Bailey Love s Short Practice of Surgery 26E 26th

Edition Norman S Williams - PDF Download (2025)

https://ebookultra.com/download/bailey-love-s-short-practice-of-
surgery-26e-26th-edition-norman-s-williams/

Visit ebookultra.com today to download the complete set of

ebooks or textbooks
We have selected some products that you may be interested in
Click the link to download now or visit ebookultra.com
for more options!.

Bailey Love s Short Practice of Surgery 28th Edition

Norman Williams

https://ebookultra.com/download/bailey-love-s-short-practice-of-
surgery-28th-edition-norman-williams/

MCQs and EMQs in Surgery A Bailey Love Companion Guide 1st

Edition Christopher Bulstrode (Author)

https://ebookultra.com/download/mcqs-and-emqs-in-surgery-a-bailey-
love-companion-guide-1st-edition-christopher-bulstrode-author/

Dinosaurs A Very Short Introduction David Norman

https://ebookultra.com/download/dinosaurs-a-very-short-introduction-
david-norman/

Love s Grateful Striving A Commentary on Kierkegaard s

Works of Love First Edition M. Jamie Ferreira

https://ebookultra.com/download/love-s-grateful-striving-a-commentary-
on-kierkegaard-s-works-of-love-first-edition-m-jamie-ferreira/
Love s Deception Adrianne Byrd

https://ebookultra.com/download/love-s-deception-adrianne-byrd/

Love s Labour s Lost Webster s Thesaurus Edition William

Shakespeare

https://ebookultra.com/download/love-s-labour-s-lost-webster-s-
thesaurus-edition-william-shakespeare/

Love s Labour s Lost Webster s Spanish Thesaurus Edition

William Shakespeare

https://ebookultra.com/download/love-s-labour-s-lost-webster-s-
spanish-thesaurus-edition-william-shakespeare/

Love s Labour s Lost Webster s German Thesaurus Edition

William Shakespeare

https://ebookultra.com/download/love-s-labour-s-lost-webster-s-german-
thesaurus-edition-william-shakespeare/

British Generals in Blair s Wars 1st Edition Jonathan

Bailey

https://ebookultra.com/download/british-generals-in-blair-s-wars-1st-
edition-jonathan-bailey/
Bailey Love s Short Practice of Surgery 26E 26th Edition
Norman S Williams Digital Instant Download
Author(s): Norman S Williams, Christopher JK Bulstrode, P Ronan O'Connell
ISBN(s): 9781444121278, 1444121278
Edition: 26
File Details: PDF, 115.88 MB
Year: 2013
Language: english
 Bailey & Love’s
SHORT
PRACTICE of
SURGERY
26th EDITION

Sebaceous horn
(The owner, the widow Dimanche, sold water-cress in Paris)

A favourite illustration of Hamilton Bailey and McNeill Love,

and well known to readers of earlier editions of Short Practice.

00-00-B&L_26th-Prelims-cpp.indd 1 19/09/2012 10:55

00-00-B&L_26th-Prelims-cpp.indd 2 19/09/2012 10:55
 Bailey & Love’s
SHORT
PRACTICE of
SURGERY
26 th
EDITION

Edited by
Norman S. Williams MS FRCS FMed Sci
Professor of Surgery and Director of Surgical Innovation,
Barts and the London School of Medicine and Dentistry,
Queen Mary, University of London and President,
The Royal College of Surgeons of England, London, UK

Christopher J.K. Bulstrode MCh FRCS(T&O)

Emeritus Professor, University of Oxford, Oxford, UK

P. Ronan O’Connell, MD FRCSI, FRCPS Glas.,

Head, Surgery and Surgical Specialties,
UCD School of Medicine and Medical Sciences
Consultant Surgeon, St Vincent’s University Hospital,
Dublin, Ireland

00-00-B&L_26th-Prelims-cpp.indd 3 19/09/2012 10:55

CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2013 by Taylor & Francis Group, LLC
CRC Press is an imprint of Taylor & Francis Group, an Informa business

No claim to original U.S. Government works

Version Date: 20121207

International Standard Book Number-13: 978-1-4665-8514-0 (eBook - VitalBook)

This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to publish reliable data
and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. The
authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright hold-
ers if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know
so we may rectify in any future reprint.

Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any elec-
tronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information
storage or retrieval system, without written permission from the publishers.

For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright.com/) or con-
tact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that
provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system
of payment has been arranged.

Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation
without intent to infringe.
Visit the Taylor & Francis Web site at
http://www.taylorandfrancis.com
and the CRC Press Web site at
http://www.crcpress.com
 Contents

Contributors viii 12. Patient safety 161

Frank Keane
Preface xiii

Acknowledgements xiv PART TWO: INVESTIGATION AND

DIAGNOSIS
Sayings of the great xvi
13. Diagnostic imaging 171
Matthew Matson, Gina Allen and Niall Power
PART ONE: PRINCIPLES
14. Gastrointestinal endoscopy 196
1. Metabolic response to injury 3 James Lindsay
Kenneth Fearon
15. Tissue diagnosis 213
2. Shock and blood transfusion 13 Roger Feakins
Karim Brohi

3. Wounds, tissue repair and scars 24 PART THREE: PERIOPERATIVE CARE

Michael Earley 16. Preoperative preparation 229
4. Basic surgical skills and Medha Vanarase, Pierre Foex and
Kevin Tremper
anastomoses 33
William E. G. Thomas 17. Anaesthesia and pain relief 238
Vivek Mehta, Richard Langford and
5. Surgical infection 50 Jagannath Haldar
Peter Lamont
18. Care in the operating room 247
6. Surgery in the tropics 68 Kath Jenkins and Hilary Edgcombe
Pradip K Datta, Pawanindra Lal and
Sanjay De Bakshi 19. Perioperative management of the
high-risk surgical patient 255
7. Principles of laparoscopic and
Mridula Rai and Kevin D Johnston
robotic surgery 93
Ara Darzi and Sanjay Purkayastha 20. Nutrition and fluid therapy 261
John MacFie
8. Principles of paediatric surgery 105
Anthony Lander 21. Postoperative care 272
Jay Kini
9. Principles of oncology 125
Robert JC Steele and Alastair J Munro 22. Day case surgery 281
Douglas McWhinnie and Ian Jackson
10. Surgical audit and clinical research 147
Jonothan Earnshaw and Birgit Whitman PART FOUR: TRAUMA
11. Surgical ethics and law 155 23. Introduction to trauma 289
Robert Wheeler Bob Handley and Peter Giannoudis

00-00-B&L_26th-Prelims-cpp.indd 5 19/09/2012 10:55

 vi CONTENTS

24. Early assessment and management PART SIX: SKIN AND SUBCUTANEOUS TISSUE
of trauma 301
42. Skin and subcutaneous tissue 577
Dinesh Nathwani and Joseph Windley
Christopher Chan and Adam Greenbaum
25. Emergency neurosurgery 310
Tony Belli and Harry Bulstrode PART SEVEN: HEAD AND NECK
26. Neck and spine 326 43. Elective neurosurgery 605
Ashley Poynton William Gray and Harry Bulstrode

27. Maxillofacial trauma 341 44. The eye and orbit 622
Charles Perkins Colm O’Brien, Hugo Henderson and
Jonathan Jagger
28. Torso trauma 351
Ken Boffard
45. Cleft lip and palate: developmental
abnormalities of the face, mouth
29. Extremity trauma 364 and jaws 634
Parminder Singh William P Smith
30. Burns 385 46. The nose and sinuses 653
Michael Tyler and Sudip Ghosh Robert W Ruckley and Iain J Nixon
31. Plastic and reconstructive surgery 401 47. The ear 661
Tim Goodacre Grant Bates
32. Disaster surgery 417 48. Pharynx, larynx and neck 674
Mamoon Rashid Rishi Sharma and Martin Birchall

49. Oropharyngeal cancer 706

PART FIVE: ELECTIVE ORTHOPAEDICS William P Smith
33. History taking and clinical 50. Disorders of the salivary glands 723
examination in musculoskeletal William P Smith
disease 437
Parminder J Singh and Hemant G Pandit PART EIGHT: BREAST AND ENDOCRINE
34. Sports medicine and sports injuries 463 51. The thyroid and parathyroid glands 741
Gina Allen Zygmunt H Krukowski

