Systemic response to surgery

The direct traumatic injury of surgery initiates a chain of physiological events via the endocrine, metabolic, cardiovascular and immune systems. The unregulated stress response can lead to systemic inflammatory response syndrome (SIRS), but alternatively if we were able to totally obliterate the response then this would predispose to infection and failure of the recovery process. To an extent the response is protective. This article will outline the components of the interlinked endocrine, metabolic, immune and haemodynamic responses and discuss the ways in which the various components of the response can be modified in order to optimize postoperative recovery and aim to reduce complications.