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Bailey & Love – Short Practice of Surgery 25 th

Now in its 25th edition, the content has been thoroughly revised and updated while retaining its traditional strengths. Under the stewardship of the eminent editorial team, comprising two editors with experience gained over previous editions and a third editor new to this edition, and in response to reader feedback, the content has been sub-divided into parts to ensure a logical sequence and grouping of related chapters throughout while the text features enthusiastically received in the last edition have been retained.

The new edition opens with sections devoted to the underlying principles of surgical practice, investigation and diagnosis, and pre-operative care. These are followed by chapters covering all aspects of surgical trauma.

The remainder of the book considers each of the surgical specialties in turn, from elective orthopaedics through skin, head and neck, breast and endocrine, cardiothoracic and vascular, to abdominal and genitourinary.

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Enteral Nutrition in the Critically Ill Patient

Clinical factors, such as premorbid nutritional status and severity of illness, determine the overall efficacy of nutritional support. Malnutrition may be defined as “a disorder of body composition in which macronutrient and/or micronutrient deficiencies occur when nutrient intake is less than required.”1 Malnutrition leads to reduced organ function, abnormal laboratory chemistry values, and poorer clinical outcome. For all hospitalized patients, the reported prevalence of malnutrition is as high as 50%. Although difficult to quantify, the incidence in intensive care unit (ICU) patients is closer to 5%. A malnourished patient is more likely to have infectious morbidity, a prolonged hospital stay, and increased mortality.2 However, not all patients in the ICU need nutritional support, and disease and nutrition exhibit complex interactions. In critical illness, malnutrition results from abnormal nutrient processing and not starvation. Each individual patient should receive a nutritional formula specific to their disease process. Keeping this in mind, it is important to provide early nutritional support during critical illness.

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