Preoperative assessment and perioperative care
How to assess, risk-stratify and optimise patients before surgery: ASA grade, cardiac risk, fasting, prophylaxis, ERAS, consent and the WHO checklist.
Checked against sourcesVerified 31 October 2026
Surgery
General surgery and its principles: care before and after an operation, the acute abdomen, trauma and surgical emergencies.
Introduction
Surgery is the treatment of disease by operation, and the care of the patient before, during and after it. Most of what a student must know is not how to operate but how to recognise who needs an operation, how to make them safe for it, and how to spot the complications that follow.
This section starts with perioperative care, anaesthesia, fluids and wounds, then the acute abdomen and abdominal surgery, vascular, urological and endocrine surgery, and finally burns, reconstruction, breast and cancer surgery.
Every topic uses the same layout: a short summary, what you should be able to do afterwards, the mechanism, the clinical picture, tests, treatment and the traps. Doses, thresholds and cut-offs are checked against named guidelines and shown with their source, because guidelines and countries sometimes differ.
How to study surgery
Learn the surgical emergencies as pathways: the acute abdomen, the ischaemic limb, the torsed testis, bleeding and sepsis. For each, say the first three actions aloud and what makes it an emergency rather than an urgent referral.
For any operation ask four questions: is the patient fit, what could go wrong, how will pain, fluids and bleeding be managed, and what are the early warning signs afterwards. The perioperative topics answer these for every specialty.
Link surgery to the medical chapters: most surgical conditions have a medical twin in cardiology, gastroenterology, endocrinology or renal medicine, so follow the related links. Content here is for study and does not replace local protocols or a senior clinician's judgement.
Contents by part
The topics below are in teaching order. Each part builds on the one before it.
- Before, during and after surgery. Assessing and preparing a patient, anaesthesia and pain control, fluids, bleeding, wounds and the common postoperative problems.
- Preoperative assessment and perioperative care
- General anaesthesia and airway management
- Regional and local anaesthesia
- Postoperative pain and opioid analgesia
- Fluids, electrolytes and nutrition in the surgical patient
- Surgical bleeding, coagulopathy and blood products
- Surgical wounds, wound healing and surgical site infection
- Postoperative fever and complications
- Stomas, drains and common surgical procedures
- The acute abdomen and abdominal surgery. The patient with an acute abdomen, intra-abdominal infection, damage-control surgery, anorectal and splenic problems.
- Vascular, urological and endocrine surgery. Limb ischaemia and venous disease, procedures on the arteries, scrotal and urological emergencies and operations, and surgery of the thyroid, parathyroid and adrenal glands.
- Acute limb ischaemia and chronic limb-threatening ischaemia
- Chronic venous disease, varicose veins and venous ulcers
- Vascular surgery procedures and endovascular repair
- Testicular torsion and urological emergencies
- Urological procedures: catheters, TURP and nephrectomy
- Thyroid, parathyroid and adrenal surgery
- Burns, reconstruction, breast and cancer surgery. Burns, plastic and reconstructive surgery, breast disease, head and neck surgery, transplantation and the principles of operating on cancer.
Topics
General anaesthesia and airway management
Stages and components of general anaesthesia, induction and inhalational agents, neuromuscular blockers, airway assessment, rapid sequence induction.Checked against sourcesVerified 31 October 2026Regional and local anaesthesia
How local anaesthetics block nerves, safe adult doses, local anaesthetic systemic toxicity and lipid emulsion, spinal versus epidural techniques, common.Checked against sourcesVerified 31 October 2026Postoperative pain and opioid analgesia
Postoperative pain: assessment, WHO analgesic ladder, multimodal analgesia, opioids and PCA, NSAIDs and paracetamol, regional techniques, opioid conversion.Checked against sourcesVerified 31 October 2026Fluids, electrolytes and nutrition in the surgical patient
Maintenance and replacement fluids, balanced crystalloids, fluid shifts after surgery, ileus, and enteral versus parenteral nutrition in surgical patients.Checked against sourcesVerified 31 October 2026Surgical bleeding, coagulopathy and blood products
Perioperative bleeding assessment, anticoagulant and antiplatelet management, blood components and thresholds, tranexamic acid and cell salvageChecked against sourcesVerified 31 October 2026
Surgical wounds, wound healing and surgical site infection
How surgical wounds heal, why they break down, how surgical site infection is classified, and the bundles that prevent it.Checked against sourcesVerified 31 October 2026Postoperative fever and complications
