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Abdominal wound dehiscence
BOOK REVIEWS George Johnson, Jr., MD, Book Review Section Editor
Reoperative
vascular
surgery
Hugh Trout III, Ralph DePalma, Joseph Giordano, eds. Monticello, Marcel Dekker, Inc., 376 pages, $89.00. This text is another in the growing family of publications directed to the needs of the contemporary vascular surgeon. Its appearance is timely because of the subject matter, that of reoperative surgery, an understanding of which is becoming increasingly important as the proportion of these patients in vascular surgical practice gradually increases. The editors have accumulated a seriesof topics that are generally recognized as problem areas in the field of reoperative vascular surgery, and although they have adopted the multiple contributor method, a senseof fluidity has been achieved by ensuring that a common approach is used for discussion of each of the topics. The introductory chapter in particular contains a very comprehensive discussion of the whole topic of reoperative vascular surgery, with an emphasis on the general principles involved. This servesas an appropriate springboard for the subsequent more detailed presentations. The appeal of the text is enhanced by the quality of the contributors and the personalized style, in which the approach used by each author to deal with particular problems is presented rather than using the less informative, but more traditional, literature-gleaning method. This approach is particularly well used in the chapters on recurrent varicose veins, graft infections, and reoperative aortic surgery, each of which in its own way contains some very useful practical management hints. The single feature detracting from the overall quality of the text is the inclusion of a chapter on the role of myocardial revascularization in patients undergoing peripheral vascularreconstruction. The pertinence of this particular topic to the issue of reoperative vascular surgery is somewhat obscure and adds little to a discussion of the issue of reoperative vascular surgery. In addition, the sequence of chapterscould perhaps have been better arranged so that individual issuessuch as aortic surgery, lower extremity revascularization procedures, and reoperative venous surgery were grouped together to facilitate quick reference. However, overall the text should be a useful addition to the library of the practicing vascular surgeon. Brian L. Thiele, MD Hershey Medical Center
Abdominal
wound
dehiscence
Galen V. Poole, Jr., MD, Mount Kisco, 1987, Futura Publishing Company, 129 pages, $24.50. This short monograph by a single author is a comprehensive summary of abdominal wound dehiscence. Al-
though the title suggests a topic of importance only to surgeons who operate within the abdominal cavity, the information contained in this book is useti to surgeons in all specialties. The text is very well organized with each chapter having appropriate titles and subtitles. An attractive technical layout of the book is complemented by printing that is clear and easily read. The author’s writing style is relaxed and lucid. Illustrations and tables are simple and support the text well. References are provided in adequate numbers and include many classicarticles along with appropriate current literature. The major value of this book is found in two chapters that thoroughly review, analyze, and discussthe many systemic and local factors related to wound healing and those that contribute to failure of healing resulting in wound dehiscence. These ex’cellent chapters present numerous concepts and technical considerations concisely and support conclusions and recommendations by extensive references. A short chapter dealing with special problems in wound dehiscenceseemsalmost an afterthought asit briefly reviewstenorrhaphy disruption, bronchopleural fistula, enteric anastomotic dehiscence,and arterial pseudoaneurysm. The author usesthese diverse surgical wounds to reinforce the importance of excessivetension, technical errors, poor blood supply, and inf:ction in failure of wound healing. This is an important and practical book. It is a clinically directed review of abdominal wound dehiscenceand a thorough analysisof contributing factors. Application of the concepts presented by Dr. Poole should minimize problems with wound healing and reduce the incidence of wound dehiscence. As such it is of tnajor interest to abdominal surgeons and is especiallyusefL1 and appropriate for residents in the early stagesof their surgical education. Robert D. Groom, II& MD University of North Carolina
Stewart’s
operative
at Chapel Hill
urology,
2nd ed., 2 ~01s.
