Principles and management of surgical infections: John Mihran Davis, G. Tom Shires. Philadelphia, 1990, J. B. Lippincott, 624 pages, $99.50

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Principles and management of surgical infections John Mihran Davis, G. Tom Shires. Philadelphia, 1990, J. B. Lippincott, 624 pages, $99.50. Infection is a major consideration in surgical therapeutics, both for the treatment of primary disease processes and for the management of surgical complications. Drs. Davis and Shires provide a multiauthored text oriented to the needs of the clinical surgeon and the surgical investigator. They bring to this effort not only their own well-recognized expertise but also an array of contributors who have made significant advances to the areas they specifically address. Several chapters are devoted to an in-depth review of the pathophysiology of infection and the multifaceted cellular and humoral responses of the host to invading bacterial, vital, or fungal pathogens. There is a valuable section on the pharmacology, of antibiotics with detailed information regarding appropriate administration in specific circumstances. This is augmented by discussions of applications of antibiotic therapy in other sections of the text devoted to individual disease entities. There are excellent and in-depth descriptions of the role of necrotizing soft tissue infections, the spleen in host immunity, transfusions and their relationship to viral infections, abdominal abscesses, and nutritional support in the management of sepsis and respiratory. distress syndrome. Specific problems relating to the subspecialty areas of vascular surgery, cardiothoracic surgery, biliary sepsis, transplantation, urology, gynecology, and trauma are discussed in depth by experts in these areas who generally cover their subjects effectively and with extensive bibliographic support. The text abounds in algorithms for management, the print is comfortable to read, and the illustrations are generally well presented. Like all multiauthored texts there is some redundancy in presentation of basic information. However, this is not altogether inappropriate, because the book will be used as a reference and the repetition of details of the pathophysiology and body responses to infection will be useful to the reader who wishes to find most of the information on a given subject confined to one or two chapters. A major criticism of the book is the relatively haphazard organization of chapters with sections on pathophysiology apparently randomly interspersed among chapters on specific organ systems. The second major shortcoming is the absence of up-to-date references, which plagues the editors of any text because of the lag time required to accumulate assigned contributions and put them through the standard editorial process. With rare exceptions the most recent references are dated 4 to 5 years before the date of publication. Nevertheless, most chapters contain extensive and often exhaustive bibliographies of the older literature so that the student searching for basic material will have little trouble finding most of the salient references from 5 years before the publication date. In spite of these criticisms this book provides a valuable resource that should be on the shelf of every practicing surgeon.