35. The spine 470 52. The adrenal glands and other
Chris Lavy and Gavin Bowden abdominal endocrine disorders 778
Tom WJ Lennard
36. Upper limb – pathology, assessment
and management 485 53. The breast 798
Vinay Takwale and Irfan Khan Richard Sainsbury

37. Hip and knee 505 PART NINE: CARDIOTHORACIC

Hemant G Pandit and Andrew Barnett
54. Cardiac surgery 823
38. Foot and ankle 518 Jonathan R Anderson and Mustafa Zakkar
Bob Sharpe
55. The thorax 850
39. Musculoskeletal tumours 526 Ian Hunt and Carol Tan
Paul Cool
PART TEN: VASCULAR
40. Infection of the bones and joints 541
Martin McNally, Philippa Matthews 56. Arterial disorders 877
and Philip Bejon Robert Sayers
41. Paediatric orthopaedics 550 57. Venous disorders 901
Deborah Eastwood Peter McCollum and Ian Chetter

00-00-B&L_26th-Prelims-cpp.indd 6 19/09/2012 10:55

 CONTENTS vii

58. Lymphatic disorders 923 71. The vermiform appendix 1199

Shervanthi Homer-Vanniasinkam and P Ronan O’Connell
David A Russell
72. The rectum 1215
PART ELEVEN: ABDOMINAL Sue Clark

59. History and examination of the 73. The anus and anal canal 1236
abdomen 941 Peter Lunniss and Karen Nugent
Mohan de Silva and V Sitaram
PART TWELVE: GENITOURINARY
60. Abdominal wall, hernia and umbilicus 948
Stephen J Nixon and Bruce Tulloh 74. Urinary symptoms and investigations 1271
Christopher G Fowler
61. The peritoneum, omentum, mesentery
and retroperitoneal space 970 75. The kidneys and ureters 1282
Charles H Knowles Christopher G Fowler

62. The oesophagus 987 76. The urinary bladder 1309

Derek Alderson Freddie Hamdy

63. Stomach and duodenum 1023 77. The prostate and seminal vesicles 1340
John N Primrose and Timothy J Underwood David E Neal and Greg L Shaw

64. Bariatric surgery 1058 78. Urethra and penis 1359

John Baxter Ian Eardley

65. The liver 1065 79. Testis and scrotum 1377

Rahul S Koti, Sanjeev Kanoria and Ian Eardley
Brian R Davidson
80. Gynaecology 1392
66. The spleen 1087 Stephen Kennedy and Enda McVeigh
O James Garden
PART THIRTEEN: TRANSPLANTATION
67. The gall bladder and bile ducts 1097
Kevin Conlon 81. Transplantation 1407
J Andrew Bradley
68. The pancreas 1118
Satyajit Bhattacharya Appendix 1:
Common instruments used in general
69. The small and large intestines 1143
surgery 1433
Gordon Carlson and Jonathan Epstein
Pradip K Datta
70. Intestinal obstruction 1181
Jim Hill Index 1437

00-00-B&L_26th-Prelims-cpp.indd 7 19/09/2012 10:55

 Contributors

Derek Alderson MD FRCS J Andrew Bradley MB ChB PhD FRCS Ac Med Sci
Barling Chair of Surgery and Head of Department, Queen Professor of Surgery, University of Cambridge, and Consultant
Elizabeth Hospital, Edgbaston, Birmingham, UK Surgeon, Addenbrooke’s Hospital, Cambridge, UK

Gina Allen BM DCH MRCGP MRCP FRCR Karim Brohi FRCS FRCA
Oxford Soft Tissue Injury Clinic (Ostic), St Luke’s Hospital, Professor of Trauma Sciences, Barts and the London School of
Oxford, UK Medicine and Dentistry, Queen Mary University of London,
London, UK
Jonathan R Anderson MD
Department of Cardiothoracic Surgery, Imperial College Harry Bulstrode MA Cantab BMBCh MRCS(Eng)
Healthcare NHS Trust, Hammersmith Hospital, London, UK Academic Clinical Fellow in Neurosurgery, Division of
Neurosciences, Southampton General Hospital, Southampton,
Andrew Barnett FRCS(Orth) UK
Consultant Orthopaedic Surgeon, Robert Jones and Agnes
Hunt Orthopaedic Hospital, Gobowen, Shropshire, UK Gordon Carlson BSc MD FRCS
Consultant Surgeon, Honorary Professor of Surgery, University
Grant Bates BSc BM Bch FRCS (deceased) of Manchester; Honorary Professor of Biomedical Science,
Ear, Nose and Throat Surgeon, John Radcliffe Hospital, Oxford University of Salford, Salford, UK
and Lecturer, University of Oxford, Oxford, UK
Christopher Chan BSC PhD FRCS FRCS(Gen Surg)
Philip Bejon MD Consultant Colorectal Surgeon, Academic Surgical Unit, Barts
Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford, Health NHS Trust, London, UK
UK
Ian Chetter MB ChB FRCSMD FRCS(Gen Surg) PG Cert Medical
Tony Belli MD FRCS(SN) Ultrasound PG Dip Clinical Education
Reader in Trauma, Neurosurgery, University of Birmingham, Professor of Surgery, Hull York Medical School, University of
Birmingham, UK Hull; Honorary Consultant Vascular Surgeon, Hull and East
Yorkshire NHS Trust, Academic Vascular Surgical Unit, Old
Satyajit Bhattacharya MS MPhil FRCS Doctors Residence, Hull Royal Infirmary, Hull, UK
Consultant Hepato-Pancreato-Biliary Surgeon, The Royal
London Hospital, London, UK Sue Clark MD FRCS(Gen Surg)
Consultant Colorectal Surgeon, St Mark’s Hospital, Harrow, UK
Martin Birchall M(Cantab) FRCS FRCS(Oto) FRCS(ORL)
Professor of Laryngology, University College London, Kevin C Conlon MA MCh MBA FRCSI FACS FRCPS(Glas) FTCD
Consultant in Otolaryngology, Head and Neck Surgery, The Professor of Surgery, Trinity College Dublin; Consultant
Royal National Throat, Nose and Ear Hospital, UCLH NHS Surgeon, St. Vincent’s University Hospital and The Adelaide
Trust, London, UK and Meath Hospital, Dublin, Ireland

Ken Boffard BSC(Hons) MB BCh FRCS FRCS(Ed) FRCPS(Glas) FACS Paul Cool MD MedSc(Res) FRCS(Ed) FRCS(Orth)
FCS(SA) Consultant Orthopaedic and Oncological Surgeon, Robert Jones
Professor and Head, Department of Surgery, Johannesburg and Agnes Hunt Orthopaedic Hospital, Gobowen, Shropshire, UK
Hospital, University of the Witwatersrand, Johannesburg,
South Africa Ara Darzi PC KBE HonFrEng FmedSci
Professor the Lord Darzi of Denham, Professor of Surgery,
Gavin Bowden MB BCh FCS(SA)(Orth) Imperial College London, St Mary’s Hospital Campus, London,
Consultant Spinal Surgeon, St Lukes Hospital, Oxford, UK UK

00-00-B&L_26th-Prelims-cpp.indd 8 19/09/2012 10:55

 CONTRIBUTORS ix

Pradip K Datta MBE MS FRCS(Ed) FRCS FRCSI FRCPS(Glas) Sudip Ghosh MB BS MS FRCS(Plast)
Honorary Consultant Surgeon, Caithness General Hospital, Consultant Plastic Surgeon, Stoke Mandeville Hospital,
Wick, Caithness, UK Aylesbury, UK

