Fundamental techniques of plastic surgery

3oo

BRITISH

JOURNAL

Elective Incisions and Scar Revision. and Co., Boston 1973.)

OF PLASTIC

SURGERY

By ALBERT F. BORGES. Pp. 315.

(Little,

Brown

This book sets out to highlight cosmetic limitations in the healing of scars, to trace as far as possible the causes of failure and to suggest ways in which failure can be avoided or corrected. The early chapters discuss factors which have a bearing on the result, such as the relationship of a cut to relaxed skin tension lines, the length and shape of the wound and the cellular activity of healing; there is only scant reference to keloid and the problem of its treatment is not included. There is good advice regarding caution in prognostication of the end result, and the historical aspects of research into scar formation are well presented. The major part of the book is concerned with surgical technique which is given in great detail with good illustrations. The author’s main theses are the importance of the choice of position and direction in elective incisions, and the use of flaps in scar revision to reduce the length of straight scars and to utilise relaxed skin tension lines as freelv as oossible. This is achieved bv Z plasty, multiple Z plasty, W plastv, VY advancement and ingenious corn&nations of these. The scientific anti -mathematical pr&entafion bf these flaps is the most valuable part of the book and will be of assistance to all surgeons particularly those Some may consider that too much complexity is inmainly concerned with the treatment of trauma. troduced in the treatment of the simpler scars illustrated, but experienced surgeons will have to admit that they have been disappointed from time to time with the results of attempts to deal with such scars by simple methods. The inherent difficulty in the situation is that a bad result in a multiple flap repair is usually more distressing to a patient than a bad result from simple suture. The author makes a good case for his contention that a bad result from multiple flaps is rarer. DAVID MATTHEWS

Fundamental Techniques of Plastic Surgery. By IAN A. MCGREGOR. Fifth Edition. (Edinburgh and London: Churchill Livingstone, Pp. x+301 with 189 illustrations. 1972.) Price k4.00. This is the fifth edition of McGregor’s deservedly popular book. Although it is only 4 years since the previous edition, there are a number of important additions and changes of emphasis. This is particularly so in relation to the increased knowledge of skin flaps and particularly to flaps with an axial vascular pattern which have become increasingly used. Although this is essentially a practical book, Mr McGregor has devoted considerable attention to the underlying physiological basis behind the planning and the use of these flaps. This will be of great value to the trainee surgeon in his understanding of the use and the limitations of these procedures. There still remain some minor defects from nrevious editions. For instance, the section on keloids and hypertrophic scars is still not as clear as it should be. In spite of the inevitable increase in price which all books have suffered, this still remains excellent value. I. F. K. MUIR