The Oxford European Wound Healing Course Handbook

The Oxford European Wound Healing Course Handbook

The American Journal of Surgery 187 (2004) 146 –147 Book reviews Cancer of the Breast, fifth edition. edited by William L. Donegan and John S. Spratt...

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The American Journal of Surgery 187 (2004) 146 –147

Book reviews Cancer of the Breast, fifth edition. edited by William L. Donegan and John S. Spratt Publisher: Saunders, Philadelphia, Pages: 1,025. Price: $179.00. The fifth edition of this monumental work is a highly referenced and very authoritative treasure trove of information about cancer of the breast and those who suffer from it. The editors’ approach to breast cancer is not simply that of a cellular disease of the breast but as a cluster of problems whose dimensions have chemical, biological, psychological, social, and legal features. The book expresses the extensive personal clinical experience of both editors as well as their critical analyses of the many published reports of clinical and epidemiologic studies. There are two hundred more pages of text in this edition than in the fourth, bringing the total to 1,025, and slight changes in font with increased space between letters and lines make for easier reading. There is a lavish use of photographs, drawings, graphs and tables; and the line drawings have been improved. In the exhaustive reference list placed at the end of each chapter, the numbered notations to the alphabetic listing of references is an improvement over the fourth edition. A very complete index is of valuable assistance in leading a reader to the sections and subsections within each chapter. There are 96 contributors plus the two editors, and 10 new chapters have been added during the 7 years since the fourth edition. The carefully tailored chapters are quite focused so that each fairly well stands alone as a small monograph on a specific subject. Some variability in literary style between chapters is due to differences in writing style of the many authors. The chapters by Donegan are exceptionally well crafted. The book covers practically all features of breast cancer, starting with its history and moving from molecular genetics to prevention, diagnosis, treatment, follow-up, and personal psychosocial aspects as well as community care. The general focus of the book is aimed toward the surgeon who treats breast cancer patients, with an attempt to introduce information from the basic sciences that may have clinical relevance or usefulness in understanding the disease and its management such as current thoughts on nutrition and prevention. There is a special section on the current status of sentinel node biopsy and the controversy around axillary dissection, with several sections on the more common surgical and ancillary management modalities. These are followed by an appropriate discussion of patient follow-up;

with emphasis on management during the postsurgical and postchemotherapy state. Personal psychosocial features, nursing care, and community resources are followed by a chapter devoted to malpractice litigation, its origins, and boundaries, and observations regarding its prevention. Epidemiologic features of the disease are covered with a major discussion of clinical trials and statistical methods. In toto, the book is a complete and extensive display of the current state of knowledge regarding cancer of the breast, both as an individual phenomenon and as it is expressed in a group. It is easy to read, a valuable reference work, and this edition meets or exceeds the quality standards that had been established in the first four editions. It is not tailored to be a “how to do it” volume but rather, is one that engages the reader in the broadest possible discussion of breast cancer and the entire spectrum of what is needed for comprehensive care of the unfortunate patients in whom this devastating disease develops. C. Barber Mueller, M.D. Hamilton, Ontario, Canada

The Oxford European Wound Healing Course Handbook edited by the Oxford Wound Healing Institute Publisher: Positif Press, Oxford, 2002. Pages: 176. Price: $40.00. This book is a collection of presentations made at the 2001 Oxford-European Summer School on Wound Healing whose theme was Applying Wound Healing to Clinical Practice. Course faculty come mostly from different parts of Europe. Topics range from the basic science of wound healing, special requirements of diabetic wounds, venous ulcers, and pressure sores to practical aspects such as the care of skin surrounding chronic wounds, pain management, rational use of dressings, and the role of bacteria in chronic wounds. Some chapters are very basic for the practicing surgeon. Those on surgical management and debridement, on acute management of traumatic wounds, and on pain management provide little new information for the surgeon, but it should be remembered that the summer school is attended by specialists from varied backgrounds. There is a paucity of basic science. Readers searching for the latest in basic science on cellular interactions, growth factors, cell migration, inter-

0002-9610/04/$ – see front matter © 2004 Excerpta Medica, Inc. All rights reserved.

Book Reviews / The American Journal of Surgery 187 (2004) 146 –147

cellular matrix formation, and wound contraction will be disappointed by this book. Two chapters deal with the value of computers for large-volume data management and with the value of wound healing centers—topics of little importance to the individual practicing physician unless they provide guidelines for referral to centers and what criteria might constitute an otherwise unrecognized difficult wound. Much information in the chapters remains empiric, based nonetheless on statistical observations, but not always founded on basic science. I enjoyed the chapters on venous ulceration, available new therapies and when to use them, skin care around wounds, the role of industry in wound healing developments, and the rationale for different dressing types. On the other hand, I gained very little new information on the management of diabetic foot wounds where I feel an algorithm of assessment with matching treatments would have been particularly helpful.


Persistence of chronic wounds is multifactorial and does require a multispecialist team. We do need to gain the interest of industry so that practical applications of basic science research can be commercialized and put into practice. This book is to be lauded for highlighting those objectives. The danger of reproducing such a collection of essays, however, is that the book cannot be expected to be a substantive wound healing text. By attempting to gain the interest of multiple specialities, the book becomes too basic in many areas for the focused specialist, such as for a practicing orthopedic, plastic, vascular, or general surgeon. It nonetheless provides some useful, selected reading for the surgeon interested in wound management. David T. Netscher, M.D. Baylor College of Medicine Houston, Texas