Fever after surgery: causes by postoperative day, bedside wound and line assessment, investigations, prevention, and early postoperative problems.Checked against sourcesVerified 31 October 2026Stomas, drains and common surgical procedures
Ileostomy versus colostomy, indications, complications and high-output stomas, surgical drains and tubes, and the typical complications of common operations.Checked against sourcesVerified 31 October 2026Acute abdomen and intestinal obstruction
Approach to the acute abdomen: peritonitis, obstruction, perforation, mesenteric ischaemia, work-up, imaging, resuscitation and when to operate.Checked against sourcesVerified 31 October 2026Surgical sepsis and intra-abdominal infection
Surgical sepsis and intra-abdominal infection: peritonitis, abscess and source control, anastomotic leak, antibiotics, and sepsis care.Checked against sourcesVerified 31 October 2026Damage-control surgery and abdominal compartment syndrome
When to abbreviate laparotomy, control bleeding and contamination, leave the abdomen open, and recognise and treat abdominal compartment syndrome.Checked against sourcesVerified 31 October 2026Anorectal disease: haemorrhoids, fissure and fistula
Graded care for haemorrhoids, fissure, abscess and fistula, with pruritus ani, incontinence outline and anal cancer red flags.Checked against sourcesVerified 31 October 2026Splenic disorders, splenectomy and asplenia
Splenic disorders: from hyposplenism and asplenia to splenic trauma, splenectomy, and post-splenectomy sepsis prevention.Checked against sourcesVerified 31 October 2026Obesity and bariatric surgery
Obesity as a chronic disease: BMI classes, complications, medical therapy including GLP-1 receptor agonists, bariatric surgery indications and follow-up.Checked against sourcesVerified 31 October 2026Acute limb ischaemia and chronic limb-threatening ischaemia
Acute arterial limb threat: the six Ps, Rutherford stages, embolism versus thrombosis, heparin and revascularisation, and reducing amputation.Checked against sourcesVerified 31 October 2026Chronic venous disease, varicose veins and venous ulcers
Chronic venous disease and varicose veins: causes, CEAP staging, duplex ultrasound, compression, endovenous ablation, surgery, and venous ulcer care.Checked against sourcesVerified 31 October 2026Vascular surgery procedures and endovascular repair
Open and endovascular repair of aortic aneurysms, carotid endarterectomy, bypass, angioplasty, stents, amputation levels and complications.Checked against sourcesVerified 31 October 2026Testicular torsion and urological emergencies
A combined guide to the urological emergencies a medical student must recognise: testicular torsion, epididymitis, Fournier gangrene, priapism.Checked against sourcesVerified 31 October 2026Urological procedures: catheters, TURP and nephrectomy
Urethral and suprapubic catheters, transurethral prostate surgery and TURP syndrome, cystoscopy, ureteric stents, nephrectomy and cystectomy with urinary.Checked against sourcesVerified 31 October 2026Thyroid, parathyroid and adrenal surgery
How neck and adrenal endocrine surgery is planned, performed and recovered from, with indications, preparation, technique and complications.Checked against sourcesVerified 31 October 2026Burns
Burns: depth, surface area, resuscitation, inhalation, chemical and electrical injuries, wound care, referral and rehabilitation.Checked against sourcesVerified 31 October 2026Plastic and reconstructive surgery basics
Core plastic and reconstructive surgery: reconstructive ladder, grafts and flaps, scars, skin-cancer margins, cleft lip and palate, breast reconstruction.Checked against sourcesVerified 31 October 2026Breast disease and surgical management of breast cancer
Breast lumps and benign disease: triple assessment, fibroadenoma, cysts, mastitis, nipple discharge; plus breast cancer types, staging, surgery, screening.Checked against sourcesVerified 31 October 2026ENT surgery basics
Core ENT surgery for medical students: neck lumps, thyroglossal and branchial cysts, cancer red flags, tracheostomy, tonsil, sinus and hearing surgery.Checked against sourcesVerified 31 October 2026Organ transplantation: principles and complications
Organ transplantation: principles and complicationsChecked against sourcesVerified 31 October 2026Principles of surgical oncology
How surgery treats cancer: intent, margins, nodes, perioperative therapy, team care, recovery, and metastases.Checked against sourcesVerified 31 October 2026Head and neck cancers
Squamous cell cancers of the oral cavity, oropharynx, larynx, hypopharynx and nasopharynx: causes, warning signs, staging and treatment.Checked against sourcesVerified 31 October 2026Salivary gland disorders and tumours
Salivary gland stones and sialadenitis, pleomorphic adenoma, Warthin tumour, malignant salivary cancers, facial nerve risk, imaging, FNA and parotidectomy.Checked against sourcesVerified 31 October 2026