key: cord-0837809-1rkmw7ss
authors: Bakota, Bore; Čretnik, Andrej
title: Advances in trauma and reconstructive surgery in Croatia despite the covid-19 pandemic()
date: 2021-09-25
journal: Injury
DOI: 10.1016/j.injury.2021.08.021
sha: 887217fc5f7d7997bd2e4ce6cc10305dd2d1f284
doc_id: 837809
cord_uid: 1rkmw7ss

nan

During the last year and a half, as the SARS COVID-19 pandemic has affected our lives so much, it is practically impossible to avoid mentioning this particular topic within our introduction.

Despite the original thought that COVID-19 is not a "surgical disease", it made such a great impact on everything surrounding us, that even our "surgical lives" were almost completely turned upside down. If anyone, the surgeons should be very much aware of the importance of wearing a mask and other protective equipment as well as of conducting various epidemiological measures in the sense of hygiene, asepsis and reducing the risk of infections. Surprisingly, wearing a mask in a correct manner together with "social distancing" has been proven, not only as "cost-effective" but also as the most efficient measure in our anti-COVID-19 strategy [1] . Despite the fact that standard surgical masks have been used for decades in surgical theaters, actually, they cannot act as a physical barrier "stopping" the viruses, a, but they have been proven as an extremely effective asset in prevention of aerosol spreading and therefore viruses forwarding [1] . Disinfection and aseptic surgery are also very well-known proven "surgical clinical practices" and have brought so much benefit in surgical strive against various infections since the time of Joseph Lister, the "father of modern Surgery" [2] . Indeed, they have demonstrated many benefits nowadays in the "anti-COVID-19 battle" as well. In other words, surgical measures and surgery itself have actually "played" not only an important, but perhaps a crucial role in fighting the COVID-19 pandemic. Nevertheless, we should be aware that a most probable R This paper is part of a supplement supported by The Croatian Trauma Society.

* Corresponding author. realistic solution to a COVID-19 pandemic is in fact a combination of a variety of measures including vaccination. As all coins have two sides, we should also keep in our minds the "dark side effect" of the COVID-19 pandemic in surgery; there were thousands of postponed and even cancelled procedures as well as clinical examinations, with prolonged waiting times and sometimes even unacceptably long waiting lists for many already scheduled patients and delays in various diagnostics and surgical therapies in all types of patients, including unfortunately, the patients with cancer and/or serious illnesses. We should also not forget that the risk for severe postoperative pulmonary complications in patients who were operated on increased from 8% in patients without COVID-19 infection to 51% in combination with COVID-19 infection, accounting for additional mortality rate of up to 10% [3 , 4] . Therefore, we should be aware of the risk stratification importance in patients, together with optimized conditioning as well of the importance of multidisciplinary team approach towards the patients, especially during the COVID-19 pandemic [5] . Moreover, applying basic science research and clinical research results promptly, into clinical practice has been shown to be crucial in fighting the COVID-19 pandemic [5 , 6] . As viruses cannot be stopped by 'customs, borders, walls and/or even armies', the logical effective solution should be in an international cooperation and solidarity that includes sharing of knowledge, skills, and competencies.

These ideas particularly, were a kind of our "fill-rouge", our governing principles in preparing the articles for this supplement with an international cooperation and contributors, sharing the ideas and our work to be published in this Injury Supplement.

We offer our readers topics in Basic science and Experimental studies as well as in a variety of Clinical trials covering several fields of Traumatology and Orthopaedic Surgery.

We sincerely hope the readers will find these topics not only interesting but also helpful in preparing strategies of patient care, and as such, we believe we have succeeded in our objective to bring some useful thoughts not only to our readers but to the entire community for the benefit of our patients.

An evidence review of face masks against COVID-19

Lister: father of modern surgery

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Dying with SARS-CoV-2 infectionan autopsy study of the first consecutive

How to risk-stratify elective surgery during the COVID-19 pandemic?

The effects of COVID-19 pandemic on the provision of urgent surgery: a perspective from the USA