter and the thyroid gland in order to find out if there might be some way either to safeguard the patient when surgery was indicated or to obviate surgery entirely.

Along the same line the use of vitamins has been advocated to make surgery less hazardous.

Interfere With Nutrition

All major surgical operations involve some interference with the patient's necessary nutrition. It is frequently necessary to curtail or completely abolish intake of food by mouth for varying periods for surgical patients.

If this disturbance of normal food intake lasts only a few days and, in the meantime, fluid intake is kept up and the patient's energy requirement is satisfied by the administration of glucose and normal saline, he suffers no harm. In many cases, especially in patients who undergo operations on the stomach and intestines, the patient has been forced to curtail his food intake for weeks, or even months; before coming to the attention of the surgeon.

Here it is possible to see malnutrition severe enough to reduce markedly the chance for brilliant results with surgical treatment.

The vitamins, those substances present in foods which do so much to keep the human machine functioning smoothly, are supplied to all of us who lead normal lives in our normal foods. But in circumstances of partial starvation, such as described above, from long-continued interference with normal digestion, they may be deficient and lead to a number of conditions important for the surgeon to consider.

Causes Hemorrhage

Deficiency of vitamin C may cause serious hemorrhage by increasing the clotting time of the blood. It may also prevent normal wound healing.

Whipple and Elliott have found that many candidates for surgery frequently suffer from prolonged malnutrition and vitamin deficiency. These deficiencies, together with the low serum protein of blood and tissues, may prevent normal healing and unquestionably predispose towards wound disruption.

With these and other facts along the same line, several surgeons (see Vorhaus, American Journal of Surgery, 1938) have advocated that intensive vitamin and mineral administration be given surgery patients for several days before an operation. Five to ten days of such administration will suffice in most cases to correct existing difficulties.

Thus surgery calls in dietetic science in order to increase its own efficiency.

EDITOR'S NOTE: Seven pamphlets by Dr. Clendening can now be obtained by sending 10 cents in coin, for each, and a self-addressed envelope stamped with a three-cent stamp, to Dr. Logan Clendening, in care of this paper. The pamphlets are: "Three Weeks' Reducing Diet", "Indigestion and Constipation", "Reducing and Gaining", "Infant Feeding", "Instructions for the Treatment of Diabetes", "Feminine Hygiene" and "The Care of the Hair and Skin".