key: cord-0781331-4xx61bma
authors: Hart, Prof. Andrew
title: Cover Illustration: “Frontline” mural, Ashton Lane, Glasgow, by the.rebel.bearBack from the Frontline
date: 2020-06-30
journal: J Plast Reconstr Aesthet Surg
DOI: 10.1016/j.bjps.2020.06.001
sha: f1e30868d85936fddaf93933f03cd3b100099f01
doc_id: 781331
cord_uid: 4xx61bma

nan

Six months on from the start of the COVID-19 pandemic parts of the U.K. have this month begun to follow many of our mainland European neighbours in loosening lockdown restrictions. Progress is far behind that of our Antipodean cousins, where rapidly enforced rigid quarantine and public health measures have been so effective -New Zealanders will delight in having beaten Australia to cross the line first in the race to go 16 days without a new case. Schools are reopening, families and friends are meeting again (in the U.K. this is restricted to meeting outdoors -always a challenge in our climate), and staff are returning to Plastic Surgery units from their redeployment to support respiratory, A&E, and ICU services. It is perhaps an appropriate moment to reflect positively on what they have achieved, and affirm that a generation who have been slighted or teased by some for being less committed than their forebears in fact stepped up when the moment came to selflessly commit, and they delivered on their "frontline" 1 . Articles in this edition show some flavour of the responses, other stories remain untold but powerful. With resilience driven from a sense of social justice and equality, within a surgical community supported through social media networks, there is much to transfer into the way in which Plastic Surgery Services and training will be delivered in the future. Renewed efforts to invigorate their training and career trajectories are now needed, in a time when traditional routes to skill acquisition from high caseloads and apprentice-type experiences will not be available.

The pursuit of equality and social justice is witnessing a rebirth as a powerful force across the world, and those in senior positions in Plastic Surgery should be seeking to deliver this within their Associations, training schemes, and departments. With specific regard to training, IT solutions empower equity and it will be interesting to follow the development of our affiliated Associations' use of web-based platforms. BAPRAS webinars are available 2 that have looked at aspects of service provision, safety, and future development of subspecialty services. EURAPS are commencing educational webinars in June. The JPRAS -ICOPLAST -PLASTA journal clubs 3 are building their content and style of delivery, and will continue to provide greater meaning when interpreting the Editor's Choice papers that are open access during the month of publication.

As services resume greater activity there will be a growing need to address challenging ethical and pragmatic issues around capacity, safety, and prioritisation. Immediate breast reconstruction is a key testing ground for this, and is being address by a BAPRAS Webinar on 11th June 2 , with Journal content to follow. Restarting paediatric services is hampered by a lack of specific data on the patterns of COVID-19 disease in children, particularly with regard to peri-operative risk for major procedures, despite their response and epidemiology clearly differing from adults 4 . Such evidence as there is points to a greater disease severity in those aged 5 or less 5 , the key age group for elective plastic surgery so national or international audit of paediatric plastic surgery safety is sought, of similar scope to that now being compiled for adult flap surgery by BAPRAS.

JPRAS will continue to support COVID-related publications, but now looks to restore equity in quality with those addressing non-COVID topics, in order to enable our readers to safely interpret findings and access data powerful enough to help them drive their local decision making, training, and service re-development.

Frontline

Systematic Review of COVID-19 in Children Shows Milder Cases and a Better Prognosis Than Adults