BOOK REVIEWS 299

R e p a i r a n d R e c o n s t r u c t i o n i n t h e O r b i t a l R e g i o n . By JOHN CLARK MUSTARDI~. Pp.

x v + 3 8 2 , w i t h 313 i l lus t ra t ions . ( E d i n b u r g h : E. & S. L i v i n g s t o n e L td . 1966.) 95s.

M r Mustard6 is to be congratulated on a very well planned and attractive volume describing principles and details of treatment in a region in which precise surgical planning is essential. In his foreword Sir Benjamin Rycroft properly states that, " Not much help can be gained from the standard text books, and this new book, therefore, has become necessary."

The book is much larger and its scope broader than is the highly selective volume by Wendell Hughes (Reconstructive Surgery of the Eyelids, 1943). It differs again from this earlier work in that it is " a practical guide to plastic surgery in the orbital region " thus containing no history and no descriptions of operations which the author does not himself use and recommend. Its essentially practical nature also means that sometimes surgeons' names commonly associated with well known operations are omitted, e.g. Mclndoe when burnt eyelids are grafted.

This is a technical book, it describes the diagnosis of abnormal anatomy and congenital defects but excludes special pathology. The illustrations are many and of good quality, particularly the line drawings. Some operative sequences are shown in colour. The chapter content is neatly organised making quick reference to a particular defect easy. The last chapter describes techniques for taking skin and mucosal grafts and for raising skin flaps but since this book is devoted to one of the regions included in the specialty of plastic surgery it does seem probable that those using the book will not often turn to these pages.

This new book must find many readers amongst the plastic and ophthalmic surgeons throughout the world. For them it could become a standard book of reference, particularly as the author has practised as both a consultant eye and a consultant plastic surgeon.

A. F. W.

T h e B u r n W o u n d . By C a p t a i n STANLEY E. ORDER, M . D . , a n d Colone l JOHN A. MONCRIEF,

M . D . Pp . 72, w i t h 34 figures. (Spr ingf ie ld , I l l i n o i s : Cha r l e s C. T h o m a s . 1965. )

Seemingly the purpose of this monograph is to emphasise the clinical and therapeutic significance of histo-pathological and bacteriological studies of the wound which is created by burning. The clinical emphasis is upon infection with Pseudomonas aeruginosa, no other organism being considered except that staphylococci and proteus are mentioned only to be dismissed, and topical therapy with Sulfamylon, supplied by Sterling Winthrop, Rensselaer, New York, is singularly extolled.

The short-term (three to four days) repeated application of homografts, even of heterografts, is advocated to expedite healing by stimulating epithelial growth in partial thickness burns and in establishing the granulation tissue barrier against bacterial invasion, without the disadvantage of the prolonged, piecemeal disintegration of the retained homograft. Yet, from Figures IO and 32, which are identical, it would appear that a partial thickness burn of loin and buttock took fifty-one days to heal, and then incompletely ?

The angiographic studies of burned skin of rats are good and very well illustrated with acknowledg- ment to several journals in which they have appeared or are to be published. The terminology o f " second degree," " deep second degree " and " third degree " burns is explained and defined. Two tables of experimental comparison of healing under several conditions, including hyperbaric oxygenation, are of interest. The third table, a diagram of the progressive patterns of fatality from Burn trauma to the Unknown, though sagittarially resplendent, is unconvincing.

Typographically it is extravagant, considering its "message." Emphasis, in both bold capitals and in italics, is overdone and loses its purpose because it " Like the lady doth protest too much, methinks ! "

A monograph with its points of value ; no price being quoted. Only one infecting organism is predominantly considered, only one proprietary panacea is advocated.

G. H. M.

P l a s t i c S u r g e r y fo r N u r s e s . By IAN A. MACGREGOR, a n d W. HENRY REID. Pp. 128, w i th

330 i l lus t ra t ions . ( E d i n b u r g h : E. & S. L i v i n g s t o n e L td . 1965. ) I5S.

Textbooks on this subject are few and one so well illustrated is a welcome addition to this branch of nursing.

The authors emphasise that this is not a book on plastic surgery nursing. It is, however, unfortunate that many small but important details in the care of such patients have been omitted. The inclusion of more detailed nursing care would have benefited those who are caring for such cases outwith specialist units. Some explanations are too detailed and technical and may be difficult for the student nurse to understand, others are too brief and are misleading and even on occasion factually incorrect. The book has many helpful illustrations and it can be recommended to nursing staff responsible for student and graduate nurse teaching.

E. W. R.