Introduction

INTRODUCTION

In high-income countries paediatric surgeons have subspecial ised, whereas in low-income countries surgeons must maintain diverse skills and knowledge. Some conditions, previously managed by paediatric surgeons, are now managed by others (e.g . clefts in plastic surgery , syndactyly in hand surgery , spina bifida and ventriculoperitoneal shunts in neurosurgery , ligation of patent ductus arteriosus in cardiac surger y and cervical cystic hygromas, thyroglossal cysts, preauricular sinuses and branchial remnants in ear, nose and throat surgery). This new edition recognises specialisation with chapters devoted to neonatal surgery , specialist paediatric urology and paediatric trauma. Those managing the general surgery of childhood in non-specialist hospitals should study the inguinoscrotal conditions described here and the foreskin as outlined in Chapter 20 . AGE Biological domains (e.g. physiology , pathology , pharmacology) change continuously with age, whereas hospital services recognise artificial boundaries often set at 12, 16 or 18. The terminology related to children and young people (CYP) includes neonate (<4 weeks) and infant (<1 year). The World Health Organization defines adolescence as ages 10–19 and young people as 10–24. Some anatomical di ff erences between infants and older children appear in 17.1 and Figure 17.1 . A few conditions described in Chapter 18 require management throughout childhood and later after handover in transitioning by adult surgeons.