Principles and Practice of Surgery

Citation

Garden, O. J., Parks, R. W., & Wigmore, S. J. (Eds.). (2022). Principles and Practice of Surgery (8th ed.). Elsevier.

Chapter Summary

The eighth edition is an edited textbook of about 580 pages in 29 chapters, arranged in four sections. Its three editors are professors of surgery at the University of Edinburgh, and the publisher presents it as the surgical companion to Davidson's Principles and Practice of Medicine, covering the core surgical topics met in an integrated medical curriculum and later in the clinical setting. Chapter titles below follow the publisher's table of contents.

Section 1: Professional Capabilities in Surgical Practice (Chapters 1–3)

Chapter 1, Professional and ethical responsibilities; Chapter 2, Patient safety and clinical human factors; Chapter 3, Evidence-based surgery. The book opens with the surgeon's professional role rather than with disease. The first two chapters are new in this edition, and the publisher highlights patient safety and clinical human factors as emerging issues the book now addresses.

Section 2: Principles of Perioperative Care (Chapters 4–11)

Chapter 4, Management of shock, fluid management and blood transfusion; Chapter 5, Nutritional support in surgical patients; Chapter 6, Infections and antibiotics; Chapter 7, Preoperative considerations, anaesthesia and analgesia; Chapter 8, Principles of the surgical management of cancer; Chapter 9, Trauma and multiple injury; Chapter 10, Practical procedures and patient investigation; Chapter 11, Postoperative care and complications. This section covers the principles that apply across surgical specialties: resuscitation and fluids, nutrition, infection, the preparation of patients for surgery including anaesthesia and pain relief, cancer surgery, trauma, practical procedures and investigations, and care after surgery.

Section 3: Gastrointestinal Surgery (Chapters 12–18)

Chapter 12, The abdominal wall and hernia; Chapter 13, The acute abdomen; Chapter 14, The oesophagus, stomach and duodenum; Chapter 15, The liver and biliary tract; Chapter 16, The pancreas and spleen; Chapter 17, The small and large intestine; Chapter 18, The anorectum. General and gastrointestinal surgery receives its own section, moving from the abdominal wall and the acute abdomen through the digestive tract from oesophagus to anorectum.

Section 4: Surgical Specialties (Chapters 19–29)

Chapter 19, Plastic surgery, including common skin and subcutaneous lesions; Chapter 20, Breast surgery; Chapter 21, Endocrine surgery; Chapter 22, Vascular and endovascular surgery; Chapter 23, Cardiothoracic surgery; Chapter 24, Urological surgery; Chapter 25, Neurosurgery; Chapter 26, Transplantation surgery; Chapter 27, Ear, nose and throat surgery; Chapter 28, Orthopaedic surgery; Chapter 29, Global surgery and anaesthesia. The final section surveys the specialties one chapter each, and ends with a chapter, new in this edition, on surgery and anaesthesia in a global context.

Key Concepts

Section 1: Professional Capabilities

• Professional and ethical responsibilities: the duties of the surgeon beyond technical skill.
• Patient safety and clinical human factors: how errors arise in surgical care and how team and system factors affect outcomes.
• Evidence-based surgery: basing surgical decisions on evaluated evidence.

Section 2: Perioperative Care

• Shock, fluids and transfusion: the resuscitation and fluid management of surgical patients.
• Perioperative assessment, anaesthesia and analgesia: preparing patients for surgery and managing pain.
• Principles of surgical oncology: the general principles of operating for cancer.
• Postoperative complications: recognising and managing problems after surgery.

Sections 3–4: Gastrointestinal Surgery and Specialties

• The acute abdomen: the assessment of sudden abdominal pain, a core surgical presentation.
• Hernia: defects of the abdominal wall and their management.
• Endovascular surgery: treatment within blood vessels, covered with vascular surgery.
• Global surgery: surgery and anaesthesia considered across health systems worldwide.

Critical Analysis

Strengths

• Principles before specialties. The table of contents gives professional practice and perioperative care eleven chapters before any organ system appears. Shock, fluids, nutrition, infection, anaesthesia, cancer principles, trauma and postoperative care are the topics shared by every specialty, and students meet them first.
• Current professional themes. New chapters on professional and ethical responsibilities, on patient safety and clinical human factors, and on global surgery bring into a student textbook subjects that the publisher describes as emerging issues in surgical practice.
• Designed for revision and the wards. The publisher lists summary boxes and evidence boxes throughout, line drawings, radiographic images and colour photographs, and alignment with undergraduate and postgraduate surgical curricula. The full text is also available online and as an eBook through Student Consult.
• Companion to Davidson. Its explicit pairing with Davidson's Principles and Practice of Medicine allows students in integrated courses to read medicine and surgery in consistent texts.

Limitations

• Breadth over depth in the specialties. Eleven specialties share Section 4 at one chapter each, within a book of about 580 pages; the publisher calls its approach succinct. Students on a specialty attachment, or trainees preparing for postgraduate examinations, will need specialty texts.
• Not a guide to clinical examination. The book explains conditions, investigation and management; the chapter list does not include a systematic treatment of eliciting surgical symptoms and signs, for which a dedicated text is needed.
• Anaesthesia as part of perioperative care. Anaesthesia appears within Chapter 7 alongside preoperative considerations and analgesia, and in the closing global chapter. Students taking an anaesthesia attachment will need specialist material.

Where It Fits in the Course

Within this course list, Principles and Practice of Surgery is the main undergraduate textbook of surgery. Two shorter books suit different needs: Browse's Introduction to the Symptoms & Signs of Surgical Disease teaches surgical history-taking and examination region by region, which this book does not, and Crash Course Surgery is a concise revision text with exam-style questions. One workable pattern is Browse alongside the first surgical attachment, this book as the main reference for surgical disease and its management, and Crash Course in the weeks before examinations.

The two remaining books are graduate-level clinical texts. Quick Hits in Obstetric Anesthesia is a guide to anaesthesia for labour, caesarean delivery and obstetric emergencies, and Surgical and Perioperative Management of Patients with Anatomic Anomalies deals with operating on patients whose anatomy is abnormal. Both build on the perioperative principles of Section 2 and are for readers who have finished an undergraduate surgical course.

How to Use This Book

The book is written for medical students in integrated curricula and for junior trainees; the publisher describes it as aligned with both undergraduate and postgraduate surgical curricula. Preclinical anatomy, physiology and pathology are the natural foundation.

A practical plan:

• Begin with Sections 1 and 2. Read the professional and perioperative chapters at the start of the first surgical attachment; Chapters 4, 7 and 11 (shock and fluids, preoperative care and anaesthesia, postoperative complications) are the daily business of surgical wards.
• Read Section 3 as the core of general surgery. Start with the abdominal wall and hernia (Chapter 12) and the acute abdomen (Chapter 13), then read the organ chapters when the matching patients are seen.
• Use Section 4 attachment by attachment. Read each specialty chapter before or during the corresponding rotation, and move to specialty texts for depth.
• Read the global surgery chapter for a wider view of how surgical care is delivered.

Use the summary boxes for revision and the evidence boxes to see what supports current practice. Pair the book with an examination text such as Browse's so that knowledge of disease is matched by skill in eliciting symptoms and signs, and use the online version through Student Consult for searching on the wards.