Brian R Davidson MD FRCS Peter Giannoudis MD FRCS

Consultant Surgeon, Royal Free Hospital and Professor of Professor of Trauma and Orthopaedic Surgery, School of
Surgery, Hampstead Campus, University College London, Medicine, University of Leeds, Leeds, UK
London, UK
Tim Goodacre MD FRCS
Sanjay De Bakshi MB BS MS FRCS FRCS(Ed) Senior Clinical Lecturer and Consultant Plastic Surgeon,
Consultant Surgeon, Unit of Surgical Gastroenterology, Oxford Radcliffe Hospitals, Oxford, UK
Calcutta Medical Research Institute, Kolkata, India
William Gray MB MD FRCSI FRCS(SN)
Ian Eardley MA MChir FRCS (Urol) FEBU Professor of Functional Neurosurgery, Institute of Psychological
Consultant Urologist, Department of Urology, St James Medicine and Clinical Neurosciences, Cardiff University,
University Hospital, Leeds, UK Cardiff, UK

Michael Earley MB MCh FRCSI FRCS(Plast) Adam Greenbaum MB BS MBA PhD FRCS(Plast) FEBOPRAS
Consultant Plastic Surgeon and Associate Clinical Professor, Consultant Plastic Surgeon, The Aesthetic Body Centre,
The Children’s University Hospital, Temple Street and Mater Hamilton, New Zealand
Misericordiae University Hospital, Dublin, Ireland
Jagannath Haldar MB BS MD FRCA
Jonothan Earnshaw DM FRCS Consultant Anaesthetist and Clinical Lead, Oxford University
Consultant Vascular Surgeon, Gloucestershire Royal Hospital, Hospitals NHS Trust, Honorary Clinical Lecturer, Oxford
Gloucester, UK Brooke’s University, Oxford, UK

Deborah Eastwood FRCS Freddie Hamdy MD MA FRCS FRCS(Ed)(Urol) FMedSci

The Catterall Unit, Royal National Orthopaedic Hospital, Director, Division of Surgery and Oncology, Oxford Radcliffe
Stanmore, Middlesex, UK Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK

Hilary Edgcombe BA BM BCh(Oxon) FRCA(Lon) Bob Handley MB ChB FRCS

Consultant Anaesthetist, Oxford University Hospitals, Oxford, John Radcliffe Hospital, Oxford, UK
UK
Jim Hill MB ChB ChM FRCS
Jonathan Epstein MA MD FRCS Consultant General and Colorectal Surgeon, Manchester Royal
Specialist Registrar in General Surgery, Hope Hospital, Salford, Infirmary, Manchester, UK
UK
Shervanthi Homer-Vanniasinkam BSc MD FRCS(Ed) FRCS
Roger Feakins MB BCh BAO BA MD FRCPI FRCPath Consultant Vascular Surgeon, The General Infirmary at
Consultant Histopathologist and NHS Professor of Leeds; Clinical Sub-Dean, University of Leeds Medical
Gastrointestinal Pathology, Department of Histopathology, School Chair, Translational Vascular Medicine, University
Barts Health NHS Trust, London, UK of Bradford; Director, Northwick Park Institute for Medical
Research, London Honorary Professor, Division of Surgical and
Kenneth Fearon MD FRCPS(Glas) FRCS(Ed) FRCS Interventional Sciences, University College London, London,
Professor of Surgical Oncology and Honorary Consultant UK
Colorectal Surgeon, Clinical Surgery, School of Clinical
Science, University of Edinburgh, Royal Infirmary, Edinburgh, Ian Hunt MB BS BSc(Hons) FRCS(C-Th)
UK Consultant Thoracic Surgeon, Department of Cardiothoracic
Surgery, St George’s Hospital, London, UK
Pierre Foex DPhil FRCA FMedSci
Nuffield Division of Anaesthetics, John Radcliffe Hospital, Ian Jackson MB ChB FRCA
Headley Way, Oxford, UK Consultant Anaesthetist, Past President British Association of
Day Surgery, York Teaching Hospital NHS Foundation Trust,
Christopher G Fowler BSc MB BS MA MS FRCP FRCS(Urol) FEBU FHEA York, UK
Professor, Department of Urology, The Royal London Hospital,
London, UK Kath Jenkins BM BS FRCA
Consultant Anaesthetist, North Bristol NHS Trust, Bristol, UK
O James Garden BSc MB ChB FRCPS(Glas) FRCS(Ed) FRCP(Ed) FRCSCan
FRACS(Hon) Kevin D. Johnston MBChB (Hons) BDS BSc MFDSRCS FRCA
Regius Professor of Clinical Surgery, School of Clinical Sciences, Specialist Registrar in Anaesthetics, Nuffield Department of
University of Edinburgh, Royal Infirmary, Edinburgh, UK Anaesthetics, John Radcliffe Hospital, Oxford, UK

00-00-B&L_26th-Prelims-cpp.indd 9 19/09/2012 10:55

 x CONTRIBUTORS

Sanjeev Kanoria FRCS James Lindsay PhD FRCP

HPB and Liver Transplant Unit, University Department of Consultant and Senior Lecturer in Gastroenterology, Digestive
Surgery, Royal Free Hospital, London, UK Diseases Clinical Academic Unit, Barts and the London
School of Medicine and Dentistry, Queen Mary University of
Frank Keane MD FRCSI FRCS FRCS(Ed) FRCPS(Glas) FRCPI
London, London, UK
Associate Professor of Surgery, Trinity College, and Consultant
Colorectal Surgeon, Adelaide and Meath Hospital, Dublin, Peter Lunniss BSc MS FRCS
Ireland Senior Lecturer, Honorary Consultant Coloproctologist, Royal
Stephen Kennedy London Hospital Whitechapel, London, UK
Professor of Reproductive Medicine and Head of Department,
Nuffield Department of Obstetrics and Gynaecology, Peter McCollum BA MB BCh BAO MCh FRCSI FRCS(Ed)

University of Oxford, Oxford University Hospitals NHS Trust, Professor of Vascular Surgery, Hull York Medical School;
The Women’s Centre, Oxford, UK Honorary Consultant Vascular Surgeon, Hull & East Yorkshire
Hospitals NHS Trust, Hull Royal Infirmary, Hull, UK
Irfan Khan MB BS MRCS
Specialty Doctor, Orthopaedics, Gloucestershire Hospitals John MacFie MB ChB R Nutr MD FRCS FRCP
NHS Trust, Gloucestershire, UK Professor of Surgery/Consultant Surgeon, PGMI, University of
Hull/Scarborough Hospital, Scarborough, UK
Jay Kini MB BS DA MD FFARCSI
Consultant Anaesthetist, Nuffield Department of Anaesthetics, Martin McNally MD FRCS(Ed) FRCS(Orth)
John Radcliffe Hospital, Oxford, UK Consultant in Limb Reconstruction Surgery, Bone Infection
Charles H Knowles BChir PhD FRCS
Unit, Nuffield Orthopaedic Centre; Honorary Senior Lecturer
Clinical Professor of Surgical Research and Hononary in Orthopaedics
Consultant Colorectal Surgeon, Centre for Digestive Diseases,
Blizard Institute, Barts and the London School of Medicine and Enda McVeigh
Dentistry, Queen Mary University, London, UK Senior Fellow in Reproductive Medicine, Nuffield Department
of Obstetrics and Gynaecology, University of Oxford, Oxford
Rahul S Koti MD FRCS University Hospitals NHS Trust, The Women’s Centre,
Honorary Lecturer in Surgery, Department of Surgery, Oxford, UK
University College London; Department of Surgery, Royal Free
Hospital, London, UK Douglas McWhinnie MD(Hons) FRCS
Consultant General and Vascular Surgeon, Past President
Zygmunt H Krukowski PhD FRCS FRCP British Association of Day Surgery, Milton Keynes NHS
Surgeon to the Queen in Scotland; Consultant Surgeon, Foundation Trust, Milton Keynes, UK
Aberdeen Royal Infirmary; Professor of Clinical Surgery,
University of Aberdeen, Aberdeen, UK Matthew Matson MRCP FRCR
Consultant Radiologist, Royal London Hospital, London, UK
Pawanindra Lal MS DNB FIMSA FRCS(Ed) FRCPS(Glas) FRCS FACS
Professor of Surgery, Maulona Azad Medical College &
Philippa Matthews MSc MRCP FRCPath DPhil
Associated Lok Nayak Hospital, New Delhi, India
Academic Clinical Lecturer in Infectious Diseases and
Peter Lamont MB ChB MD FRCS FEBVS Microbiology, Oxford University Hospitals NHS Trust, Oxford,
Consultant Vascular Surgeon, Department of Vascular Surgery, UK
Bristol Royal Infirmary, Bristol, UK
Vivek Mehta MD FRCA FFPMRCA
Anthony Lander Phd FRCS(Paed) DCH Consultant in Pain Medicine, Deputy Director, Pain and
Consultant Paediatric Surgeon, Birmingham Children’s Anaesthesia Research Centre, St Bartholomew’s and Royal
Hospital, Birmingham, UK London Hospitals, Barts Health NHS Trust, London, UK
Richard Langford MD FRCA FFPMRCA
Alastair J Munro BSc FRCP(E) FRCR
Professor of Anaesthesia and Pain Medicine and Directory, Professor of Radiation Oncology, University of Dundee,
Pain and Anaesthesia Research Centre, St Bartholomew’s and Tayside Cancer Centre, Ninewells Hospital and Medical
Royal London Hospitals, Barts Health NHS Trust, London UK School, Dundee, UK
Chris Lavy OBE MD MCh FRCS
Honorary Professor and Consultant Orthopaedic Surgeon, Dinesh Nathwani MB ChB MSc FRCSI(Tr & Orth)

