The present article provides an overview of the current and expected effects of plastic surgery in Europe. It presents the experience of departments for plastic and reconstructive surgery, as evaluated by interviews with members of the Executive Committee (ExCo) of the European Society of Plastic, Reconstructive and Aesthetic Surgery (ESPRAS). The objective of this overview is to summmarise current information in our area of work and to make this accessible to a broad group of readers. As our knowledge is rapidly increasing during the current pandemic, it is evident that we can only provide a snapshot and this will inevitably be incomplete.

Zusammenfassung Hintergrund Im Rahmen des ELF der ESPRAS wurde die Notwendigkeit standardisierter Richtlinien zur Brustrekonstruktion auf europäischer Ebene definiert. Ziel dieser Studie ist es, zunächst einen Überblick über den aktuellen Status, Entwicklungen und mögliche regionale Unterschiede der Brustrekonstruktion in Europa zu geben, wobei ein Schwerpunkt auf dem Angebot, der Verteilung und dem Zugang zur Brustrekonstruktion liegt. Materialien und Methoden Es erfolgte eine internetbasierte Befragung von in der Brustrekonstruktion spezialisierten Plastischen Chirurgen, welche zusätzlich die nationalen Versorgungsstrukturen ihrer jeweiligen Länder überblicken. Geeignete Teilnehmer wurden über das ExCo der ESPRAS und nationale Delegierte von ESPRAS identifiziert. Die Ergebnisse wurden mit aktueller evidenzbasierter Literatur verglichen. Ergebnisse 33 Teilnehmer aus 29 europäischen Ländern nahmen an der Studie teil. Im Vergleich zur Gesamtzahl durchgeführter Mastektomien war die Inzidenz der Brustrekonstruktionen in Europa relativ gering, vergleichbar mit anderen großen geografischen Regionen, wie z. B. Nordamerika. Die Verfügbarkeit und der Zugang zur Brustrekonstruktion war innerhalb Europas gleichmäßig verteilt, allerdings kann die geografische Region das Verfahren der Brustrekonstruktion (Eigengewebe vs. Implantat) beeinflussen. Deutliche Differenzen zeigten sich bezüglich Brustrekonstruktionen bei bestrahlten Patientinnen. Schlussfolgerung Die Studie identifizierte ein ausgeprägtes Maß an Inkohärenz in den internationalen Standards zwischen den europäischen Ländern. Es besteht großer Bedarf für kohärente europäische Leitlinien. Europäische, multizentrische klinische Studien sollten initiiert werden, um eine evidenzbasierte Grundlage zu schaffen.

T Th he e n ne ew w c co on nt tr ra ac ct t a an nd d t tr ra ai in ni in ng gAnn R Coll Surg Engl (Suppl) 2010; 92:000-000 PRESIDENT'S MESSAGE HUGH PHILLIPS PRESIDENT

The aim of this paper is to summarize the results of a consensus process and a European webinar of the two societies, European Association of Societies of Aesthetic Surgery (EASAPS) and the European Society of Plastic, Reconstructive and Aesthetic Societies (ESPRAS) on what is considered safe practice based on the scientific knowledge we have today. This review of the current situations gives considerations which have to be taken into account when getting back to work in plastic surgery with COVID-19 in Europe. At all times, one should be familiar the local and regional infection rates in the community, with particular emphasis on the emergence of second and third waves of the pandemic. Due to the fast-evolving nature of the COVID-19 pandemic the recommendations aim to be rather considerations than fixed guidelines and might need to be revised in near future.

Coronavirus disease-2019 (COVID-19) is the infectious disease caused by the recently discovered coronavirus, SARS-CoV2. This new virus and disease were unknown before the outbreak began in Wuhan, China, in December 2019. The number of publications with regard to COVID-19-related information is exponentially increasing, but there are also some retracted papers appearing on PubMed, including those retracted from The Lancet Global Health and the New England Journal of Medicine. In a PubMed search for "COVID," there were 1595 articles by April 1, 2020. As of June 30, the number of articles has now reached 25,913. In this editorial, 4 specific areas of information are looked at but the principles apply to many other areas of medicine. The specifics looked at are PPE for tracheostomy, testing for COVID-19, pregnancy and COVID-19, and surgical expectations during redeployment. We must make no mistake that we are seeing a disease that modern medicine has never encountered before. This article is not aimed at belittling or dismissing any of the advice of the Royal Colleges' or PHE advice, but it demonstrates the tsunami of information and the ambiguity that surgeons are experiencing throughout the UK right now. This is unlikely to be the end of progression regarding healthcare planning and development for unencountered viruses 9. In the next few months and beyond, there are likely to be adaptions and revisions of more documents advising on various aspects of healthcare with regard to COVID-19 management and for possible future viruses not yet seen by the modern world before.