Minor Surgery and Skin Lesions: Diagnosis and Management on CD-ROM

Roger Kneebone, Julia Schofield

Primal Pictures, London, $65

ISBN 1 902470052

Rating:

Minor Surgery and Skin Lesionspresents in a spectacular way minor surgical techniques, and I have never seen them illustrated before with such clarity. The cartoon-like animations and the clear sound track answer many questions that, because of their apparent simplicity, are never asked lest the questioner betrays his ignorance, like the emperor's new clothes. Having practised minor surgery in general practice for 30years, I found new solutions to many simple problems that I tackled with what I thought was common sense, which is the enemy, I fear, of progress.

Minor surgery has become much more important to general practitioners, who are being encouraged for many reasons to carry out these minor procedures in their practices. Apart from being lucrative, minor surgery is a satisfying aspect of general practice. This CD Rom will also appeal to junior hospital medical staff, who are often thrown in at the deep end by their senior surgical colleagues and expected to carry out minor surgery lists with little training or supervision.

I learnt several simple but valuable points, such as the optimum ratio between the length and width of an ellipse excision and that the excision should be started at the apices and extend to the middle, which may be obvious but need stressing and quantifying. The medicolegal precautions that need to be taken were dealt with succinctly, as were many other aspects of medical practice. The exact anticipated size of any resultant scar and the possibility of a keloid forming must be carefully explained to patients beforehand.

The humility born of great experience shows itself clearly in the patient education leaflet, and in the advice to send all removed tissue for histology no matter how benign the lesion may seem. The authors' backgrounds—a surgeon who became a general practitioner and a general practitioner who became a dermatologist—may account for the breadth of understanding of the topic.

The only flaw was the frustration of having to transfer from the main text to illustrations and related matters through the red and orange icons, but this drawback may be of little importance when using this CD as a reference source. Apart from this minor quibble, I found that Minor Surgery and Skin Lesions presents much factual information in a very agreeable and enjoyable form.