Nuffield Department of Orthopaedics, Rheumatology and Consultant and Honorary Senior Clinical Lecturer, Department
Musculoskeletal Sciences (NDORMS), University of Nuffield, of Trauma and Orthopaedic Surgery, Imperial College
Nuffield Orthopaedic Centre, Oxford, UK Healthcare, Academic Health Sciences Centre, London, UK

Tom WJ Lennard MD FRCS David E Neal FMedSci MS FRCS

Professor of Surgery, Newcastle University, Newcastle upon University Department of Oncology, Addenbrooke’s Hospital,
Tyne, UK Cambridge, UK

00-00-B&L_26th-Prelims-cpp.indd 10 19/09/2012 10:55

 CONTRIBUTORS xi

Stephen J Nixon FRCS(Ed) FRCP(Edin) David A Russell MB ChB MD FRCS(Gen Surg)

Consultant Surgeon, Department of Surgery, Royal Infirmary of Consultant Vascular Surgeon, Leeds Vascular Institute, Leeds
Edinburgh, Edinburgh, UK General Infirmary, Leeds, UK

Iain J Nixon MB ChB FRCS(Ed)(ORL-HNS) Richard Sainsbury MD FRCS

Clinical Fellow, Head and Neck Service, Memorial Sloan Consultant Breast Surgeon, Southampton University Hospitals
Kettering Cancer Center, New York, NY, USA NHS Foundation Trust, Southampton, UK

Karen Nugent MA MS FRCS Anand Sardesai MB BS MD FRCA

Professorial Surgical Unit, Southampton General Hospital, Consultant Anaesthetist, Addenbrook’s Hospital, Cambridge, UK
Southampton, UK
Robert Sayers
Colm O’Brien MD FRCS FRCOphth Professor of Vascular Surgery, Leicester Royal Infirmary,
Professor of Ophthalmology and Consultant Ophthalmic Leicester, UK
Surgeon, University College Dublin and Mater Misericordiae
University Hospital, Dublin, Ireland Rishi Sharma MRCS DOHNS
Specialist Registrar, Ear Nose and Throat Surgery, Guy’s and St
P Ronan O’Connell MD FRCSI FRCPS(Glas) Thomas’ Hospital, London, UK
Professor of Surgery, University College Dublin; Consultant
Surgeon, St Vincent’s University Hospital, Dublin, Ireland Bob Sharp BMBCh MA FRCS FRCS(Tr & Orth)
Consultant Orthopaedic Surgeon, Oxford University Hospitals,
Hemant G Pandit FRCS(Orth) DPhil (Oxford) The Nuffield Orthopaedic Centre, Oxford, UK
Honorary Senior Clinical Lecturer in Orthopaedics, Nuffield
Orthopaedic Centre and Nuffield Department of Orthopaedics, Greg L Shaw MD FRCS(Urol)
Rheumatology and Musculoskeletal Sciences (NDORMS), Clinical Lecturer in Urology, Cambridge University,
Oxford, UK Cambridge, UK

Charles Perkins FDSRCS FFDRCSI FRCS Mohan de Silva MS FRCS(Ed) FCSSL

Consultant Oral and Maxillofacial Surgeon, Department of Professor of Surgery and Dean, Faculty of Medical Sciences,
Oral and Maxillofacial Surgery, Gloucestershire Royal Hospital, University of Sri Jayawardenepura Gangodawila, Nugegoda,
Gloucester, UK Colombo, Sri Lanka

Niall Power Parminder J Singh MB BS MRCS FRCS(Tr & Orth) MS

Royal London Hospital, London, UK Consultant Orthopaedic Surgeon, Maroondah Hospital and
Honorary Senior Lecturer, Monash and Deakin University,
Ashley Poynton MD FRCSI FRCS(TrandOrth) Melbourne, Australia
Consultant Spinal Surgeon, National Spinal Injuries Unit,
Mater Misericordiae University Hospital, Dublin, Ireland V Sitaram MS FRCPS(Glas)
Professor of Surgery, Department of Hepatic, Pancreatic &
John N Primrose MB ChB(Hons) FRCS MD Biliary (HPB) Surgery, Christian Medical College, Vellore, India
Professor, University Surgical Unit, Southampton General
Hospital, Southampton, UK William P Smith FDSRCS FRCS(Ed) FRCS
Consultant Maxillofacial Surgeon, Northampton General
Sanjay Purkayastha BSc MB BS MD FRCS(Gen Surg) Hospital NHS Trust, Northampton, UK
Locum Consultant, General & Bariatric Surgery, St Mary’s
Hospital, Paddington, Imperial College Healthcare NHS Trust, Robert JC Steele MB ChB MD FRCS(Ed)
London, UK Professor, Head of Academic Surgery, Ninewells Hospital and
Medical School, Dundee, UK
Mridula Rai MB BS MD FRCA
Consultant Anaesthetist, Nuffield Department of Anaesthetics, Vinay Takwale MB MS FRCS(Tr & Orth)
Modular Building, John Radcliffe Hospital, Oxford, UK Consultant Orthopaedic Surgeon, Gloucestershire Hospital,
Gloucester, UK
Mamoon Rashid FRCS FCPS(Pak)
Professor of Plastic and Reconstructive Surgery, Shifa College Carol Tan MB ChB FRCS(C-Th)
of Medicine; Consultant Plastic Surgeon and Programme Consultant Thoracic Surgeon, St George’s Hospital, London,
Director, Shifa International Hospital, Islamabad, Pakistan UK

Robert W Ruckley MB ChB FRCS FRCS(Ed) William EG Thomas MS FRCS FSACS(Hon)

Consultant Ear Nose and Throat and Head and Neck Surgeon Consultant Surgeon and Honorary Senior Lecturer in Surgery,
(retired), Darlington Memorial Hospital, Darlington, UK Sheffield, UK

00-00-B&L_26th-Prelims-cpp.indd 11 19/09/2012 10:55

 xii CONTRIBUTORS

Kevin Tremper PhD MD Robert Wheeler MS FRCS FRCPCH LLB(Hons) LLM

Robert B Sweet Professor and Chair, Department of Consultant Paediatric Surgeon, Child Health, University
Anesthesiology, University of Michigan, Ann Arbor, MI, USA Hospitals of Southampton, Southampton, UK

Bruce Tulloh MB MS(Melb) FRACS FRCS(Ed) Birgit Whitman PhD

Department of Surgery, Royal Infirmary of Edinburgh, Head of Research Governance, University of Bristol, Bristol,
Edinburgh, UK UK

