Some clinical aspects of geriatric surgery.

The relative frequency of surgical problems in the aged is discussed and some statistics based on experience are given. General rules in the management of the aged are suggested and the situation is analysed with stress on biological age and past influences. The increased importance in surgery of fluid loss as well as shock is discussed. A regimen for fluid replacement therapy is suggested. Problems in history-taking and the investigation of the elderly surgical patient are debated, and the value of ice as an anaesthetic agent for geriatric patients is discussed. Points about postoperative care are made. The problem of emergency surgery in the elderly, with emphasis on conservatism, is set out. The importance of avoiding complications, of reassurance and of optimism is stressed.