Plastic surgery. 3rd edition

Plastic surgery. 3rd edition

442 Injury: the British Journal of Accident Surgery Vol. 1 ~/NO. 5 Outpatient Surgery. By George J. 255x 180mm. _ Pp. 1482. Illustrated. Philadelnhi...

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Injury: the British Journal of Accident Surgery Vol. 1 ~/NO. 5

Outpatient Surgery. By George J. 255x 180mm. _ Pp. 1482. Illustrated. Philadelnhia. Saunders. E28.75.


II. 1980.

This impressively large book is prefaced by an impressive ideal: to improve the treatment of patients outside the wards of a hospital. The author states ‘Anyone who has heard the commotion, smelled the fear and anger and seen the turmoil of the outpatient department will appreciate the need for better services in this area’. What follows, all 1400 pages of it, is often of very specialized interest and certainly not what one would expect to find in a book entitled Outpatient Surgery. Who would expect to find under ‘outpatient surgery’: hiatus hernia repair; an account of operability of patients with congenital and acquired heart disease; a detailed account of the fat, calorie and sodium content of common foods; tables listing centrally located APUD cells, their products and clinical syndromes; a 40-page chapter on transplantation; 62 pages on metabolism and endocrinology; and 37 pages on cancer chemotherapy? The book is certainly comprehensive, but it is difficult to find a connection between most of the chapters and ‘outpatient surgery’ in the sense of what this term means to a British reader. Presumably it means to be a comprehensive do-it-yourself manual for a medical practitioner working in what is described as a ‘freestanding outpatient surgical centre’ where almost any patient can be dealt with who does not require more than 24 hours of hospital admission. Much of the book is, therefore, parochial to the United States and concerned with such subjects as organization and commercial viability. Not that British or Continental European medical planners should ignore some of the important pointers contained in the book to the potential future for medical care outside hospital. Within this comprehensive tome are several useful practical chapters; particularly those on regional and local anaesthesia, urology (including a useful technique for performing circumcision under local anaesthesia), paediatric surgery and a well written conventional account of outpatient anorectal surgery (unfortunately this includes an account of the now almost obsolete Thiersch operation of wire or plastin, per&anal encirclement). In the reviewer’s opinion approximately two-thirds of the book is irrelevant padding and it is not possible to justify its price for the pertinent third. JOHN ALEXANDER-WILLIAMS

Plastic Surgery. 3rd edition. Edited by William C. Grabb and James W. Smith. 234 x 190 mm. Pp. 970. 1980. Massachusetts, Little Brown. f25.00. In every surgical speciality there are 4 or 5 books that are rightly regarded as essential reading for all trainees. The volumes are usually so concise and comprehensive that even established specialists ignore them at their peril. In plastic surgery we have two outstanding texts: Grabb and Smith published in the United States

and Ian McGregor’s book Fundamental Techniques of Plastic Surgery-and their Surgical Applications published on this side of the Atlantic. A new edition of each book has just appeared in the bookshops. Grabb and Smith have enlisted the help of 71 experts as co-authors of the 55 chapters in this book. Most of the experts are from the United States and more than half are new collaborators in this work. It must have been a difficult decision to ‘drop’ some of the earlier contributors but I confess that I would have no hesitation in dropping some of the new ones. Many of the original chapters have been drastically pruned or combined with other sections. Yet Millard’s chapter on the cleft lip is virtually unchanged and could well do with rewriting. Ten new chapters have been added including new sections on microsurgery and the breast. It is no surprise that these chapters are amongst the best in the book. The orthopaedic and accident surgeon (and trainee) will find the chapters on basic techniques, tissue transplantation and implantation materials excellent value along with the section on hands and that on lower limbs. The chapters on microsurgery are first class and give sound guidance: so too does the section on bums. The text is beautifully printed and with the exception of chapter 14 all the drawings are clear and informative. The references to each chapter are relevant, up to date but perhaps largely restricted to the American literature. A disturbing trend is the habit of referring to work published in innumerable symposia or those very expensive, glossy, multi-authored American books that are flooding the market. Often these chapters contain nothing that has not already been published by the author in a recognized journal. For the trainee, the original published paper is infinitely more useful and accessible: the book may not be available at all in his library. Too many of the references are examples of unabashed name dropping (personal communications) but the Blue Riband must surely go to the author of chapter 46, who quotes his own name in the list of references followed by the communication that never was: ‘Unpublished letter to editor. PIast. Reconstr. Surg. 1979’. There are several unfortunate mis-spellings of well known names such as Rhomberg, Clelland, Villain and Jacque Joseph. Strange new adjectives appear like the ‘retruse columella’ or verbs like ‘enkindle’. A technique for removing tattoos with rock salt and abrasion is described as ‘sialabmsion’. ‘Salabrasion’ is surely what the author intended. ‘Spit and polish’ is all very well for cleaning a Sam Browne belt or the Presidential chain of office: I cannot imagine it doing much good to tattoos. Incidentally in the index to the book we find yet another spelling: ‘Silabrasion’. The mediaeval scholars were very wise to chain their precious books to their library furniture. This book is such a mine of information that it, too, needs watching. All my copies of the earlier editions of Grabb and Smith ‘went walkies’ remarkably auickly. If this new edition suffers the same fate it w& just go to show how good a book it is! MICHAEL N. TEMPEST