BOOK REVIEWS should be ... book a valuable reference, which will increase their understand- ... Heart-Lungand Lung Transplantation" bring us worthwhile in-.
Vol.
2116
No. 5
613
BOOK REVIEWS
should be placed on the salutary effects of enteral feeding. Specific indications for the use of total parenteral nutrition with case examples might also be included. A chapter that reviews the principal factors influencing nutrient utilization by cells (nutrient delivery, cell membrane transport, and intracellular metabolism) and how these various steps are modulated by feeding and stress might also be added. An additional chapter might focus on fat metabolism and the use of specific fatty acids as immunomodulators in critically ill patients. The use of specific case examples illustrating the indications for feeding, nutrient requirements, and the logic behind the decisions would also be valuable. Residents in all phases of training will find this easy to use book a valuable reference, which will increase their understanding of surgical nutrition. WILEY W. SOUBA, M.D. Gainesville, Florida Complications in Thoracic Surgery. Walter G. Wolfe. 319 St. Louis: Mosby-Year Book, 1992. $95.00.
pp.
IT IS impossible in a volume of 319 pages to cover thoroughly all of the complications in thoracic surgery, but Dr. Wolfe has given it his best. The chapter subjects represent a wide spectrum of problems including anesthetic complications, cardiac and renal problems, the hazards of improper positioning of the patient, and complications of radiation therapy, just to name a few. These provide a nice supplement to the expected chapters on complications of pulmonary resections, bronchoplastic procedures, and others. Dr. Wolfe's choice of contributors is a bit unusual and, on balance, admirable. In addition to well-recognized senior people such as Drs. Sealy, Moran, Oldham, and Ramming, he has sought energetic young people in thoracic surgery and related fields to write appropriate chapters. These young people provide new perspectives while they gain the discipline and experience of writing authoritatively and for a wide audience. As with any multi-authored text, there is variation in narrative and illustration. Some of the origiiu"l drawings, especially those in Chapter 27 on tracheal fistulas, are especially clear and pleasing. Some others do not meet those standards. Dr. Wolfe and his co-author, Dr. Duhaylongsod, have done a particularly fine job with their chapter entitled "Complications of Pulmonary Resection." The narrative is comprehensive and readable and especially well supported by appropriate references. Dr. Ferguson's chapter on "Arrhythmias Associated with Thoracotomy"
the subject admirably. The editor is to be complimented on choosing new as well as standard topics for inclusion in this book. Chapters on "Thoracic Manifestations of HIV-l Infection" and "Complications of
covers
Heart-Lung and Lung Transplantation" bring us worthwhile in-
formation on rapidly evolving fields. The authors have included up-to-date references in most, if not all, chapters. We surgeons learn by our own mistakes. It is important that we also learn from the mistakes made by others. I tell our residents that I hope they never learn to take care of a complication, knowing full well that they will. I want them to prevent complications instead. Reading this informative book from cover to cover and then keeping it handy for ready reference when needed will help thoracic surgeons at any stage of their careers prevent and treat complications that may occur. JAMES B. D. MARK, M.D.
Palo Alto, California Wound Healing: Biochemical and Clinical Aspects. I. Kelman Cohen, Robert F. Diegelmann, and William J. Lindblad. 656 pp. Philadelphia: W. B. Saunders, 1992. $115.00.
THERE HAS been an explosive growth of wound healing research in the past decade. The translation of basic science discoveries into clinical reality reflects the application of new molecular and cellular biology tools and the impending introduction of effective vulnerary agents. The editors have had a longstanding interest in tissue repair research. They have assembled an impressive array of 69 contributors from diverse areas including molecular
biology, biochemistry, immunology, pharmacology, and surgery, and the authors share their unique perspectives on tissue repair. This menagerie permits the editors to fulfill their stated goal of fostering communication between diverse disciplines, which may lead to more intellectual fermentation and understanding. The product is a nicely bound, well-illustrated, 35-chapter and 360page textbook that has a broad scope and gives the reader a thorough information base for wound repair study. The text is well organized and divided into five major sections. The concisely written chapters are easy to read. The book begins with a historical perspective on wound healing research. The first major section describes the basic biologic processes involved in wound healing, such as inflammation, fibroblast proliferation, angiogenesis, wound contraction, and epithelialization. The next section is devoted to the structural and regulatory components of wound healing, which reflects the recent impact of cellular and molecular biology. These chapters address specific areas of the extracellular matrix, including collagen and its degradation, proteoglycans, cell adhesion molecules, and chemoattractants and growth factors. The most glaring shortcoming of the textbook is the lack of a comprehensive treatment of the role of growth factors in wound repair, which is an intense area of investigation. The chapter devoted to chemoattractants and growth factors includes only one page on the modulation of healing by addition of growth factors to wounds, and does not even mention a single member of the fibroblast growth factor family. A 1992 textbook should devote at least one chapter to a systematic analysis of the multiple growth factors known to be present in wounds. The
third section focuses on factors affecting wound repair such as metabolic aspects, the immune system, and the wound microenvironment. A chapter is devoted to the burgeoning research area of tissue repair in the mammalian fetus, but it was disappointing to see that there were no references cited beyond 1989. After this broad overview of the principles of wound healing with emphasis on basic biology and fundamental principles, the book then approaches specific wound healing responses by organ system. These chapters are well-written and address repair of the skin, bone and cartilaginous tissue, tendon and ligament, lung,liver, the alimentary canal, and peripheral nerve. A chapter devoted to repair in the cardiovascular system is conspicuously absent.
Finally, the last section is devoted to clinical management of healing tissues. Specific chapters include factitious problems in wound healing, keloids and excessive dermal scarring, scleroderma, burn scar and skin equivalents, clinical management of nonhealing wounds, wound dressings, and surgical devices in wound healing management. Overall, this comprehensive textbook provides a firm foundation for the study of the basic processes of wound repair and their clinical implications. As with many textbooks, the chapter to 2 bibliographies lag the release date of the textbook by up comyears. Nonetheless, Wound Healing is the most current pilation of basic science and clinical aspects of tissue repair. Surgeons are all students of wound healing and its sequelae, and I would recommend this text
as an
addition to
any
surgeon's
library.
N. Scorr ADZICK, M.D. San Francisco, California
