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Simply Local Flaps

Chatterjee, Abhishek M.D., M.B.A.

Plastic and Reconstructive Surgery: June 2019 - Volume 143 - Issue 6 - p 1809
doi: 10.1097/PRS.0000000000005682
Book and Media Reviews

Disclosure:The author has no financial interest to declare in relation to the content of this book.

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Arun K. Gosain, M.D.

Review Editor

It is with great pleasure that I review the book entitled Simply Local Flaps, by Michael Klaassen, Earle Brown, and Felix Behan. This work reads easily, and simplifies the treatment of difficult clinical plastic surgery scenarios with the use of local flaps. Those who would benefit most from the book’s contents would be both experienced plastic surgeons, looking for details on how to perform particular techniques, such as the keystone flap (chapters 12 and 13), and plastic surgery trainees, who would benefit from the general approach to plastic surgery decision making highlighted in the earlier sections of the book.

The combined experience of the authors equals approximately 100 years, and this is well represented by the multitude of drawings and photographs of clinical cases with the appropriate local flaps applied. Heavily focused on facial lesions and wounds, the book stresses the basics of planning and drawing the actual local flaps with basic ellipse options, and then goes through intermediate and advanced techniques that range from rotational flaps to transposition and pedicled flaps. One particular strength is that the focus on reconstruction is not only for lesions but also for surgical complications, such as scars and contractures, making the book applicable both to the general plastic surgery practitioner and to subspecialists in a particular field. While stressing the basic principles of judgment, design, and surgical planning with the credibility of their experience, the authors provide a source of information that would be readily useful to the junior plastic surgery trainee, who can use this book as a base from which to address reconstructive problems in a stepwise fashion. Higher-level trainees and junior attendings would particularly benefit from the more advanced reconstructive techniques with regard to transposition flaps and local tissue rearrangement techniques, such as the “jumping man” and the multitude of “plasty” options described (M, W, and so on).

At its core, this book is also an excellent reference source for commonly described but potentially difficult or confusing techniques. It is simply not possible to have a step-by-step description of every possible local flap described. The authors make an effort in teaching the principles of advancement, rotation, and transposition with the hope that these fundamental principles can be used in designing solutions. While they stress at length the fundamentals of design in the beginning and midsections of the book, the last third of the book is spent describing more complex local flaps, such as the Karapandzic flap, hinge flaps, and combination flaps for difficult clinical problems. With this layout, the reader is methodologically exposed to an increasingly difficult array of designs and clinical scenarios without being overwhelmed, as the beginning chapters act as a foundation for the latter ones. The reader may also need to reference other articles or surgical atlases for specific complex flaps.

Every good book has areas for potential improvement. While the strengths of this book include its easy readability, well-designed layout, abundance of drawings and patient photographs, and wealth of appropriate clinical information for local flap design and application, it does focus more on the head and neck region than on other anatomic regions. There is no mention of local flaps for the breast, which would be nice given the rise in oncoplastic surgery and the role of local flaps in increasing breast conservation. Nevertheless, this book provides an excellent introduction and summary of local flap options. It would serve as an essential read for the plastic surgery trainee and an excellent reference source for the clinically busy plastic surgeon.

Copyright © 2019 by the American Society of Plastic Surgeons