Essential Surgery: Problems, Diagnosis and Management

Elective Orthopaedics

Introduction Anatomy Of The Skeleton Basic musculoskeletal anatomy needs to be understood when managing orthopaedic care. The normal locomotor system relies on a stable skeleton to provide attachment for muscles and a base for positioning the hands and feet in…

Blood Transfusion

Principles of Blood Transfusion The ability to safely transfuse blood and blood products has revolutionised outcomes from major trauma and from complex surgery involving heavy blood loss, such as arterial reconstruction, open-heart surgery and organ transplantation. For replacing blood loss,…

Medical Problems

Introduction General surgical operations are now performed on patients who are older, more frail and with significant and often multiple (medical) comorbidities, so it becomes even more important to appreciate and consider these ‘medical’ conditions. Detailed reports of emergency abdominal…

Preoperative Assessment and Management of Postoperative Problems

Preoperative Assessment Introduction Patients with medical comorbidity and advanced age are increasingly being considered for surgery. Timely and considered preoperative assessment is crucial for ensuring any patient is safe and in the best possible condition before the operation and that…

Screening for Adult Disease

Principles of Screening Introduction Medical screening is a public health activity that involves examining or testing asymptomatic, apparently healthy people to detect disease at an early stage. Measures can then be taken to prevent the disease (if there is a…

Imaging and Interventional Techniques in Radiology and Surgery

Introduction This chapter gives an overview of imaging, endoscopic, interventional and biopsy procedures used to make a diagnosis and treat patients. Interventional radiology describes minimal access procedures using image guidance to treat conditions whilst causing least trauma. It is usually…

Shock and Resuscitation

The Pathophysiology of Shock The term ‘shock’ can be defined as acute circulatory failure of sufficient magnitude to compromise tissue perfusion , which if untreated, proceeds rapidly to irreversible organ damage and death of the patient. Circulatory failure and subsequent…

Immunity, Inflammation and Infection

Immune Responses Introduction The innate immune response constitutes the first line of defence against invading microorganisms. The key mechanism is the body’s recognition of pathogen-derived molecules by Toll-like receptors (TLRs) found on the surface of dendritic cells. This triggers inflammatory…

Managing Physiological Change in the Surgical Patient

Systemic Responses Factors Responsible for Systemic Responses ( Box 2.1 ) Surgical patients are subject to a variety of major stressors that make massive demands on the body’s ability to maintain physiological equilibrium and sustain life. Examples of such stressors…