Preoperative counseling and management: Preoperative Evaluation, Informed Consent, Perioperative Planning, Surgical Site Infection Prevention, and Avoidance of Complications

This chapter focuses on the preoperative evaluation of the surgical patient. It begins with the history and physical exam followed by the preoperative laboratory evaluation of a surgical patient. After a thorough discussion of informed consent, an evidence-based approach to perioperative management is outlined that includes a large section on enhanced recovery after surgery (ERAS). The enhanced recovery protocol begins with preparing the patient prior to surgery, setting appropriate expectations, intraoperative care including positioning and anesthesia management, plans for surgical site infection reduction, and venous thromboembolism prevention. It also outlines the management of common comorbid conditions that affect surgery, such as chronic anticoagulation use and the use of stress dose steroids and cardiopulmonary disease.