BOOK REVIEWS

Fundamental Techniques of Plastic Surgery and their Surgical Applications. By IAN A. MCGREGOR. Pp. 244, illustrated. (Edinburgh and London: E. & S. Livingstone Ltd. 196o.) £I . IOS.

This book is wri t ten for t he informat ion o f surgeons who are un t r a ined in plastic surgery. T h e first par t describes su tu r ing , free skin graf t ing and ful l - thickness flaps to repair skin defects resul t ing f rom t r auma , infection, neop la sm and the surgeon ' s knife. T h e second part applies these techniques to general and orthopzedic surgical needs with special sections on the hand and eyelids.

For those who are not acqua in ted with the surgery of repair the in fo rmat ion in the first par t will be revealing b u t it could be expanded with advantage. T h e " Z-p las ty " receives considerable at tent ion and poss ib ly too m u c h is accorded to the " tube pedicle ."

T h e second par t is necessar i ly l imited by the author to those repairs wh ich he apparent ly considers to be wi th in the scope o f those who have read the first part. M a n y of the procedures descr ibed should hard ly be advoca ted for per formance by the un t r a ined , for failure would increase defects and d is f igurement enormous ly . T h e dangers of some ra ther elaborate repairs are insufficiently s tressed ; for example , those o f " back cut t ing " rotat ion flaps.

Some c o m m o n problems receive bu t scanty considerat ion, such as the infected fracture wi th loss of skin ; whi ls t considerable space is given to the cross-f inger flap, ye t it is " a flap to be u sed sparingly and only when the indicat ions are clear." T h e contra indicat ions are not d iscussed decisively. T h e free graft of toe sk in is no t described.

T h e at t i tude towards the h a n d is reasonable bu t could be improved. T i s s u e of doubt fu l viability should be given the benef i t of the doubt somet imes and ablat ion deferred, especially w h e n t he experience of the operator is small .

Some il lustrations are d ivorced f rom the text by an interval of several pages : several are of flaps which should not be u n d e r t a k e n by the inexperienced.

More a t tent ion to the f u n d a m e n t a l principles which under l ay the art and craft of plast ic surgical repair work would add to the practical value of such a book as this : so would the inc lus ion of t r ea tmen t of facial fractures, o f wh ich so m a n y know so little.

Some loose t e rms appear : W h i c h is the " fifth finger " ? W h e n does " bony infection " become " bu rned out " ? Is there really a " classical cross-leg posi t ion " ? W h y is the re no men t ion of the complicat ion o f cross-leg work by stiffness o f adjacent joints ?

Considerable t hough t and m u c h hard work has p roduced a book which m a y assist bu t canno t replace the proper educat ion o f surgeons , which is by clinical s tudy , demons t r a t i on and example . T h e un t ra ined shou ld always be encouraged to adopt the s imples t m e t h o d to heal a wound wh ich carries no risk of ex tending the in jury , or of complicat ing the definit ive repair.

The re is no shor t -cu t on t he long hard road of experience and only h a r m can result f r om p rema tu re surgical adventure .

G. H. M.

Peripheral Facial Palsy, Pathology and Surgery. By K. KETTEL. Pp. 34I, with I27 illustrations. (Oxford : Blackwell Scientific Publications. I959.) £6.

As D r C a w t h o m e so apt ly s tates in his foreword, this m o n o g r a p h besides be ing a guide to the l i terature gives an account o f D r Ket te l ' s wide experience in t he surgical t r e a tmen t of facial palsy. I warmly c o m m e n d this book to plastic surgeons. T h e ana tomy, physiology and pathology are fully d iscussed followed by chapters on the more clinical aspects of surgical repair. T h o u g h the p rocedures adopted in mos t plast ic surgery uni ts are not descr ibed the in format ion contained in this book should prove of the greates t value to our specialty.

A. B. W.

Clinical Radiology. The Journal of the Faculty of Radiologists. Vol. XI. No. i. January 196o. Editor: DAVID SUTTON, M.D., M.R.C.P., F.F.R. Quarterly Subscription £3.3 s- per annum.

T h e Journal o f the Facul ty o f Radiologists now appears u n d e r a new name. W i t h the increas ing circulat ion and the in ternat ional s ta tus enjoyed by the Journa l the Counci l decided to apply the title " Clinical Radiology." T h e policy is to p resen t scientific papers o f in teres t to diagnost ic radiologists and to radiotherapis ts . W i t h the new title and fo rmat there is an accompanying change o f publ ishers . I feel sure the Counc i l of the Facul ty o f Radiologists will have very happy and product ive associations with M e s s r s E. & S. Livings tone Ltd .

A. B. W.

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