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Lower extremity amputation
BOOK REVIEWS George J o h n s o n , Jr., M D , B o o k R e v i e w S e c t i o n E d i t o r Atlas of bedside procedures T. J. Vander Salm, B. S. Cutler, H. B. Wheeler, eds. Boston, 1988, Little, Brown and Co., 525 pages, $35.00. This is the second edition of an atlas intended for the instruction of residents, medical students, and other medical personnel involved in the application of or in assistance with common and sometimes uncommon bedside procedures. It may also be an excellent reference book for emergency departments, clinics, or clinical skills courses in medical school. With the exception of Dr. Lazar Greenfield's chapter on vena cava filter placement, all contributing authors are either current or past members of the faculty of the University of Massachusetts Medical School. An outline format with many line drawings for clarification allows the succinct presentation of one technique in each chapter. No inference is made as to the superiority of a given technique; those illustrated were simply felt by the authors to be safe and reliable when performed as described. Each chapter begins with the indications and/or contraindications for a given procedure, a list of the necessary equipment, and appropriate preparation indnding description of landmarks and positioning techniques. The descriptions are thorough and well illustrated. Sufficient detail is provided to understand and carry out the procedures. Associated complications, including methods to prevent them follow, and the chapters end with an adequate yet not exhaustive bibliography. The brevity of the authors' format does preclude discussion of the anatomic and physiologic particulars that favor a given technique when more than one exists. The reader trying to master a new [invasive] technique is in a high acuity "window." A short discussion based on anatomic relationships or practicality with regard to postprocedure nursing care, etc., would be easily retained and often a valuable adjunct. The range of topics covered include, general surgery, vascular, intensive care medicine, cardiac, thoracic, gastrointestinal, urology, renal, gynecology, and orthopedics. Various venous and arterial access techniques are described. The first chapter is devoted solely to the Seldinger technique; added since the first edition. Other chapters include, Swan-Ganz and temporary pacemaker placement, airway management techniques, feeding tube placement, and multiple needle biopsy techniques for a variety of organs. There are 40 chapters in all. Levels of difficulty vary from peripheral venous cannulation to caval filter placement requiring fluoroscopic assistance, to administration of intravenous regional anesthesia. The material covered in this atlas is of sufficient breadth to make it an excellent reference book. Its best application will likely be as a general teaching guide in the emergency department setting, for residents and medical students beginning their clinical years, and as a quick review for the 708
nonnovicc for whom a refresher is in order before pcrforming a procedure only infrequently practiced. Kevin D. Nolan, MD, MPH North CarolinaMemorial Hospital
Lower extremity amputation Wesley S. Moore, James M. Malone, eds. Philadelphia, 1989, W. B. Saunders Company, 368 pages, $65.00. This multianthored textbook is well organized and indexed, and subheads are well written. References are adequate and reasonably up to date. The book incorporates technical, social, economic, educational, and behavioral intervention into an integrated treatment regimen. The book reflects the personal intellectual input of the two distinguished editors known for their expertise in the field of amputation. They have selected known, recognized authorities as contributors who have presented updated evaluations and statements. Indications, assessment, techniques, complications, and extended necessary information on rehabilitation, especially the use of groups as a treatment approach, are presented. The audience for this book includes the general and vascular surgeon, and the orthopedic surgeon who does amputations. The text is so superb as to inform and share information crossing disciplines in an effective fashion, therefore providing interest for the social worker and other members of the rehabilitation team. The authors review methods of assessment for determination of level of amputation in a lucid, readable fashion. Those chapters on technique include important tips; the illustrations are clear and depict important anatomic considerations. Special praise should be directed to Gallo and Brown for their chapter on anesthetic considerations (every surgery resident should read it), and Iacono and Linford for their chapter on pain management after amputation. These chapters make the book outstanding by themselves. The references at the end of some chapters are inconsistent and reflect the only major weakness of editing; for example, some are alphabetical and numbered, some are in order of appearance and nurnbered, and Chapter 13 has no numbers, possibly reflecting the degree of effort. The sections on prosthetic fitting, timing, varieties of prosthesis, and fixnctional limitations of prostheses are clear and appropriate for the surgical audience. The chapter on energy expenditure is appropriately informative, but has only one reference in 1985 with most from the late 1970s. Similarly, the chapter on biomechanics references from 1985 are from texts and most are not of recent vintage. The content of both offers a "concise explanation of what the s u r g e o n . . , needs to k n o w . . . "
Volume l0 Number 6 December 1989
Maybe the surgeons need to know more or be more up to date. Moore and Malone have produced a sound, comprehensive, valuable text of current practice in amputation surgery. I recommend its use in the instruction of trainees and as a refresher for physicians who care for the patient with lower extremity amputation. Morris Kerstein, MD Tulane Medical School
C o m m o n problems in vascular surgery David C. Brewster, MD. Chicago, 1989, Year Book Medical Publishers, 469 pages, $48.00. Amid the proliferation of large, encyclopedic texts on vascular surgery, this compact volume presents a different and useful perspective. The author has selected 64 brief clinical scenarios of commonly encountered vascular problems. The book covers six broad areas--cerebrovascular, aneurysms, occlusive disease, trauma, venous, and miscellaneous topics. Each case is then analyzed and discussed by an invited "consukant," who describes an approach to the problem based on personal experience and practice. The contributors are recognized authorities, who generally have significant publications in the subject area to support their management plan. The topics are carefully selected and fialfill the author's goal of addressing "common problems." As one would expect in any mukiauthored work, there is some variability
