Review of Hayes' Practical Skin Cancer Surgery.

Review by Christian Lefebvre

This is an extremely practical book offered to all clinicians interested in dermatologic surgery. Dr. Hayes proposes an all-inclusive package covering every aspect of an office practice of dermatologic surgery, froflm the design of the operating room and its lighting to technical aspects of surgical intervention, be it a simple biopsy or the most complicated operation. The reader is instructed by texts, figures and tables depicting details of the interventions. Perhaps the only addition that might be desirable would be a series of videos showing the main or the most complicated interventions. This could conceivably be added to the electronic version of the book, which is the version I used for this review.

The style of writing is such that a reader soon feels as if he were in a discussion with the author himself, as if being guided by him—as if looking over his shoulder! Residents completing their formation in dermatology and wishing to practice surgery will find this book most useful. For the practicing dermatologist and dermatologic surgeon, it will deepen surgical knowledge by offering an easily consulted and very complete database. In my personal case, as a general dermatologist, the reading of this book was a powerful incentive and a good tool to improve my technical skills.

Everywhere in the book, one feels that Dr. Hayes masters the subject completely. It is evident that he has extensive experience and that he wants and knows how to share it.

Here in Canada, and particularly in the Province of Quebec where I have my practice, dermatologists do mostly basic and simple interventions, relying largely on specialized colleagues, plastic surgeons and/or “Mohs’ surgeons.” Apparently the education of dermatologists in Australia includes a larger part of surgery. My question may appear naïve but: do all dermatologists feel capable and self-confident enough to practice all the interventions described by Dr. Hayes in his book?

Hayes M. Practical Skin Cancer Surgery. Churchill Livingstone: London, 2014. ISBN 9780729539326. 304 pages.

Last, I agree completely with Dr. Hayes when he insists on doing a biopsy before any possibly mutilating surgery. A surprising biopsy result is indeed always possible and a precise diagnosis remains the cornerstone on which to decide the most adequate intervention.

In summary, I heartily recommend this book to any practitioner interested in dermatological surgery. The subject is ever more important as our ageing population of patients is at more risk every day of developing skin tumors for which treatment is possible and efficient. Even if one does not practice surgery, it is apropos, in order to inform and reassure a patient, to have a precise idea of the situation to which a patient referred to a surgeon will be exposed.

Christian Lefebvre

Dermatologist

Montreal, Canada

Response from Dr. Mileham Hayes

I am glad for Dr. Lefebvre’s review and that my book seems to have achieved my objectives, which were not only to provide clear and logical steps, but to identify, “sign-post,” and solve those circumstances where the surgeon is not sure how to proceed.

I have subsequently found two omissions from my work. Firstly, I would recommend excising deeper in the glabella area as, for some reasons, BCCs are deeper there in my experience; and secondly, re-excision is mandatory if there is not deep clearance—but observation may suffice if there is lateral involvement.

Finally, I also found it gratifying that my practical suspicion that “the lateral nasal branch of the facial artery (aka, angular) seems to wind around the base of the lateral ala” (p 208) has now been confirmed. [1]