By P. Ronan O'Connell, Norman Williams, Christopher Bulstrode

ISBN-10: 1444121278

ISBN-13: 9781444121278

Now in its twenty sixth version, Bailey & Love's brief perform of Surgery combines its conventional strengths trusted for many years with contemporary updates and new discoveries within the box. The e-book emphasizes potent medical exam and soundly dependent surgical ideas, whereas considering the newest advancements in surgical perform.

The eminent editorial crew contains 3 editors with event won over earlier versions. This new version displays advancements made up of reader suggestions and editor perception. The e-book opens with an advent dedicated to the underlying ideas of surgical perform. It then provides crucial fabric on research and prognosis, perioperative care, and all elements of surgical trauma. the rest of the publication considers all of the surgical specialties in turn:

• optionally available orthopaedics
• dermis and subcutaneous tissue
• Head and neck
• Breast and endocrine system
• Cardiothoracic and vascular
• belly and genitourinary
• Transplantation

Bailey & Love's brief perform of surgical procedure has large attract all these learning surgical procedure, from undergraduate clinical scholars to these in instruction for his or her postgraduate surgical examinations. additionally, its excessive status and attractiveness for unambiguous recommendation make it the 1st element of reference for plenty of training surgeons. This quantity continues to be one of many world's per-eminent clinical textbooks, with lifetime revenues in way over 1000000 copies.

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Additional resources for Bailey & Love's Short Practice of Surgery (26th Edition)

Example text

However, this cardiovascular state is only maintained by reducing perfusion to the skin, muscle and gastrointestinal tract. There is a systemic metabolic acidosis and activation of humoral and cellular elements within the underperfused organs. Although clinically occult, this state will lead to multiple organ failure and death if prolonged due to the ischaemia–reperfusion effect described above under Ischaemia–reperfusion syndrome. Patients with occult hypoperfusion (metabolic acidosis despite normal urine output and cardiorespiratory vital signs) for more than 12 hours have a significantly higher mortality, infection rate and incidence of multiple organ failure (see below under Multiple organ failure).

CHAPTER 2 Shock and blood transfusion LEARNING OBJECTIVES INTRODUCTION Shock is the most common and therefore the most important cause of death of surgical patients. Death may occur rapidly due to a profound state of shock, or be delayed due to the consequences of organ ischaemia and reperfusion injury. It is important therefore that every surgeon understands the pathophysiology, diagnosis and priorities in management of shock and haemorrhage. SHOCK Shock is a systemic state of low tissue perfusion which is inadequate for normal cellular respiration.

Currently, the only clinical indicators of perfusion of the gastrointestinal tract and muscular beds are the global measures of lactic acidosis (lactate and base deficit) and the mixed venous oxygen saturation. Base deficit and lactate Lactic acid is generated by cells undergoing anaerobic respiration. The degree of lactic acidosis, as measured by serum lactate level and/or the base deficit, is sensitive for both diagnosis of shock and monitoring the response to therapy. Patients with a base deficit over 6 mmol/L have a much higher morbidity and mortality than those with no metabolic acidosis.

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Bailey & Love's Short Practice of Surgery (26th Edition) by P. Ronan O'Connell, Norman Williams, Christopher Bulstrode


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