MEDIA REVIEWS
ATLAS OF SURGICAL TECHNIQUES IN TRAUMA
Edited by Demetrios Demetriades, Kenji Inaba, and
George Velmahos.
New York: Cambridge University Press, 2015;
336 pp (hardcover).
Atlas of Surgical Techniques in Trauma is a complemen-
tary edition to the published series on trauma injuries.
The authors produced this book for the purpose of pro-
viding a quick focused review of the common surgical
procedures in trauma and acute care settings.
What is interesting about this book is that it is a pro-
duct of highly experienced surgeons who work closely
in the same institutions and share similar approaches
and surgical techniques. These surgeons obtained high-
quality pictures to demonstrate their surgical
approaches. The images were obtained from fresh,
well-maintained human cadavers in their anatomy labs.
This book is a single-volume edition divided into few
chapters arranged in sections based on anatomical
areas. The text is divided into 10 sections and 39 chap-
ters starting with a general conduct of an operating
room followed by a resuscitation section. The text is
written in a descriptive easy-to-read format using bul-
let-points method to explain the procedure step by step.
The unique feature of the edition is the use of extensive,
high-quality pictures to explain the steps in performing
the intended surgical procedure, tools and equipment
that are being used, patient positioning, and the impor-
tant anatomical landmarks. These features make this
book ideal to be used by surgeons for a rapid review of
the procedure.
The book begins with an introduction by the editors
in which they state that it is designed to provide a
rapid, highly visual summary of the anatomy, procedu-
ral sequencing, and pitfalls associated with trauma
procedures. They note that the book is intended to
for use by trainees as well as more experienced
practitioners.
Each chapter, although written by different authors,
starts with a surgical anatomy column explaining the
major structures and landmarks in the area relevant to
the procedure followed by a general principle column
explaining, in most of the times, the indications and
contraindications of the intended procedure with an
additional column for special instruments if required.
This is followed by an in-depth discussion of the specic
approach including patient positioning, the incision,
exposure, repair, and closure. The chapter usually n-
ishes with tips and pitfalls and sometimes a section
about postoperative considerations.
Section 1, Operating Room General Conduct,
describes the location and design of the trauma opera-
tion room with the necessary setups and equipment. It
focuses mainly on the logistics, communications, and
the ideal facilitation of trauma cases in terms of mini-
mizing transport and accelerating multidisciplinary
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involvement with the capacity to deal with simultaneous
cases.
Section 2 is about the resuscitation procedures in the
emergency department. This section is valuable to the
emergency physicians as well as the trauma surgeons,
and it does a great job explaining the lifesaving proce-
dures, including cricothyrotomy, chest tube insertion,
and thoracotomy. What makes this section invaluable to
the learners is the description of multiple approaches to
some of the procedures depending on operator prefer-
ence and the availability of tools.
Head trauma is covered in section 3. This section is
also benecial to emergency physicians as some of the
procedures could be applied in the emergency depart-
ment. It mainly focuses on the evacuation of different
types of hematomas and ways to monitor intracranial
pressure.
Section 4 mainly concentrates on neck injuries due to
the highly vascular and vital anatomy of that area. Sur-
gical management of injuries to major arteries and
veins is discussed in detail. Tracheal and laryngeal inju-
ries are also discussed, along with a separate chapter
about the cervical part of the esophagus and aerodiges-
tive structures.
Section 5 is about chest trauma. The authors started
this section with general principles of trauma opera-
tions to the chest, elaborating more about ways to per-
form thoracotomy. It serves as an introduction to the
rest of the chapters in this section, in which different
organs are discussed starting with cardiac and main
vasculature, followed by the lungs and diaphragm, and
ending with thoracic esophagus.
Abdominal traumas are covered in Section 6. This
provides a comprehensive review on the essential
abdominal surgical emergencies. This section also starts
with a chapter about the general principles of abdomi-
nal operations for trauma and explains differences in
laparotomy approaches in different situations. This is
followed by an interesting chapter explaining the con-
cept of damage control in abdominal traumas aiming
for rapid control of bleeding and contamination that in
turn decreases surgical stress and gives more focus on
resuscitation. The rest of the chapters mainly explain
abdominal organs and vascular injuries and the appro-
priate approaches in surgical management.
Section 7 contains only one chapter which illustrates
the surgical techniques in controlling hemorrhage
caused by pelvic fractures. In this chapter, the authors
focus mainly on the importance of supportive manage-
ment to patients with pelvic bleeding, as it is sufcient
to stabilize these patients most of the time. The authors
then discuss the surgical method of intervention for
cases with severe bleeding which are not responding to
the conventional ways.
Sections 8 and 9 highlight injuries to upper and lower
extremities, respectively. It begins with vascular injuries
to the limbs and surgical approaches in management,
2016 by the Society for Academic Emergency Medicine
doi: 10.1111/acem.12879
ACADEMIC EMERGENCY MEDICINE March 2016, Vol. 23, No. 3 www.aemj.org
particularly compartment syndrome requiring fas-
ciotomies. These sections both end with discussion of
surgical amputation in terms of indications, special situ-
ations, and various approaches.
The last section focuses on orthopedic damage con-
trol for fracture management. It explains the treatment
goals in orthopedic trauma emergencies from improv-
ing vascular ow and perfusion to managing open and
long-bone fractures with emphasis on prioritizing other
life-threatening associated injuries.
Atlas of Surgical Techniques in Trauma mainly focuses
on the surgical part of trauma with fewer details about
medical and pharmacology resuscitation in trauma. In
other words, it manly explains what to do inside the
operating suite. This book covers the essential topics in
trauma surgeries supplemented with a great volume of
gures, which are the cornerstone of this book. It is
obvious that it serves as a quick recap intended to be
used by experienced surgeons who already have
enough information about the different aspects of
trauma management and general guidelines. It could
also serve the new surgical trainee in acquiring the
e7
basic techniques in trauma surgeries. Some chapters
are also invaluable to emergency physicians as they
illustrate lifesaving procedures that are applicable in the
department. This book went beyond its purpose as an
atlas and elaborated surgical details in an organized
and effective way. It would make a great contribution to
any library for a surgeon or critical care provider, espe-
cially when their time may be limited. As mentioned in
the preface, this edition is amenable to be formatted
to an electronic version for tablets and smartphones. In
doing so, it would make it a must-have for surgeons
from all levels.
doi: 10.1111/acem.12879
Kathleen Cowling, MS, DO
(cowling.911@cmich.edu)
Almohanad Eidah, MD
Department of Emergency Medicine, Central Michigan
University College of Medicine,
Saginaw, MI
Supervising Editor: Peter E. Sokolove, MD