Michael Tyler FRCS(Plast) MB CHM Joseph Windley MB BS BSc(Hons) MRCS

Stoke Mandeville Hospital, Aylesbury, UK Specialist Registrar, Department of Trauma and Orthopaedic
Surgery, Imperial College Healthcare, Academic Health
Timothy J Underwood BSc(Hons) MB BS PhD FRCS Sciences Centre, London, UK
MRC Clinician Scientist and Honorary Consultant Surgeon,
University Surgical Unit, Southampton General Hospital, Mustafa Zakkar PhD
Southampton, UK Department of Cardiothoracic Surgery, Imperial College
Healthcare NHS Trust, Hammersmith Hospital, London, UK
Medha Vanarase MB BS MD FRCA(Cert Ed)
Consultant Anaesthetist, Oxford Radcliffe Hospitals NHS
Trust, Oxford, UK

00-00-B&L_26th-Prelims-cpp.indd 12 19/09/2012 10:55

 Preface

In this age of rapid electronic access to scientific papers and eru- surprising in a text of this length. We apologise in advance for
dite surgical opinion one has to ask whether there is still a place any errors and thank our eagle-eyed readers whom we know
for a comprehensive surgical textbook that takes several years to from experience will let us know of any that they find. This is a
compile and risks losing its immediacy. The success of the 25th Bailey & Love tradition and we value all contributions that can
edition of Bailey & Love together with the numerous positive improve accuracy.
communications we have received since its publication suggest Several editions ago we introduced the concept of learning
that the answer is very much in the affirmative. However, it is objectives and summary boxes in order to help examination
essential that in producing further editions cognisance is taken candidates in their revision. The feedback regarding these
of what the “customer” wants. Consequently before preparing innovations was extremely positive and we have attempted to
the 26th edition of this venerable text we conducted consider- ensure that these are comprehensive, standardised and liberally
able market research as to what had succeeded in the previous dispersed through the text.
edition, what had been omitted and how we could improve The authors of the chapters have been carefully chosen
content and presentation. Readers from a range of backgrounds not just for their undoubted experience and expertise in their
from undergraduates to hard bitten and, dare we say, cynical specialty but also their ability to write both accurately and suc-
senior consultants were asked for their opinion. Their musings cinctly. Writing is a skill honed by practice; it is a labour of love
and frank criticisms were all taken very seriously and many of and takes time and patience to perfect. The best authors are
their suggestions were adopted for this edition. A few chapters like gifted musicians who, after numerous rehearsals, are able to
were removed or consolidated into others; new chapters have deliver a perfect recital. It is our belief that our contributors have
been added focusing on the important topics of patient safety, done just this and we the editors have attempted wherever pos-
day case surgery and bariatric surgery. sible to ensure there is a rhythm and harmony flowing through
All existing chapters have been radically revised and have the pages. However, at the end of the day we appreciate it will be
been thoroughly brought up to date. We have attempted to up to the audience to decide how successful we and our authors
ensure more conformity with regard to illustrations; however, we have been in this endeavour.
have kept faith with Hamilton Bailey and McNeil Love’s origi- It has been a pleasure and privilege to edit this historic text-
nal concept of ensuring clinical photographs are liberally used book beloved of so many students and trainees through the dec-
to not only enhance the text but more importantly illuminate ades. However, we are conscious that previous reputation counts
a clinical point. Many new photographs have been introduced, for very little unless the present product meets expectations and
some of which have been provided by our readers, which is very is relevant to the present era. This thought has always been
much a Bailey & Love tradition. in our minds when preparing the content of the 26th edition.
Although we have been ruthless in removing old material we We very much hope it fits the bill and fulfils your requirements
make no excuse for retaining the odd original pen drawing taken whether you, the reader, are studying for an exam, checking
from the first few editions. This is not just for nostalgia’s sake but on an area of practice that you may be unfamiliar with or just
because they illustrate a pertinent point not easily captured by refreshing your memory about some forgotten fact or biographi-
a modern photograph. Another tradition beloved of readers has cal detail.
of course been the autobiographical notes. These have all been Norman S. Williams
painstakingly researched and added to by Pradip Datta. Christopher J.K. Bulstrode
We recognise that despite very careful attention to detail by P. Ronan O’Connell
our authors there may be an occasional error in the text that 2012
we and our proof readers have failed to spot. It would not be

00-00-B&L_26th-Prelims-cpp.indd 13 19/09/2012 10:55

 Acknowledgements

Sometimes a new edition of Bailey & Love feels like a swan Chapter 18, Care in the operating room, contains some mate-
swimming swiftly but serenely across a lake. From afar it may rial from ‘Care in the operating room’ by Sunny Deo and Vipul
look effortless (and beautiful we hope), but to those who are Mandalia. The material has been revised and updated by the
closer to the action you can glimpse the webbed feet paddling current authors.
away furiously beneath the surface driving that swan forward.
The three editors are one part of a huge orchestra too large to Chapter 19, Perioperative management of the high-risk
mention all by name. However, it is a pleasure to acknowledge surgical patient, contains some material from ‘Perioperative
some of the most notable amongst the players. management of the high-risk surgical patient’ by Rupert M. Pearse
Gavin Jamieson initiated the new edition as commission- and Richard M. Langford. The material has been revised and
ing editor under the supervision of Jo Koster, who then took updated by the current authors.
over following Gavin’s departure. Sarah Penny and Stephen
Clausard took on the awesome responsibility of pulling all things Chapter 20, Nutrition and fluid therapy, the author would like
‘manuscript-related’ together. Susie Bond, Alyson Thomas and to thank Marcel Gatt MD FRCS, who provided some illustrations
Theresa Mackie have done a great job with the copy editing and helped with proofreading the text.
and proof reading, while the index has been compiled ably by
Christopher Boot. Mr Pradip Datta FRCS completely revamped Chapter 21, Postoperative care, contains some material
the historical footnotes, going back all the way to the first edi- from ‘Postoperative care’ by Alistair Pace and Nicholas C.M.
tion to check that we had left no ‘jewels’ out of the crown. Mr Armitage. The material has been revised and updated by the
Hemant Pandit FRCS, Dr Medha Vanarese FRCA and Mr current author.
Parminder Singh FRCS helped enormously with the commis-
sioning and editing of the orthopaedic, anaesthetic and trauma Chapter 25, Head injury, contains some material from ‘Head
chapters respectively. injury’ by Richard Stacey and John Leach. The material has
been revised and updated by the current authors.
Chapter 4, Basic surgical skills and anastomoses, contains
some material from ‘Basic surgical skills and anastomoses’ by David Chapter 34, Sports medicine and sports injuries, contains
J. Leaper. The material has been revised and updated by the some material from ‘Sports medicine and sports injuries’ by D.L.
current author. Back and Jay Smith. The material has been revised and updated
by the current author.
Chapter 5, Surgical infection, contains some material from
‘Surgical infection’ by David J. Leaper. The material has been Chapter 36, Upper limb – pathology, assessment and man-
revised and updated by the current author. agement, contains some material from ‘Upper limb – pathology,
assessment and management’ by Srinath Kamineni. The material
has been revised and updated by the current authors.
Chapter 8, Principles of paediatric surgery, contains some
material from ‘Principles of paediatric surgery’ by Mark Stringer. Chapter 37, Hip and knee, contains some material from ‘Hip
The material has been revised and updated by the current and knee’ by Vikas Khanduja and Richard N. Villar. The mate-
author. rial has been revised and updated by the current authors.

Chapter 11, Surgical ethics and law, contains some mate- Chapter 38, Foot and ankle, contains some material from
rial from ‘Surgical ethics’ by Len Doyal. The material has been ‘Foot and ankle’ by Mark Davies, Matthew C. Solan and Vikas
revised and updated by the current author. Khanduja. The material has been revised and updated by the
current author.
Chapter 16, Preoperative preparation, contains some mate-
rial from ‘Preoperative preparation’ by Lisa Leonard and Sarah J. Chapter 41, Paediatric orthopaedics, contains some material
Barton. The material has been revised and updated by the cur- from ‘Paediatric orthopaedics’ by the current author and Joanna
rent authors. Hicks, which has been revised and updated for this edition.

