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.
