key: cord-0719142-d8lw7nod authors: Cherubino, Mario; Valdatta, Luigi title: Plastic Surgery in Coronavirus Disease 2019 Emergencies: Report from Northern Italy date: 2020-05-13 journal: Plast Reconstr Surg Glob Open DOI: 10.1097/gox.0000000000002913 sha: 944d04c66309a1328226fcabef6d6670d2c46ff5 doc_id: 719142 cord_uid: d8lw7nod nan A t the present time, we are in the middle of a critical global pandemic infection. 1, 2 Since last February, in Northern Italy, the spreading of the infection forced health care to execute a major shutdown of activities. 3 The first and most affected region in Italy is Lombardy, which has the most advanced healthcare in the whole country. Since February 24, all the elective cases were partially stopped, while from March 2, a complete stop of surgeries was put into effect. General plastic surgery activities were progressively reduced: in the first week, we were able to perform breast reconstruction procedures, including second-stage procedures. The reduction in elective activities was intended to reach 2 different results: first, to have healthcare staff (both doctors and nurses) available to be assigned where needed, and second, to avoid any unnecessary contact between patients and sanitary operators. The outpatient's activities at the moment are still operative, but only for urgent visit and medications. Notwithstanding the elective procedures that are suspended, urgent and oncologic procedures must be guaranteed. The regional (Lombardy) health care system reorganized the hospital network into 2 different typologies, the Hub hospitals and the Spoke hospitals. 4 The Hub hospital is the main hospital for a specific disease (Oncological, Interventional Cardiology, etc). There are 18 hub hospitals from the 112 hospitals. The same hospital can be hub for one disease and spoke for others. The plastic surgery department nowadays is organized as follows: The ASST Settelaghi Hospital of Varese, in which we work, is 1 of only 3 hubs for traumatic pathology and the only one in microsurgery and hand surgery in Lombardy that counts 9 million inhabitants. Therefore, the plastic surgery division continues to assure service, taking care of patients with the following urgent pathologies: hand fractures, microsurgical replants, posttraumatic urgencies for damage control, 5 necrotizing fasciitis (Figs. 1, 2 ) or septic states due to soft tissues or prosthetic material infections. (See Video 1 [online] , which displays the debridement of abdominal external oblique and latissimus dorsi muscles' fascia.) Despite the increase of the overall affluence, due to the nation's total quarantine, the incidence of trauma has decreased. This makes it possible to redirect part of the staff to other health care activities. In conclusion, the division of Plastic Reconstructive and Aesthetic Surgery, in this moment of emergency in Related Digital Media are available in the full-text version of the article on www.PRSGlobalOpen.com. VIewPOINT PRS Global Open • 2020 the region most affected by the disease outside of China, continues to play its role, focusing on postoncological reconstructive and posttraumatic cases. The Italian health system, with an impressive and difficult internal reorganization, is functional to face the emergency and to allow the continuity of care for nondeferrable pathologies. World Health Organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19) WHO novel coronavirus 19 disease DGR+2906 + 8+marzo+2020.pdf?MOD=AJPERES&CACH EID=ROOTWORKSPACE-5e0deec4-caca-409c-825b-25f 781d8756c-n3anYxS. Accessed Role of negative pressure therapy as damage control in soft tissue reconstruction for open tibial fractures The authors have no financial interest to declare in relation to the content of this article.