Grabb’s Encyclopedia of Flaps. Fourth Edition

The fourth edition of Grabb’s Encyclopedia of Flaps is an impressive compilation of reconstructive techniques for defects from head to toe. The encyclopedia is organized into five parts: Part I, Head and Neck; Part II, Upper Extremity; Part III, Breast, Chest Wall, and Trunk; Part IV, Abdominal Wall and Pelvic Region; and Part V, Lower Extremity. Each part is further subdivided into sections for a comprehensive selection of anatomical regions of the body. Within this framework, a total of 577 chapters describe reconstruction techniques. The chapters are clearly organized, with the majority divided into six sections: Indications, Anatomy, Flap Design and Dimensions, Operative Technique, Clinical Results, and Summary. Each chapter is authored by two to three contributors, with evaluative editorial comments preceding some chapters. Thus, the encyclopedia presents the clinical expertise of an impressive cohort of surgeons. Editor comments provide further insight into merits and critiques of the reconstructive option.A comprehensive, diverse presentation of reconstructive concepts and techniques is a strength of this encyclopedia. Several chapters start a section with a basic principle or concept, such as the chapter “Skin Expansion” to start Part III, Breast, Chest Wall, and Trunk Reconstruction; or the chapter “Expansion of Vaginal Lining by Graduated Dilation” to start Section B of Part I, Vaginal, Vulvar, and Perineal Reconstruction. Sections then include workhorse and creative flap options for reconstruction of the anatomical region. The full height of the reconstructive ladder is represented, including chimeric flaps and functional or neurotized options. For example, the breast reconstruction section includes 25 flap options, including fat grafting, abdominal soft-tissue rearrangement, omental coverage of breast implants, variations of the latissimus, and an array of microsurgical autologous free tissue transfers. The section on nasal reconstruction (Chapter 35 through 79) is organized by subunit and includes techniques such as the bilobed flap, variations of the forehead flap, local chondromucosal and mucosal flaps, microvascular auricular flaps, and multi-island free radial forearm flaps for nasal lining. A weakness of the encyclopedia is its use of visual aids. The majority of photographs are in black and white, making key anatomy described in captions difficult to see. Second, the use of diagrams is not standardized across chapters. Some authors create clear, detailed diagrams of flap geometry and dimensions and include color photographs of preoperative markings, whereas others present lesser quality preoperative, intraoperative, and postoperative photographs to convey marking and operative technique. Despite this weakness, clear, detailed prose organized in sequential sections on anatomy, flap design and dimensions, and operative technique convey enough detail for the reader to meaningfully learn the reconstructive technique. We commend the editors for the breadth and accessibility of anatomical regions and reconstructive options covered in this volume. Among these are bread-and-butter problems encountered by the plastic surgeon, including reconstruction of the scalp; face; breasts; chest wall; abdomen; upper and lower extremities; and lumbosacral, ischial, and trochanteric prominences. Sections on pharyngoesophageal, penoscrotal, anal, and vulvovaginal reconstruction are likewise covered in detail and serve as handy references for problems less frequently encountered in general practice. In summary, the volume is a thorough, foundational contribution to the many flap encyclopedias in publication. Grabb’s Encyclopedia brings together the experience of over 400 surgeons and the insights of the four accomplished editors to create a formidable reference volume. Rachita Sood, M.D., M.P.H.Sumanas W. Jordan, M.D., Ph.D.