This book provides a practical guide to decision making within the realm of trauma surgery. Each chapter covers the ideal approach, rather than customary care, for the treatment of the chosen difficult decision or controversy. A broad range of topics are covered with particular attention given to resuscitation, wound management, thoracic and abdominal trauma, antimicrobial management, transplant considerations, vascular trauma, traumatic brain injury, pediatric trauma and ethics. Difficult Decisions in Trauma Surgery aims to help improve the treatment of trauma patients and is relevant to surgical trainees and practicing surgeons, and as well as medical professionals working within trauma medicine.

This text provides a comprehensive and state-of-the-art overview of the major issues specific to the surgical decision-making process. These include patient’s anatomy and pathophysiology as well as the magnitude of the injury at hand, the surgeon's own physiologic and mental status, training and experience, and many other factors such as creativity, leadership skills, and overall "biochemistry" of the environment. The text reviews theoretical as well as objective information that surgeons use to make intraoperative decisions in situations, often with very limited data; decisions that will decide between a patient's living or dying, such as in trauma surgery and other complex surgeries. How surgeons choose one technical approach over another in these situations is covered. This book fills a critical need for resource materials on these topics and includes both theoretical as well as practical presentations of many typical patients seen in operating rooms around the world. Surgical Decision Making: Beyond the Evidence Based Surgery is written by academic and clinical practicing surgeons that face intraoperative decision situations on a daily basis and therefore provides a unique and valuable resource in the field for surgeons currently in training and for those already in clinical or research practice.

This revised and expanded new edition reviews surgical decision-making in complex surgical procedures, including making difficult decisions, continuous awareness of the patient’s physiologic status, the biochemical profile, endpoint resuscitation and the surgeon's own physiologic status. Other specific surgical decisions are discussed, such as when to operate and when not to operate, re-operations and operations in specific conditions and age groups. This new edition addresses these and other elements that are important for the intraoperative and perioperative decision-making process, including basic questions that have not been answered appropriately in the literature. Many of us make decisions based on current evidence, but much of it based on “a gut feeling” or “intuition” or the “gray hair effect,” among other techniques. In this book, the anatomy of such decisions is explored from a theoretical standpoint as well as objective data that we as surgeons use to make surgical decisions. Nowhere else is the matter of how we make a decision -- often with a very limited amount of data, decisions that will decide between someone living or dying -- more prevalent than in trauma surgery and other complex surgeries, including the unplanned return to the operating room. Our collective firsthand experience as surgeons points to a combination of factors contributing to our perioperative and intraoperative decision-making process, including education, clinical know-how, mentoring, and the creativity and excellence that come with long practice and strict discipline. The second edition of Surgical Decision-Making: Evidence and Beyond provides a unique and valuable resource in the field for surgeons currently in training and for those already in clinical academic or community surgery practice.

This book looks at specific vascular surgery questions that have arisen and where careful analysis is given according to the level of supporting evidence available. As new technology is introduced to treat the cardiovascular system, alternative therapies begin to challenge and also complement traditional vascular surgery. All chapters contain the PICO table to summarise specific characteristics relative to the questions posed in each chapter. Difficult Decisions in Vascular Surgery- An Evidence-Based Approach is a current and timely reference source for practicing surgeons, surgeons in training, and educators, that describes the recommended ideal approach, rather than customary care, in selected clinical situations.

Trauma surgery has increasingly become a specialized field inspired by different principles and philosophy. A good trauma surgeon is a surgeon who knows how to perform abdominal vascular, thoracic, urologic, gynecologic, and orthopaedic procedures and is able to repair multiple traumatic injuries in the best sequence possible. In this first volume, practical, up-to-date guidance is provided on the optimal critical care and ICU management of trauma patients. In addition, individual chapters focus on specific injuries in orthopaedic trauma (and especially spinal trauma) and neurotrauma, with the aim of providing a fresh view of the surgical approach and practical suggestions for improving the skills of treating surgeons. Educational issues and the organization of a trauma center are also covered. The volume will be a handy pocket guide for trainee surgeons and any surgeon, physician, or nurse who treats trauma patients. It will be particularly relevant for emergency department physicians, critical care and ICU doctors, orthopaedic surgeons, neurosurgeons, and professionals responsible for trauma care and decision making, programs of trauma education, or organization of a trauma center. Also available: Trauma Surgery Vol. 2: Thoracic and Abdominal Trauma

Trauma surgery has increasingly become a specialized field inspired by different principles and philosophy. A good trauma surgeon is a surgeon who knows how to perform abdominal, vascular, thoracic, urologic, gynecologic, and orthopaedic procedures and is able to repair multiple traumatic injuries in the best sequence possible. In this second volume the focus is exclusively on thoracic and abdominal trauma, with coverage of injuries to all regions. The surgical techniques employed in managing such trauma are carefully described with the aid of high-quality illustrations. Exploratory surgery (via either laparotomy or laparoscopy), damage control surgery, and definitive surgery are all fully covered, and attention is drawn to important technical tips and tricks. The volume will be a handy pocket guide for trainee surgeons who are beginning to deal with severe multiple trauma patients, as well as for all general or specialty surgeons and professionals (including scrub nurses and theatre staff) who are involved in trauma care and wish to keep abreast of developments in this complex field.

