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Book reviews

Anesthesia and Perioperative Care of the Combat Casualty. Textbook of Military Medicine. Part IV - Surgical Combat Casualty Care R. Zujtcliiik, R. E Rellaniy orid C. M. Gr(indiJ (eds) . 287 x 220 I ? I I ? ~ . Pp. 1931. Illustrated 199.5. Eicoma, M+i.slr ington: TMM Pi I hlica tior 1s. Price I I ot siryplic~d.

This large volume. comprising over 1930 p;igcs. deals with anaesthetic and surgical techniques relevant to trauma for military and civilian proctitioncrs. An interesting historical overview moves on to a vast archive built up over ISOyears quoting multinational worldwide experience. Chapters arc devoted to airway management. fluid resuscitation and physiological monitoring. Special reference is made t o field deployment and mobile hospitals. Military anaesthetic machines. techniques and drugs are covered in detail and there are specilic sections devoted to close circuit inhalation. intravenous anaesthesia and transfusion policy. The illustrations are beautifully presented; the anatomical three-dimensional coloured prints which enhance the text about regional anaesthetics are outstanding. iis arc the plates of ballistic and burn wounds o f many parts of the body. I recommend any surgical trainee to peruse these 170 pages, as important basic surgical principles are clearly demonstrated. Metabolic derangements. nutritional support. multiple organ failure. ventilatory management and renal failure. have chapters to themselves. and the various forms of military medical evacuation make for interesting reading. Problems such as hypothcrmia arid chemical ngcnts arc discussed. giving insight into dealing with mass casualties in unpleasant conditions. Finally. there is ;I brief history o f anaesthesia, from the time of Joseph Priestly to the present day. This volume is a welcome addition to trauma management. The authors have succeeded in crystiillizing a vast field into an enjoyably readable form. I commend it to all those with an interest in the care of the injured.

B. A. Price

MDHU Frirnley Park Ilospiral Portsnioitth Road Camberlev GU16 5UJ UK

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The Basic Science of Vascular Disease - A. A! Sidayv, B. E. Sumpio and R. (7. DePalma (eds). 285 X 220 mm. Pp. 904. Illitstrated 1997. Armonk, New York: Futuru Pirblisking Company. US$I 75.

Three distinguished editors have assemhled an all-star cast from American academic vascular surgery to produce a wide-ranging. large textbook o f basic science considerations in vascular practice. This text probahly has no competitor at present, although one is forthcoming from Cambridge University Press. The book is divided into three sections. The first section covers the embryology, physiology and anatomy of the arterial venous and lymphatic system. Of special interest is the chapter o n 'Molecular Biology and the Vascular Surgeon' by Peyman and Surnpio. Dr Surnpio is probably the best qualified surgeon scientist to write on this subject and the chapter bears his imprint. However, I think that to get through this chapter one needs to have a fairly advanced background in molecular biology, making i t unsuitable for the beginner. The second section is entitled 'The Essential Tools for the Treatment o f Vascular Disease' and comprises a slightly mixed bag, ranging from the function of endovascular devices and vascular grafts, to blood rheology and a discussion on lipoproteins in vascular disease. There is a chapter on statistics by Sushi1 Gupta which is very

curious: i t is essentially a simple primer of statistical techniques written by a surgeon and contains only a single example from the vascular literature. The third section is another mixed bag entitled 'The Science o f Selected Titles' and, again. the subject matter ranges from a discussion of thc genetics of aortic aneurysm formation to the mechanics of foot ulceration in diahetic neuropathy.

1 feel that the editors hiivc had ;I very difficult job i n trying to range broadly over the whole spectrum of conditions that arc met in vascular practice. Thcy havc certainly not left any significant gaps but have had to sacrifice ;I ccrtain amount of depth in return. I 'hc chaptcrs on v;iscuI;ir cell biology are very worthwhile and the many isolated chiiptcrs o n misccllancous topics ;ire. for the most part, o f good quality. These serve a s a collection o f essays to spark initial intcrcst riitlicr than as the support for a n y form of sustained study. I recommend this book: i t is the only one o f its kind. I t ;Iddresses the important biological issues in vascular disease. I n the UK. where the majority of vascular clinicians arc still surgically trained. it is important n o t to lose sight o f hasic considerations in this discasc. 1 recommend this volume for every established vascular unit. particularly [hose that ;ire involved i n lahor;itory-b;ised research.

P. Chan C'lir 1 i c .rr 1 Scicr r c i ~ C c p r I rrc Nor/ircwr Gi,twrt11 Ho.s/) i /ol Slref/idd S5 7A L! U K

Surgical Diseases of the Spleen J. R. Hiatt. E. H. Pliillips tirid L. Morgc.ri.stcwr (c8d.s). 240 X 160 rniii. Pp. 2X5. Illrrstratcri. 1997. Ilcitic~lhcr~: Springel: Dhf I98.00.

The spleen has always fascinated surgeons: many spleens were at one time removcd fo r cnjoynicnt rather than bcnclit. This delightful and reudoble book is ; i n cxccllent summary of thc history and practice of splenic surgery. The chaptcrb on trauma and o n laparoscopic splcncctoniy are c r f particular v;ilire. Thc emphasis o n splenic conserv;itioii is ii recurrent and important theme. including good descriptions o f partial splcncctomy. Very full references make this 21 valuable source-hook. Thc opcration descriptions are fully detailed. a s are possible coniplic;itions. Small howel obstruction is listed among thc latter: I would havc added that this is always caused by ii loop of jcjununi bccoming adherent t o the splenic bed. and that th i s can usually hc prevented by tucking the small bowel helow the splcnic flexure. firmly in the lower abdominal compartment. at the conclusion of the operation.

One surprising omission, in the section o n postsplcnectomy infections, is any mention o f bahesiosis. This plasmodia1 infection is associated with a mortality of over SO per cent and occurs almust exclusively after splcncctomy. Ilcath is often duc to i t being mistaken f o r malaria. out o f ignorance. Although rare i t is therefore very important. The commoner form in the USA is due to R. microri and is widespread hut not yet rcportcd from Southern California. The European infection with R. r l i i ~ c q y r i s is more serious; although o n l y 22 cases have been rcportcd I know of one unreported fatal case from thc UK.

J . Spencer

Rqul I'ostgruduure ~l.lcriic~i~l Scliool Ifaniriiersrnirli Ifo.spi ta1 Dir Ctrne Road I~orldon w12 OHS UK

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