surgeon is then able to proceed. There is no need for the assistant tage is such that it is impossible to hold the correct posi- to move from the head of the table as this is a good position from tion for sufficient time. The precaution of leaving the which to render assistance for the subsequent parts of the opera- head of the table clear is, therefore, strongly recom- tion. mended. The authors feel that the method described rep- resents a logical addition to the inferior pedicle tech- nique since it provides stability of the tissues and there- Discussion fore facilitates accurate dissection. The method described of holding the breast is akin to the basic grip of the ball used by a fast bowler in cricket . References It may therefore be dubbed the bowlers grip. The blood supply of the breast has been demonstrated 1. Robbins TH (1977) A reduction mammaplasty with the areola- to come from perforating arteries from the chest wall [3, nipple based on an inferior pedicle. Plast Reconstr Surg 59:64 4] and it is principally these vessels which nourish the 2. MCC Masterclass Chap 1, p 15. Pub. Weidenfeld and Nichol- pedicle. The method described for holding the pedicle son (1995) 3. Ribeiro L (1975) A new technique for reduction mammaplasty. minimizes the risk of undercutting its base and therefore Plast Reconstr Surg 55:330 allows for maximum preservation of nipple/areolar com- 4. Courtiss et al. (1977) Reduction mammaplasty by the inferior plex blood supply. pedicle technique. Plast Reconstr Surg 59:500 It is possible to perform the maneouvre from a posi- tion at the side of the table, but the mechanical disadvan- European ~1~ ,,i 0 %na, o, ElflStlC bufgery © Springer-Verlag 1997 Eur J Plast Surg (1997) 20:226 Urken, M.L., Cheney, M.L., Sullivan, M.J., Biller, H.F.: Atlas H~iring, R., Zilch, H. (eds): Diagnose und Differentialdiagnose of regional and free flaps for head and neck reconstruction. in der Chirurgie und benachbarten Fachgebieten (Diagnosis Philadelphia: Lippincott-Raven 1994. 379 pages, US$210.00. and differential diagnosis in surgery and in neighbouring spe- cialties). Vol. I and II, 2nd edition, in German. London, Glasgow, ISBN 0-7817-0197-X. This atlas of flaps is divided into three parts, these being re- Weinheim, New York, Tokyo, Melbourne, Madras: Chapman and gional flaps, free flaps, and nerve grafting and donor sites. Each Hall 1995. 1784 pages. ISBN 3-8621-0002-6. part is then further subdivided. The regional flaps are grouped into The contents of the two volumes, divided into 59 chapters, are muscle and musculocutaneous, cutaneous and fasciocutaneous, written by 91 living contributors (two deceased). There are two and mncosal flaps. The free flap section is divided into muscle main sections: Special diagnostic techniques and special surgery and musculocutaneous flaps, fascial and fasciocutaneous flaps, diseases. This reviewer is simply overwhelmed by the mass of composite free flaps, visceral flaps, and technical considerations surgical information so excellently provided as well as by the le- for free flap transfers. Part three is not subdivided. Each chapter is gal implications concerning the present German law, at times spe- very well-illustrated, utilizing both drawings and cadaver dissec- cifically highlighted. In the concise text, the essential points, and tions for each flap. The neurovascular anatomy is particularly when necessary the team approach, both for diagnosis and thera- well-illustrated and explained thoroughly in the text. Anatomical py, are stressed. All the so diverse chapters, presented in much variations, potential pitfalls, postoperative complications, and unity and clarity, bear the stamp of the two editors, who must be postoperative care are all outlined. At the end of each chapter, congratulated for achieving an immense task. The forward of this there is extensive list of references on each flap discussed. The second edition starts with a well known quotation from Goethe's sections are well-organized, starting out with the most commonly Faust, "Its true, I do know much, however I want to know it all." used flaps, working towards flaps that are less frequently used. In Perhaps this encyclopedic opus of almost 1800 pages is an at- the regional flaps section, the palatal island flap is illustrated, this tempt to present all of the present day's knowledge of the art of illustrates the commitment to thoroughness on the part of the au- surgery. For whom? In the first place, the medical student is ad- thors since this flap is not commonly used, however it could be dressed and the trainee in his first years of rotation through a sur- very useful is certain situations. This is a valuable atlas for anyone gical specialty (what is general surgery?). He will find excellent who is performing reconstruction of the head and neck, it is well- overviews and summaries of the particular field with which he organized, well-illustrated, and thorough. (R.A. Fort6, Southfield) needs to be acquainted. (L. Clodius, Ztirich)
European Journal of Plastic Surgery – Springer Journals
Published: Jul 1, 1997
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