00-00-B&L_26th-Prelims-cpp.indd 14 19/09/2012 10:55

 ACKNOWLEDGEMENTS xv

Chapter 43, Elective neurosurgery, contains some material from Chapter 59, History and examination of the abdomen, con-
‘Elective Neurosurgery’ by John Leach and Richard Kerr. The tains some material from ‘History and examination of the abdomen’
material has been revised and updated by the current authors. by Simon Paterson-Brown. The material has been revised and
updated by the current authors.
Chapter 44, The eye and orbit, contains some material from
‘The eye and orbit’ by Jonathan D. Jagger and Hugo W.A. Chapter 60, Abdominal wall, hernia and umbilicus, contains
Henderson. The material has been revised and updated by the some material from ‘Hernias, umbilicus and abdominal wall’ by
current author. Andrew N. Kingsnorth, Giorgi Giorgobiani and David H. Bennett.
The material has been revised and updated by the current authors.
Chapter 48, The pharynx, larynx and neck, contains some
material from ‘The pharynx, larynx and neck’ by Jonathan D. Chapter 61, The peritoneum, omentum, mesentery and retro-
Jagger and Hugo W.A. Henderson. The material has been peritoneal space, contains some material from ‘The peritoneum,
revised and updated by the current author. omentum, mesentery and retroperitoneal space’ by Jerry Thompson.
The material has been revised and updated by the current author.
Chapter 52, The adrenal glands and other abdominal endo-
crine disorders, contains some material from ‘Adrenal glands and Chapter 65, The liver, contains some material from ‘The liver’
other endocrine disorders’ by Matthias Rothmund. The material by Brian R. Davidson. The material has been revised and updat-
has been revised and updated by the current author. ed by the current authors.

Chapter 54, Cardiac surgery, contains some material from Chapter 69, The small and large intestines, contains some
‘Cardiac surgery’ by Jonathan Anderson and Ian Hunt. The material from ‘The small and large intestines’ by Neil J. McC
material has been revised and updated by the current authors. Mortensen and Shazad Ashraf. The material has been revised
and updated by the current authors.
Chapter 55, The thorax, contains some material from ‘The
thorax’ by Tom Treasure. The material has been revised and Chapter 70, Intestinal obstruction, contains some material
updated by the current authors. from ‘Intestinal obstruction’ by Marc Christopher Winslet. The
material has been revised and updated by the current author.
Chapter 56, Arterial disorders, contains some material from
‘Arterial disorders’ by John A. Murie. The material has been Chapter 76, The urinary bladder, contains some material from
revised and updated by the current author. ‘The urinary bladder’ by David E. Neal. The material has been
revised and updated by the current author.
Chapter 57, Venous disorders, contains some material from
‘Venous disorders’ by Kevin Burnand. The material has been Chapter 78, Urethra and penis, contains some material from
revised and updated by the current authors. ‘Urethra and penis’ by Christopher G. Fowler. The material has
been revised and updated by the current author.
Chapter 58, Lymphatic disorders, contains some material from
‘Lymphatic disorders’ by Shervanthi Homer-Vanniasinkam and Chapter 79, Testis and scrotum, contains some material from
Andrew Bradbury. The material has been revised and updated ‘Testis and scrotum’ by Christopher G. Fowler. The material has
by the current authors. been revised and updated by the current author.

00-00-B&L_26th-Prelims-cpp.indd 15 19/09/2012 10:55

 Sayings of the great

Both Hamilton Bailey and McNeill Love, when medical stu- Investigating Nature you will do well to bear ever in
dents, served as clerks to Sir Robert Hutchinson, 1871–1960, mind that in every question there is the truth, whatever
who was Consulting Physician to the London Hospital and our notions may be. This seems perhaps a very simple
President of the Royal College of Physicians. They never tired consideration; yet it is strange how often it seems to be
of quoting his ‘medical litany’, which is appropriate for all disregarded. If we had nothing but pecuniary rewards and
clinicians and, perhaps especially, for those who are surgically worldly honours to look to, our profession would not be
minded. one to be desired. But in its practice you will find it to
be attended with peculiar privileges; second to none in
From inability to leave well alone;
intense interest and pure pleasures. It is our proud office
From too much zeal for what is new and contempt for
to tend the fleshy tabernacle of the immortal spirit, and
what is old;
our path, if rightly followed, will be guided by unfettered
From putting knowledge before wisdom, science before
truth and love unfeigned. In the pursuit of this noble and
art, cleverness before common sense;
holy calling I wish you all God-speed.
From treating patients as cases; and
Promoter’s address, Graduation in Medicine,
From making the cure of a disease more grievous than its
University of Edinburgh, August, 1876, by Lord Lister,
endurance,
the Founder of Modern Surgery
Good Lord, deliver us.
Surgery has undergone many great transformations during
To which may be added:
the past fifty years, and many are to be thanked for their
The patient is the centre of the medical universe around contributions – yet when we think of how many remain
which all our works revolve and towards which all our to be made, it should rather stimulate our inventiveness
efforts trend. than fuel our vanity.
J.B. Murphy, 1857–1916, Professor of Surgery, Sir Percival Pott, 1714–88, Surgeon,
Northwestern University, Chicago, IL, USA St Bartholomew’s Hospital, London, UK
To study the phenomenon of disease without books is If you cannot make a diagnosis at least make a decision!
to sail an uncharted sea, while to study books without Sir Harry Platt, 1897–1986,
patients is not to go to sea at all. Professor of Orthopaedics, Manchester,
Sir William Osler, 1849–1919, and President of the Royal College of Surgeons England,
Professor of Medicine, Oxford, UK London, UK
A knowledge of healthy and diseased actions is not less If the surgeon cuts a vessel and knows the name of that
necessary to be understood than the principles of other vessel, the situation is serious; if the anaesthetist knows
sciences. By and acquaintance with principles we learn the name of that vessel, the situation is irretrievable.
the cause of disease. Without this knowledge a man Maldwyn Morgan 1938–
cannot be a surgeon. … The last part of surgery, namely Anaesthetist, Hammersmith Hospital, London, UK
operations, is a reflection on the healing art; it is a tacit
acknowledgement of the insufficiency of surgery. It is like
an armed savage who attempts to get that by force which
a civilised man would by stratagem.
Hunter, 1728–1793, Surgeon, St George’s Hospital,
London, UK

00-00-B&L_26th-Prelims-cpp.indd 16 19/09/2012 10:55

 PART

1 Principles

1 Metabolic response to injury 3

2 Shock and blood transfusion 13

3 Wounds, tissue repair and scars 24

4 Basic surgical skills and anastomeses 33

5 Surgical infection 50

6 Surgery in the tropics 68

7 Principles of laparoscopic and robotic

surgery 93

8 Principles of paediatric surgery 105

9 Principles of oncology 125

10 Surgical audit and clinical research 147

11 Surgical ethics and law 155

12 Patient safety 161

01-00-B&L_26th-Pt1-pp.indd 1 30/07/2012 07:29

01-00-B&L_26th-Pt1-pp.indd 2 30/07/2012 07:29
 Metabolic response
CHAPTER

1 to injury

LEARNING OBJECTIVES

To understand: • Changes in body composition that accompany

• Classical concepts of homeostasis surgical injury
• Mediators of the metabolic response to injury • Avoidable factors that compound the metabolic
• Physiological and biochemical changes that response to injury
occur during injury and recovery • Concepts behind optimal perioperative care