Book Reviews 709
in the content and quality of discussion, but each chapter clearly represents the personal approach of an experienced practicing surgeon. Several topics are noteworthy in their concise, thorough analysis. "Acute leg ischemia secondary to intraaortic balloon pump insertion," discussed by Curler, is required reading for all who deal with these patients. Mannick develops a conservative, logical, and comprehensive approach to '~The patient with clandication alone." The complicated problem of "Associated renal artery disease in preoperative aneurysm patient" is simplified and made clear by Dean and Tribble. Some topics, including "Vascnlogenic impotence" and "Bleeding esophageal varices" might be of limited interest to the average reader. This 450 page book is well constructed, durably bound, and printed on good-quality paper. Line drawings are sharp and, with few exceptions, well chosen. Arteriograms are reproduced with clarity. The computergenerated 9- or 10-point type could benefit from a bolder face. At a time when texts can cost well over $200, this volume is an excellent value. Common problems in vascular surgery is highly recommended to residents or fellows in training, and to all pracricing vascular surgeons. Robert C. Batson, MD Clinical Professorof Surgery Louisiana State UniversitySchool ofMedicine
nonnovicc for whom a refresher is in order before pcrforming a procedure only infrequently practiced. Kevin D. Nolan, MD, MPH North CarolinaMemorial Hospital
Lower extremity amputation Wesley S. Moore, James M. Malone, eds. Philadelphia, 1989, W. B. Saunders Company, 368 pages, $65.00. This multianthored textbook is well organized and indexed, and subheads are well written. References are adequate and reasonably up to date. The book incorporates technical, social, economic, educational, and behavioral intervention into an integrated treatment regimen. The book reflects the personal intellectual input of the two distinguished editors known for their expertise in the field of amputation. They have selected known, recognized authorities as contributors who have presented updated evaluations and statements. Indications, assessment, techniques, complications, and extended necessary information on rehabilitation, especially the use of groups as a treatment approach, are presented. The audience for this book includes the general and vascular surgeon, and the orthopedic surgeon who does amputations. The text is so superb as to inform and share information crossing disciplines in an effective fashion, therefore providing interest for the social worker and other members of the rehabilitation team. The authors review methods of assessment for determination of level of amputation in a lucid, readable fashion. Those chapters on technique include important tips; the illustrations are clear and depict important anatomic considerations. Special praise should be directed to Gallo and Brown for their chapter on anesthetic considerations (every surgery resident should read it), and Iacono and Linford for their chapter on pain management after amputation. These chapters make the book outstanding by themselves. The references at the end of some chapters are inconsistent and reflect the only major weakness of editing; for example, some are alphabetical and numbered, some are in order of appearance and nurnbered, and Chapter 13 has no numbers, possibly reflecting the degree of effort. The sections on prosthetic fitting, timing, varieties of prosthesis, and fixnctional limitations of prostheses are clear and appropriate for the surgical audience. The chapter on energy expenditure is appropriately informative, but has only one reference in 1985 with most from the late 1970s. Similarly, the chapter on biomechanics references from 1985 are from texts and most are not of recent vintage. The content of both offers a "concise explanation of what the s u r g e o n . . , needs to k n o w . . . "
Volume l0 Number 6 December 1989
Maybe the surgeons need to know more or be more up to date. Moore and Malone have produced a sound, comprehensive, valuable text of current practice in amputation surgery. I recommend its use in the instruction of trainees and as a refresher for physicians who care for the patient with lower extremity amputation. Morris Kerstein, MD Tulane Medical School
C o m m o n problems in vascular surgery David C. Brewster, MD. Chicago, 1989, Year Book Medical Publishers, 469 pages, $48.00. Amid the proliferation of large, encyclopedic texts on vascular surgery, this compact volume presents a different and useful perspective. The author has selected 64 brief clinical scenarios of commonly encountered vascular problems. The book covers six broad areas--cerebrovascular, aneurysms, occlusive disease, trauma, venous, and miscellaneous topics. Each case is then analyzed and discussed by an invited "consukant," who describes an approach to the problem based on personal experience and practice. The contributors are recognized authorities, who generally have significant publications in the subject area to support their management plan. The topics are carefully selected and fialfill the author's goal of addressing "common problems." As one would expect in any mukiauthored work, there is some variability
Book Reviews 709
in the content and quality of discussion, but each chapter clearly represents the personal approach of an experienced practicing surgeon. Several topics are noteworthy in their concise, thorough analysis. "Acute leg ischemia secondary to intraaortic balloon pump insertion," discussed by Curler, is required reading for all who deal with these patients. Mannick develops a conservative, logical, and comprehensive approach to '~The patient with clandication alone." The complicated problem of "Associated renal artery disease in preoperative aneurysm patient" is simplified and made clear by Dean and Tribble. Some topics, including "Vascnlogenic impotence" and "Bleeding esophageal varices" might be of limited interest to the average reader. This 450 page book is well constructed, durably bound, and printed on good-quality paper. Line drawings are sharp and, with few exceptions, well chosen. Arteriograms are reproduced with clarity. The computergenerated 9- or 10-point type could benefit from a bolder face. At a time when texts can cost well over $200, this volume is an excellent value. Common problems in vascular surgery is highly recommended to residents or fellows in training, and to all pracricing vascular surgeons. Robert C. Batson, MD Clinical Professorof Surgery Louisiana State UniversitySchool ofMedicine