A. C. Novick, S. B. Streem, J. E. Pontes, eds. Baltimore, 1989, Williams and Wilkins 832 pages, $195.00. Stewads Operative Urology has become well recognized in the field sincethe publication of the first edition in 1975. The second edition has been extensively revised and rewritten. Considerable space in the book is devoted to renovascular surgery. The chapter on basic techniques of vascular surgery (written by Banowsky) is quite comprehensive with details on vascularinstrumentation, sutures, and many fine points of vascular technique. Trainees and established practitioners will find many useful hits and much information in this chapter. Additional sections are devoted to conven599
Reoperative
vascular
surgery
Hugh Trout III, Ralph DePalma, Joseph Giordano, eds. Monticello, Marcel Dekker, Inc., 376 pages, $89.00. This text is another in the growing family of publications directed to the needs of the contemporary vascular surgeon. Its appearance is timely because of the subject matter, that of reoperative surgery, an understanding of which is becoming increasingly important as the proportion of these patients in vascular surgical practice gradually increases. The editors have accumulated a seriesof topics that are generally recognized as problem areas in the field of reoperative vascular surgery, and although they have adopted the multiple contributor method, a senseof fluidity has been achieved by ensuring that a common approach is used for discussion of each of the topics. The introductory chapter in particular contains a very comprehensive discussion of the whole topic of reoperative vascular surgery, with an emphasis on the general principles involved. This servesas an appropriate springboard for the subsequent more detailed presentations. The appeal of the text is enhanced by the quality of the contributors and the personalized style, in which the approach used by each author to deal with particular problems is presented rather than using the less informative, but more traditional, literature-gleaning method. This approach is particularly well used in the chapters on recurrent varicose veins, graft infections, and reoperative aortic surgery, each of which in its own way contains some very useful practical management hints. The single feature detracting from the overall quality of the text is the inclusion of a chapter on the role of myocardial revascularization in patients undergoing peripheral vascularreconstruction. The pertinence of this particular topic to the issue of reoperative vascular surgery is somewhat obscure and adds little to a discussion of the issue of reoperative vascular surgery. In addition, the sequence of chapterscould perhaps have been better arranged so that individual issuessuch as aortic surgery, lower extremity revascularization procedures, and reoperative venous surgery were grouped together to facilitate quick reference. However, overall the text should be a useful addition to the library of the practicing vascular surgeon. Brian L. Thiele, MD Hershey Medical Center
Abdominal
wound
dehiscence
Galen V. Poole, Jr., MD, Mount Kisco, 1987, Futura Publishing Company, 129 pages, $24.50. This short monograph by a single author is a comprehensive summary of abdominal wound dehiscence. Al-
though the title suggests a topic of importance only to surgeons who operate within the abdominal cavity, the information contained in this book is useti to surgeons in all specialties. The text is very well organized with each chapter having appropriate titles and subtitles. An attractive technical layout of the book is complemented by printing that is clear and easily read. The author’s writing style is relaxed and lucid. Illustrations and tables are simple and support the text well. References are provided in adequate numbers and include many classicarticles along with appropriate current literature. The major value of this book is found in two chapters that thoroughly review, analyze, and discussthe many systemic and local factors related to wound healing and those that contribute to failure of healing resulting in wound dehiscence. These ex’cellent chapters present numerous concepts and technical considerations concisely and support conclusions and recommendations by extensive references. A short chapter dealing with special problems in wound dehiscenceseemsalmost an afterthought asit briefly reviewstenorrhaphy disruption, bronchopleural fistula, enteric anastomotic dehiscence,and arterial pseudoaneurysm. The author usesthese diverse surgical wounds to reinforce the importance of excessivetension, technical errors, poor blood supply, and inf:ction in failure of wound healing. This is an important and practical book. It is a clinically directed review of abdominal wound dehiscenceand a thorough analysisof contributing factors. Application of the concepts presented by Dr. Poole should minimize problems with wound healing and reduce the incidence of wound dehiscence. As such it is of tnajor interest to abdominal surgeons and is especiallyusefL1 and appropriate for residents in the early stagesof their surgical education. Robert D. Groom, II& MD University of North Carolina
Stewart’s
operative
at Chapel Hill
urology,
2nd ed., 2 ~01s.
A. C. Novick, S. B. Streem, J. E. Pontes, eds. Baltimore, 1989, Williams and Wilkins 832 pages, $195.00. Stewads Operative Urology has become well recognized in the field sincethe publication of the first edition in 1975. The second edition has been extensively revised and rewritten. Considerable space in the book is devoted to renovascular surgery. The chapter on basic techniques of vascular surgery (written by Banowsky) is quite comprehensive with details on vascularinstrumentation, sutures, and many fine points of vascular technique. Trainees and established practitioners will find many useful hits and much information in this chapter. Additional sections are devoted to conven599