BASIC CONCEPTS IN HOMEOSTASIS of the ‘open loop’ system, whereby only with medical/surgical
resolution of the primary abnormality is a return to classical
In the eighteenth and nineteenth centuries, a series of eminent homeostasis possible.
scientists laid the foundations of our understanding of homeo- As a consequence of modern understanding of the meta-
stasis and the response to injury. The classical concepts of homeo- bolic response to injury, elective surgical practice seeks to
stasis and the response to injury are: reduce the need for a homeostatic response by minimising the
primary insult (minimal access surgery and ‘stress-free’ peri-
• ‘The stability of the “milieu intérieur” is the primary condition
for freedom and independence of existence’ (Claude Bernard); operative care). In emergency surgery, where the presence of
i.e. body systems act to maintain internal constancy. tissue trauma/sepsis/hypovolaemia often compounds the primary
problem, there is a requirement to augment artificially homeo-
• ‘Homeostasis: the co-ordinated physiological process which
maintains most of the steady states of the organism’ (Walter static responses (resuscitation) and to close the ‘open’ loop by
Cannon); i.e. complex homeostatic responses involving the intervening to resolve the primary insult (e.g. surgical treatment
brain, nerves, heart, lungs, kidneys and spleen work to of major abdominal sepsis) and provide organ support (criti-
maintain body constancy. cal care) while the patient comes back to a situation in which
homeostasis can achieve a return to normality (Summary box
• ‘There is a circumstance attending accidental injury which
does not belong to the disease, namely that the injury done, 1.1).
has in all cases a tendency to produce both the deposition
and means of cure’ (John Hunter); i.e. responses to injury
are, in general, beneficial to the host and allow healing/ Summary box 1.1
survival.
In essence, the concept evolved that the constancy of the Basic concepts

PART 1 | PRINCIPLES
‘milieu intérieur’ allowed for the independence of organisms, ■ Homeostasis is the foundation of normal physiology
that complex homeostatic responses sought to maintain this ■ ‘Stress-free’ perioperative care helps to preserve homeostasis
constancy, and that within this range of responses were the ele- following elective surgery
ments of healing and repair. These ideas pertained to normal ■ Resuscitation, surgical intervention and critical care can
physiology and mild/moderate injury. In the modern era, such return the severely injured patient to a situation in which
concepts do not account for disease evolution following major homeostasis becomes possible once again
injury/sepsis or the injured patient who would have died but
for artificial organ support. Such patients exemplify less of the
classical homeostatic control system (signal detector–proces- This chapter aims to review the mediators of the stress
sor–effector regulated by a negative feedback loop) and more response, the physiological and biochemical pathway changes
associated with surgical injury and the changes in body com-
position that occur following surgical injury. Emphasis is laid
John Hunter, 1728–1793, surgeon, St George’s Hospital, London, UK. He is regarded on why knowledge of these events is important to understand
as ‘The Father of Scientific Surgery’. To further his knowledge of venereal disease he the rationale for modern ‘stress-free’ perioperative and critical
inoculated himself with syphilis in 1767. care.

Claude Bernard, 1813–1878, Professor of Physiology, The College de France, Paris, France.
Walter Bradford Cannon, 1871–1945, Professor of Physiology, Harvard University Medical School, Boston, MA, USA.

01-01-B&L_26th-Pt1_Ch1-pp.indd 3 10/09/2012 10:21

Other documents randomly have
different content
1.C. The Project Gutenberg Literary Archive Foundation (“the
Foundation” or PGLAF), owns a compilation copyright in the
collection of Project Gutenberg™ electronic works. Nearly all the
individual works in the collection are in the public domain in the
United States. If an individual work is unprotected by copyright law
in the United States and you are located in the United States, we do
not claim a right to prevent you from copying, distributing,
performing, displaying or creating derivative works based on the
work as long as all references to Project Gutenberg are removed. Of
course, we hope that you will support the Project Gutenberg™
mission of promoting free access to electronic works by freely
sharing Project Gutenberg™ works in compliance with the terms of
this agreement for keeping the Project Gutenberg™ name associated
with the work. You can easily comply with the terms of this
agreement by keeping this work in the same format with its attached
full Project Gutenberg™ License when you share it without charge
with others.

1.D. The copyright laws of the place where you are located also
govern what you can do with this work. Copyright laws in most
countries are in a constant state of change. If you are outside the
United States, check the laws of your country in addition to the
terms of this agreement before downloading, copying, displaying,
performing, distributing or creating derivative works based on this
work or any other Project Gutenberg™ work. The Foundation makes
no representations concerning the copyright status of any work in
any country other than the United States.

1.E. Unless you have removed all references to Project Gutenberg:

1.E.1. The following sentence, with active links to, or other

immediate access to, the full Project Gutenberg™ License must
appear prominently whenever any copy of a Project Gutenberg™
work (any work on which the phrase “Project Gutenberg” appears,
or with which the phrase “Project Gutenberg” is associated) is
accessed, displayed, performed, viewed, copied or distributed:
 This eBook is for the use of anyone anywhere in the United
States and most other parts of the world at no cost and with
almost no restrictions whatsoever. You may copy it, give it away
or re-use it under the terms of the Project Gutenberg License
included with this eBook or online at www.gutenberg.org. If you
are not located in the United States, you will have to check the
laws of the country where you are located before using this
eBook.

1.E.2. If an individual Project Gutenberg™ electronic work is derived

from texts not protected by U.S. copyright law (does not contain a
notice indicating that it is posted with permission of the copyright
holder), the work can be copied and distributed to anyone in the
United States without paying any fees or charges. If you are
redistributing or providing access to a work with the phrase “Project
Gutenberg” associated with or appearing on the work, you must
comply either with the requirements of paragraphs 1.E.1 through
1.E.7 or obtain permission for the use of the work and the Project
Gutenberg™ trademark as set forth in paragraphs 1.E.8 or 1.E.9.

1.E.3. If an individual Project Gutenberg™ electronic work is posted

with the permission of the copyright holder, your use and distribution
must comply with both paragraphs 1.E.1 through 1.E.7 and any
additional terms imposed by the copyright holder. Additional terms
will be linked to the Project Gutenberg™ License for all works posted
with the permission of the copyright holder found at the beginning
of this work.

1.E.4. Do not unlink or detach or remove the full Project

Gutenberg™ License terms from this work, or any files containing a
part of this work or any other work associated with Project
Gutenberg™.

1.E.5. Do not copy, display, perform, distribute or redistribute this

electronic work, or any part of this electronic work, without
prominently displaying the sentence set forth in paragraph 1.E.1
with active links or immediate access to the full terms of the Project
Gutenberg™ License.

1.E.6. You may convert to and distribute this work in any binary,
compressed, marked up, nonproprietary or proprietary form,
including any word processing or hypertext form. However, if you
provide access to or distribute copies of a Project Gutenberg™ work
in a format other than “Plain Vanilla ASCII” or other format used in
the official version posted on the official Project Gutenberg™ website
(www.gutenberg.org), you must, at no additional cost, fee or
expense to the user, provide a copy, a means of exporting a copy, or
a means of obtaining a copy upon request, of the work in its original
“Plain Vanilla ASCII” or other form. Any alternate format must
include the full Project Gutenberg™ License as specified in
paragraph 1.E.1.

1.E.7. Do not charge a fee for access to, viewing, displaying,

performing, copying or distributing any Project Gutenberg™ works
unless you comply with paragraph 1.E.8 or 1.E.9.

1.E.8. You may charge a reasonable fee for copies of or providing

access to or distributing Project Gutenberg™ electronic works
provided that:

• You pay a royalty fee of 20% of the gross profits you derive
from the use of Project Gutenberg™ works calculated using the
method you already use to calculate your applicable taxes. The
fee is owed to the owner of the Project Gutenberg™ trademark,
but he has agreed to donate royalties under this paragraph to
the Project Gutenberg Literary Archive Foundation. Royalty
payments must be paid within 60 days following each date on
which you prepare (or are legally required to prepare) your
periodic tax returns. Royalty payments should be clearly marked
as such and sent to the Project Gutenberg Literary Archive
Foundation at the address specified in Section 4, “Information
 about donations to the Project Gutenberg Literary Archive
Foundation.”

• You provide a full refund of any money paid by a user who

notifies you in writing (or by e-mail) within 30 days of receipt
that s/he does not agree to the terms of the full Project
Gutenberg™ License. You must require such a user to return or
destroy all copies of the works possessed in a physical medium
and discontinue all use of and all access to other copies of
Project Gutenberg™ works.

• You provide, in accordance with paragraph 1.F.3, a full refund of

any money paid for a work or a replacement copy, if a defect in
the electronic work is discovered and reported to you within 90
days of receipt of the work.

• You comply with all other terms of this agreement for free
distribution of Project Gutenberg™ works.

