Flaps: Practical Reconstructive Surgery

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Review by L Flood
Middlesborough, UK

You do get a lot of book for your money here, as well as online videos (illustrating 16 different flap techniques), which we have come to expect, and even an e-version of the book itself (provided you do not overlook the inconspicuous little slip with your access code).

I was initially unsure of the relevance to our readers, but was pleasantly surprised to see just how much the head and neck features here. Perhaps as it is 'on show', in Western society anyway, the face, neck and scalp are prime sites for repair work. As I keep scratching at that rolled edge lesion on my left cheek, this reminded me to contact my local experts before the week is out.

The editors of this multi-author text hail from Liverpool, Swansea and Atlanta, Georgia. The authors generally are plastic and reconstructive surgeons, but there is the odd (and I do mean that in the nicest possible way) ENT contributor to be found, especially on nasal reconstruction.

I was encouraged that the first chapter 'Basic Principles' almost exclusively applied these to the face and scalp, to illustrate techniques. The next chapter made microvascular anastomosis look like child's play, and, later, I was struck at how colourful the imaging, once so monochrome, has now become. The text is very up-to-date throughout, with some leading edge developments covered.

I then skipped through breast and perineal reconstruction, but got to Chapter 6, 'Current Options for Head and Neck Reconstruction'. This had superb illustrations of some excellent outcomes, following challenging surgery. Post-operative monitoring of free flaps has come a long way from the days when one's thumb impression was the sole clue as to perfusion, clearly. Indeed, there even seems a place for smart phone technology!

Section II is entitled 'Reconstructive Flaps A-Z' and, cleverly, offers just that. There are 40 chapters, arranged alphabetically, from 'Anterolateral Thigh...' to 'Vertical or Oblique...'. How did the editors resist just sticking in 'Z-plasty'? The axial deltopectoral flap of my youth is still there, and the pectoralis major myocutaneous flap of my senior registrar days is unchanged, but the reconstructive armamentarium is massively expanded now.

Section II, 'Masterclasses in Reconstructive Flaps', really is dominated by complex facial reconstructions and is of great relevance to the head and neck trainee, although few of us are yet ready to tackle Chapter 54 on facial transplantation. This book is obviously aimed at our colleagues in plastic surgery, but a major portion of its content is of great value to those involved in head and neck respective surgery, whether trainee or expert. A book this size probably belongs in the hospital, rather than in the ENT or maxillofacial surgery departmental library, but that e-copy is attractive!

Amazon Link: Flaps: Practical Reconstructive Surgery
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