British Journal of Plastic Surgery (1996), 49, 334-335 0 1996 The British Association of Plastic Surgeons

Book Reviews

The Arterial Anatomy of Skin Flaps. 2nd edition. By George C. Cormack and B. George H. Lamberty. Churchill Livingstone, Edinburgh 1994. ISBN O-4430-4567-4. Pp 538, ill. Price &179. The first edition of this comprehensive and informative text on the arterial anatomy of skin flaps was published 10 years ago. This book rapidly became essential reading for all reconstructive sur- geons and is no doubt one of the most frequently consulted texts in the plastic surgery library. Since the first edition appeared in 1986 there have been numerous advances which have necessitated the printing of this second edition.

The (manual style) format of the first edition has been retained, despite some criticism from reviewers. The text is some 83 pages longer and contains a further 131 new illustrations. Red colour bars have been introduced to highlight the beginning of each chapter. There are occasional spelling mistakes, which should be noted and corrected when the third edition is published, but these are inevitable in a text of this magnitude and in no way distract the reader.

Following an introduction, Chapter 2 discusses the microcircul- ation and how this relates to the physiology of flaps. Although there has perhaps been a disappointing lack of advance in this field over the last decade, there is new information on the role of endothelins and free radicals. Chapters 3-6 comprise the bulk of the anatomical studies which, save for a few additions regarding new knowledge of vessel variability in Chapter 6, are largely unaltered. Most of the new material is found in Chapter 7,

reflecting the numerous new flaps which have been described. There is an entirely new Chapter 8, dealing specifically with the blood supply to the bone and periosteum and the clinical appli- cations of bone and periosteal flaps. The references at the end of each chapter are not comprehensive, as is often the case in American textbooks, but give the reader the most sentinel papers published on the topic. For the trainee surgeon, this avoids having to wade through piles of journals when trying to find an important reference. There are two indexes, a subject index and an author index; the latter can prove useful when one can only remember a flap by who described it, rather than the correct anatomical name.

There have been criticisms by trainees that the descriptions of clinical uses of the flaps and flap elevation are not always compre- hensive and easy to follow, but this reflects the purpose of this book, which is a manual of the arterial anatomy rather than an atlas of flaps and their uses. Due to constraints on cost, the anatomical drawings are in two colours only and do not compare with those in anatomical atlases. 1 would suggest that trainees using this book should do so in conjunction with a Grant’s Atlas of Anatomy and a copy of the original article describing the flap.

The book is printed clearly on good quality paper with a firm binding. At fl79, this text will stretch the pocket of those trainees to whom it is targeted. However, I would recommend this as an essential textbook for all plastic surgery trainees, and a very useful reference for all reconstructive surgeons.

N. J. PERCIVAL

An Atlas of Flaps in Limb Reconstruction. By Alain C. Masquelet and Alain Gilbert. Martin Dunitz Ltd., London, 1995. Pp x+265, ill. ISBN l-85317-172-7. Price 599.50.

The authors set out to comprehensively describe those flaps from all parts which have a role in reconstruction of the limbs. Clearly the list is considerable but nevertheless the authors have managed to describe the mainstream flaps extremely well. The section on ‘Hand and Digits’, however, is not exhaustive with for instance a description of only a relatively small number of flaps for finger tip reconstruction.

This Atlas is beautifully illustrated in colour. There are no anatomical or clinical photographs. All of the illustrations are

drawn from anatomical dissections with excellent artistry by Leon Dorn. The design and lay-out of the book are systematic. The French authors in their ‘Historical Review’ of the subject rightly acknowledge the unique contribution of French anatomists to the study of vascular anatomy. Apart from the descriptive dissections flap by flap, there are excellent chapters on the basic principles of flap design and dissection, preoperative planning and an interesting approach in the final chapter which deals with ‘Indications for pedicled island flaps’. The bibliography and index is in keeping with international standards and the quality of paper, binding and printing are without fault.

This is a first-class reference Atlas which would be fully appreci- ated by both novice and experienced reconstructive surgeons.

J. 0. SMALL

Fundamental Techniques of Plastic Surgery and their Surgical Applications. Ninth edition. By I. A. McGregor and A. D. McGregor. Churchill Livingstone, Edinburgh 1995. Pp. xii +244, ill. ISBN O-443-05028-7. Price c35.00.

If the mark of amateurism is not knowing what to leave out, then the McGregors have produced a professional book.

Clear text, excellent line drawings and a good basic index make it an outstanding example of what a fundamental publication should be.

It is of such dimension that it could be, spouse permitting, read in bed. It provides at least a single workable way of reconstructing most defects. The didacticism typical of both authors is of course an asset to the fundamentalist.

If there is criticism to be made it lies in the inclusion of some

techniques, for example of microvascular tissue transfer, which are perhaps fundamental to current plastic surgery but where there is not sufficient detail of the actual technique to be of practical use. This is also true of transfers of tubed flaps by a carrier, and gastrocnemius flaps. That would not matter if good complementary texts were cited; not a massive bibliography, just a good source, just one for each problem or technique. Twenty pages more of bibliography distributed throughout the book would enable the fundamental reader to take the critical step to be a fundamental practitioner.

Every medical library should have a copy of this book and every surgeon should skim it; even GPs would be richer for reading it. For the beginner in plastic surgery it is an alphabet with which to build the story of plastic surgery.

R. SANDERS

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