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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE

A Journal on Physiopathology and Surgery of the Foot


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Chirurgia del Piede 2009 December;33(3):145-9

language: Italian

Stress as a risk factor in foot surgery

Napoli V. 1, Napoli E. 2

1 Centro di Chirurgia del Piede, Clinica “Fornaca di Sessant”, Torino, Italia
2 Villa Maria Pia Hospital, Torino, Italia


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Operative stress, the clinical expression of neuroendocrine response to surgical intervention, is triggered by surgical trauma and maintained by the surgical wound; the response is modulated by various processes that influence its degree and duration. But neuroendocrine response is also fundamental for the body’s regenerative ability and the defences it can mount against infection. When, however, surgical trauma, because of its biological impact or because the patient’s psychological and physical conditions were inadequately evaluated, overwhelms the body’s defence system, a vicious cascade of events may ensue, leading to complications and altered organ function. Operative stress is a risk factor for which no indices exist, despite the need to understand its modes of onset and the causes that may increase or decrease its impact. For this reason, predisposing factors to operative stress should be determined for each patient individually, as well as for specific interventions, especially for minor operations, under which foot surgery is sometimes classified, for which risk is subtle, complications are unexpected and often difficult to classify.

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