1.E.9. If you wish to charge a fee or distribute a Project Gutenberg™

electronic work or group of works on different terms than are set
forth in this agreement, you must obtain permission in writing from
the Project Gutenberg Literary Archive Foundation, the manager of
the Project Gutenberg™ trademark. Contact the Foundation as set
forth in Section 3 below.

1.F.

1.F.1. Project Gutenberg volunteers and employees expend

considerable effort to identify, do copyright research on, transcribe
and proofread works not protected by U.S. copyright law in creating
the Project Gutenberg™ collection. Despite these efforts, Project
Gutenberg™ electronic works, and the medium on which they may
be stored, may contain “Defects,” such as, but not limited to,
incomplete, inaccurate or corrupt data, transcription errors, a
copyright or other intellectual property infringement, a defective or
damaged disk or other medium, a computer virus, or computer
codes that damage or cannot be read by your equipment.

1.F.2. LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except for

the “Right of Replacement or Refund” described in paragraph 1.F.3,
the Project Gutenberg Literary Archive Foundation, the owner of the
Project Gutenberg™ trademark, and any other party distributing a
Project Gutenberg™ electronic work under this agreement, disclaim
all liability to you for damages, costs and expenses, including legal
fees. YOU AGREE THAT YOU HAVE NO REMEDIES FOR
NEGLIGENCE, STRICT LIABILITY, BREACH OF WARRANTY OR
BREACH OF CONTRACT EXCEPT THOSE PROVIDED IN PARAGRAPH
1.F.3. YOU AGREE THAT THE FOUNDATION, THE TRADEMARK
OWNER, AND ANY DISTRIBUTOR UNDER THIS AGREEMENT WILL
NOT BE LIABLE TO YOU FOR ACTUAL, DIRECT, INDIRECT,
CONSEQUENTIAL, PUNITIVE OR INCIDENTAL DAMAGES EVEN IF
YOU GIVE NOTICE OF THE POSSIBILITY OF SUCH DAMAGE.

1.F.3. LIMITED RIGHT OF REPLACEMENT OR REFUND - If you

discover a defect in this electronic work within 90 days of receiving
it, you can receive a refund of the money (if any) you paid for it by
sending a written explanation to the person you received the work
from. If you received the work on a physical medium, you must
return the medium with your written explanation. The person or
entity that provided you with the defective work may elect to provide
a replacement copy in lieu of a refund. If you received the work
electronically, the person or entity providing it to you may choose to
give you a second opportunity to receive the work electronically in
lieu of a refund. If the second copy is also defective, you may
demand a refund in writing without further opportunities to fix the
problem.

1.F.4. Except for the limited right of replacement or refund set forth
in paragraph 1.F.3, this work is provided to you ‘AS-IS’, WITH NO
OTHER WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED,
INCLUDING BUT NOT LIMITED TO WARRANTIES OF
MERCHANTABILITY OR FITNESS FOR ANY PURPOSE.

1.F.5. Some states do not allow disclaimers of certain implied

warranties or the exclusion or limitation of certain types of damages.
If any disclaimer or limitation set forth in this agreement violates the
law of the state applicable to this agreement, the agreement shall be
interpreted to make the maximum disclaimer or limitation permitted
by the applicable state law. The invalidity or unenforceability of any
provision of this agreement shall not void the remaining provisions.

1.F.6. INDEMNITY - You agree to indemnify and hold the Foundation,

the trademark owner, any agent or employee of the Foundation,
anyone providing copies of Project Gutenberg™ electronic works in
accordance with this agreement, and any volunteers associated with
the production, promotion and distribution of Project Gutenberg™
electronic works, harmless from all liability, costs and expenses,
including legal fees, that arise directly or indirectly from any of the
following which you do or cause to occur: (a) distribution of this or
any Project Gutenberg™ work, (b) alteration, modification, or
additions or deletions to any Project Gutenberg™ work, and (c) any
Defect you cause.

Section 2. Information about the Mission

of Project Gutenberg™
Project Gutenberg™ is synonymous with the free distribution of
electronic works in formats readable by the widest variety of
computers including obsolete, old, middle-aged and new computers.
It exists because of the efforts of hundreds of volunteers and
donations from people in all walks of life.

Volunteers and financial support to provide volunteers with the

assistance they need are critical to reaching Project Gutenberg™’s
goals and ensuring that the Project Gutenberg™ collection will
remain freely available for generations to come. In 2001, the Project
Gutenberg Literary Archive Foundation was created to provide a
secure and permanent future for Project Gutenberg™ and future
generations. To learn more about the Project Gutenberg Literary
Archive Foundation and how your efforts and donations can help,
see Sections 3 and 4 and the Foundation information page at
www.gutenberg.org.

Section 3. Information about the Project

Gutenberg Literary Archive Foundation
The Project Gutenberg Literary Archive Foundation is a non-profit
501(c)(3) educational corporation organized under the laws of the
state of Mississippi and granted tax exempt status by the Internal
Revenue Service. The Foundation’s EIN or federal tax identification
number is 64-6221541. Contributions to the Project Gutenberg
Literary Archive Foundation are tax deductible to the full extent
permitted by U.S. federal laws and your state’s laws.

The Foundation’s business office is located at 809 North 1500 West,

Salt Lake City, UT 84116, (801) 596-1887. Email contact links and up
to date contact information can be found at the Foundation’s website
and official page at www.gutenberg.org/contact

Section 4. Information about Donations to

the Project Gutenberg Literary Archive
Foundation
Project Gutenberg™ depends upon and cannot survive without
widespread public support and donations to carry out its mission of
increasing the number of public domain and licensed works that can
be freely distributed in machine-readable form accessible by the
widest array of equipment including outdated equipment. Many
small donations ($1 to $5,000) are particularly important to
maintaining tax exempt status with the IRS.

The Foundation is committed to complying with the laws regulating

charities and charitable donations in all 50 states of the United
States. Compliance requirements are not uniform and it takes a
considerable effort, much paperwork and many fees to meet and
keep up with these requirements. We do not solicit donations in
locations where we have not received written confirmation of
compliance. To SEND DONATIONS or determine the status of
compliance for any particular state visit www.gutenberg.org/donate.

While we cannot and do not solicit contributions from states where

we have not met the solicitation requirements, we know of no
prohibition against accepting unsolicited donations from donors in
such states who approach us with offers to donate.

International donations are gratefully accepted, but we cannot make

any statements concerning tax treatment of donations received from
outside the United States. U.S. laws alone swamp our small staff.

Please check the Project Gutenberg web pages for current donation
methods and addresses. Donations are accepted in a number of
other ways including checks, online payments and credit card
donations. To donate, please visit: www.gutenberg.org/donate.

Section 5. General Information About

Project Gutenberg™ electronic works
Professor Michael S. Hart was the originator of the Project
Gutenberg™ concept of a library of electronic works that could be
freely shared with anyone. For forty years, he produced and
distributed Project Gutenberg™ eBooks with only a loose network of
volunteer support.
Project Gutenberg™ eBooks are often created from several printed
editions, all of which are confirmed as not protected by copyright in
the U.S. unless a copyright notice is included. Thus, we do not
necessarily keep eBooks in compliance with any particular paper
edition.

Most people start at our website which has the main PG search
facility: www.gutenberg.org.

This website includes information about Project Gutenberg™,

including how to make donations to the Project Gutenberg Literary
Archive Foundation, how to help produce our new eBooks, and how
to subscribe to our email newsletter to hear about new eBooks.
Welcome to our website – the ideal destination for book lovers and
knowledge seekers. With a mission to inspire endlessly, we offer a
vast collection of books, ranging from classic literary works to
specialized publications, self-development books, and children's
literature. Each book is a new journey of discovery, expanding
knowledge and enriching the soul of the reade

Our website is not just a platform for buying books, but a bridge
connecting readers to the timeless values of culture and wisdom. With
an elegant, user-friendly interface and an intelligent search system,
we are committed to providing a quick and convenient shopping
experience. Additionally, our special promotions and home delivery
services ensure that you save time and fully enjoy the joy of reading.

Let us accompany you on the journey of exploring knowledge and

personal growth!

ebookultra.com