BOOK

LYMPHOEDEMA. Edited by LEO CLODIUS. (Stuttgart: Georg Thieme, 1977,)

REVIEWS

Pp. 192, with 35 tables and 158 illustrations.

one of the most intractable problems which face the . . . . . “.. _ . . Lymphoedema in its various forms still presents plastic surgeon. The dynamics of fluid interchange in hvmg tissue are not yet tully understood and present many controversial features. Further elucidation of these mechanisms will illuminate not only the treatment of lymphoedema but also our knowledge of the complex local circulatory factors concerned whenever tissue is transplanted. These problems are thus of general interest byond the treatment of lymphoedema itself, and for this reason the publication of this excellently produced monograph is greatly to be welcomed.

Under the editorship of L. Clodius, 17 authors from various countries contribute sections on lymph flow physiology and pathology, conservative methods, and a variety of surgical procedures in treatment. The subject in these respects is well covered, and there is a very good bibliography. Some of the sections were presented as lectures at the Congress of Lymphology in Tucson. As a collection of papers, the addition of a chapter on classification of types and differential diagnosis would have perhaps served to unify this volume axid make it a more comprehensive work. In some of the sections it is impossible to determine what type or types of lymphoedema has been treated, and this makes the results diflicult to assess. The emphasis in both the experimental and the surgical aspects tends to fall on obstructive types of lymphoedema, and there is little to be gleaned of the aetiology of idiopathic lymphoedema (praecox). Satisfactory results are claimed from a variety of different procedures, and it is interesting to see the revival of the Gillies flap transfer from arm to leg in the treatment of filarial patients, an operation which carries the risk of inducing lymphoedema of the upper extremity in praecox patients.

This volume is well worth the scrutiny of all who have to deal with these difficult problems. Nor surprisingly, many questions are left unanswered and much is controversial; but if this book stimulates new thought and renewed research, it will have served its purpose well.

JOHN WATSON

TRANSACTIONS OF THE SIXTH INTERNATIONAL CONGRESS OF PLASTIC AND RECONSTRUCTIVE SURGERY. Edited by DANIEL MARCHAC and JOHN HUESTON. Pp. XXVI+ 735 with 538 illustrations.

This volume contains a summary of the proceedings of the Sixth International Plastic and Reconstructive Congress and a representative selection of papers has been included. The volume is much smaller than those following the previous two Congresses and the aim stated in the preface of presenting the trends in as clear and concise a form as possible has been achieved.

As with all such publications, one of the main interests is in the exposition of currently important topics. This volume contains a large number of papers on microsurgery, and the portion on crania-facial deformities constitutes more than twice the coverage given to any other subject.

There are several interesting symposia, the conclusions of which are presented in a concise form and these are perhaps the best parts of the volume. These symposia cover a wide range of topics, including: the use of omenturn; biochemistry and biomechanics of scar tissue; thumb reconstruction; radio-dermatitis; the surgery of the eyelids in facial palsy; and fronto-orbito-nasal trauma. On aesthetic surgery, problems of blepharoplasty and chin surgery are discussed and, on burns, new concepts in skin transplantation and the various techniques of excision and covering.

As with any such volume, the standard of the papers is very widely variable and some are excellent, whereas a few are poorly supported by references. However, the overall standard is good. The book is one more to be dipped into selectively rather than read as a whole, and should be a part of any plastic surgical library, although probably it does not merit a place on the individual surgeon’s bookshelf. Anyone who does not have access to this volume need not feel cheated, as virtually all of the more significant papers have been published elsewhere, either prior to or subsequent to this Congress.

w. H. REID

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