Perforator Flaps: Anatomy, Technique and Clinical Applications

Abstract

This extensive and highly detailed work comprises two volumes and provides a comprehensive account of perforator flaps and their use in reconstructive surgery. Perforator flaps have gained popularity in recent years in many aspects of reconstruction and the Initial chapter of the book provides a brief history of flap surgery, describing the relatively recent appreciation of the fact that perforating vessels were capable of sustaining a large variety of flaps. The first volume gives detailed accounts of flap types, anatomy and physiology and overall provides an excellent account of the basic principles underlying perforator flaps. This volume also includes chapters on planning and complications. The latter of these gives a very clear account of the main ‘golden rules’ for complication avoidance in this type of surgery. The remainder of this volume is divided into three sections dealing with flaps of the head and neck, upper extremity and trunk. The first section of the second volume deals with flaps of the lower extremity followed by a good account of the clinical applications of a wide range of perforator flaps for reconstruction in various sites of the body. The final part of the second volume is, in my view, one of the most interesting sections of the entire book. Entitled ‘Controversies and Future Directions’, this explores a number of newer concepts, including that of the ‘freestyle free flap’ (a flap harvested from any region of the body, based on a vessel identified by Doppler), ‘supermicrosurgery’ (vessels of 0.5–0.8 mm) and neurocutaneous perforator flaps. The quality of the presentation and illustration is high throughout. As with most multi-author texts there is invariably some overlap in the various chapters, but this is a minor criticism. I have no doubt that this two-volume set would be a significant asset to any individual or department involved in reconstructive surgery and I recommend it highly.