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CHURCHILL LIVINGSTONE An imprint of Elsevier Limited © Elsevier Limited 2000, All rights reserved, The right of Alan D. McGregor to be identified as author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers ora licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham. Court Road, London WIT 4LP. Permissions may be sought directly from Elsevier’s Health Sciences Rights Department in Philadelphia, USA: phone: (+1) 215 239 3804, fax: (+1) 215 239 3805, e-mail: You may also complete your request or-line Via the Elsevier homepage (http:/ /, by selecting ‘Support and contact’ and then ‘Copyright and Permission’. First edition 1960 Second edition 1962 Third edition 1965 Fourth edition 1968 Fifth edition 1972 Sixth edition 1975 Seventh edition 1980 Eighth edition 1989 Translated into Spanish, Japanese, Italian, German Ninth edition 1995 Tenth edition 2000 Reprinted 2004, 2005 (twice), 2006, 2007, ISBN 978 0 443 063725, British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloguing in Publication Data A catalogue record for this book is available from the Library of Congress Medical knowledge is constantly changing. As new information becomes available, changes in treatment, procedures, equipment and the use of drugs become necessary. The editors, authors, contributors and the publishers have taken care to ensure that the information given in this text is accurate and up to date. However, readers are strongly advised to confirm that the information, especially with regard to drug usage, complies with the latest legislation and standards of practice. ‘your source for books, FLSEVIER journais and multimedia inthe health sciences | Working together to grow li libraries in developing countries | vewwcheviccom | wanwbooksidong | wwwcmbecorg. | HESEVIER £8 2 Saber Foundation Printed in China 8/06 Foreword to the first Edition Like other surgical specialties, plastic surgery originated through the efforts of a small group of enthusiasts who, by utilising a particular refine- ment of technique, soon raised the standards of surgical craftsmanship within a narrow field to a high pitch of efficiency. Then came the war, and the techniques primarily evolved for hiding facial blemishes and correcting visible deformities were applied with immense success to the treatment of wounds in general. Since then, as a natural sequel, plastic surgeons have widened still fur- ther their range of interests, notably in casualty work, in hand injuries and in burns. In doing so, they have implictly ceased to regard themselves as a class apart, exclusive authorities in a chosen field, but rather as expert advisers and helpful collaborators in a wide range of surgery. Mr, [Ian A.] McGregor is emphatically of this latter class, trained in the Glasgow Schoo! of Plastic Surgery, broadened in experience by the responsibility of a busy casualty department, and with a particular interest in the surgery of the hand. His book reflects these interests and this experience, being designed not for special- ists but for all those who are concerned with the healing of wounds. Its approach is essentially practical, dealing as it does with the choice of incisions, with stitchcraft, avoidance of ugly scars, methods of skin grafting, and similar mat- ters, and with their application to casualty surgery, orthopaedics and general surgery. It will assuredly receive a warm welcome. C.F. W. Illingworth Glasgow, 1960