This unique and innovative title offers a comprehensive exploration of the intersection of ethics, violence, trauma, and trauma surgery. Underscoring that the causes of violence include a wide range of socioeconomic factors, including poverty and the lack of economic opportunity, and that violence often occurs in impoverished and underserved communities, various authors from a wide range of disciplines outline how intentional violence toward another person is multidimensional and complex. Many of the authors use Chicago as a framework for their chapter discussion, but there are similarities in many urban settings throughout the United States and abroad. Part I of the book, Ethical Issues Related to Violence, includes seven chapters that examine ethical issues related to violence. Each of these chapters discusses a different but intersecting aspect of how violence challenges ethical standards in medicine and health. Part II, Ethical Issues Related to Trauma and Trauma Surgery, offers eight chapters that address various aspects of ethical issues related to trauma and trauma surgery. Part III, Additional Concerns Relating to Violence and Trauma, describe a series of issues relating to violence and trauma, including surgical procedures, psychological distress, and geographic disparities in access to trauma care. Developed by nationally renowned thought leaders in the field, Violence, Trauma, and Trauma Surgery is a major and novel contribution to the clinical literature and will be of great interest to all physicians, clinicians, researchers, social scientists, students, policymakers, hospital administrators and community leaders concerned with understanding and improving outcomes relating to violence, trauma, and trauma surgery.

Critical care medicine is responsible for many of the most important advances in outcomes after cardiothoracic surgery in the past two decades. The expertise developed in this subspecialty accounts for the resiliency that characterizes gold standard results evident in institutions recognized for excellence. This volume is intended to share ideas and algorithms that will improve outcomes in cardiothoracic critical care units. This book is part of the Difficult Decisions in Surgery series that covers surgical specialties. The volumes are multi-authored, containing brief chapters, each of which are devoted to one or two specific questions or decisions within that specialty that are difficult or controversial. The volumes are intended as a current and timely reference source for practicing surgeons, surgeons in training, and educators that describe the recommended ideal approach, rather than customary care, in selected clinical situations.

Unique book provides comprehensive discussion of MIS versus traditional techniques in modern Acute Care Surgery The combination of a surgeon shortage and poor access to emergency surgical care led to establishment of the Acute Care Surgery paradigm and subspecialty in 2003. Concurrently, minimally invasive approaches revolutionized surgical practice in the 21st century. In the U.S., acute care surgeons stand at the front line of patient care for emergency general surgery, trauma, and surgical critical care, and thus are positioned to positively impact healthcare delivery and costs. Surgical Decision Making in Acute Care Surgery by renowned surgeons Kimberly Davis and Raul Coimbra is the first text that comprehensively discusses when to use minimally invasive techniques and advanced technology versus traditional open procedures in acute traumatic and non-traumatic surgical emergencies. The text begins with three opening chapters covering the background of the Acute Care Surgery subspecialty, anatomic and physiological considerations, and the impact of acute surgical illness on pre- and post-operative critical care decisions. Subsequent chapters outline surgical approaches for commonly encountered acute conditions. Trauma chapters cover interventions for cervical, blunt and penetrating abdominal, and thoracic injuries. Emergency general surgery topics run the gamut from appendicitis to emergency management of paraesophageal hernias and esophageal perforations. An impressive group of senior surgeons and younger rising stars in American surgery share their expertise throughout the book. Key Highlights Disease-specific chapters include epidemiology, pathogenesis, diagnostic tools, treatment strategies, surgical techniques, cost analyses, complications, and national guidelines where available Subchapters feature expert commentary on preceding chapters, including clinical pearls and controversies (e.g. operative vs. nonoperative management) In-depth discussion of surgical decision making encompasses the type of surgical approach, as well as indications and contraindications for MIS The roles of MIS procedures such as laparoscopy, thoracoscopy, radiology-based percutaneous techniques, as well as endovascular surgery are examined The quintessential resource on contemporary Acute Care Surgery practice, this is a must-read for residents, junior faculty, and practicing surgeons in this discipline.

In 50 Landmark Papers every Trauma Surgeon Should Know, editors Stephen Cohn and Ara Feinstein have compiled a selection of the most influential contributions to the specialty of trauma surgery. This book comprises 50 thought-provoking reviews of carefully selected papers and explains how trauma surgery practice has changed as a result of this research. The selection of key papers, the insights into the significance of each paper from trauma experts, and the opportunity to read the original authors' thoughts about their groundbreaking developments, make this a unique and fascinating resource. Of interest to surgical residents and trainees, Trauma and Surgical Critical Care fellows and all members of the Trauma team. This is both an informative and personal look at the foundation stones of modern Trauma care. Key Features Unique commentaries by original authors and experts Demonstrates how clinical practice has adapted following these landmark studies Specialty-defining papers are brought to life, and their impact assessed Shows how the insight and vision of individual surgeons propelled change