Conference Schedule

Day1: February 25, 2019

Keynote Forum

Biography

Vincent Maida is a Consultant in Palliative Medicine & Wound Management at the William Osler Health System in Toronto. He has graduated with his MD from the University of Toronto and was promoted to an Associate Professor at the University of Toronto in 2011 after the five years from his junior promotion. He has completed his MSc in Wound Management from University of Toronto in 2010. In 2011, he completed his Medical Teachers Certificate, and in 2014, he completed his Certificate in Patient Safety and Quality Improvement, both at the University of Toronto. He is an Active Researcher with particular interests in pain and symptom management, wound management, prognosis and medical education. Over the past 10 years, he has published four textbook chapters over 35 original research papers, created numerous original conceptual innovations in Palliative Medicine and Wound Management, as well as delivering over 100 national and international presentations on five continents, 15 countries, and over 50 cities. Over the past 10 years, his publications have been cited by other researchers and authors more than 500 times worldwide.

Abstract

Statement of the Problem: The endocannabinoid system is ubiquitous throughout the human body and has recently been found to have a significant representation throughout the integumentary system, both cutaneous membranes and mucous membranes. Topical medical cannabis (TMC) based medicines are intrinsically lipophilic and contain both delta-9-tetrahydrocannabinols (THC) and cannabidiol (CBD) in varying proportions. Given that wound beds are largely lipophilic absorption of lipophilic agents, such as cannabinoids, is enhanced.
 
 
Methodology & Theoretical Orientation: A series of n=1 trials were initiated on a cohort of stalled recalcitrant wounds, composed of cases of greater than 12 months duration, were treated with TMC based medicines. All cases were previously afforded with all available evidence-based treatments that confirmed with local best practices and wound-bed preparation principles. Ten cases were studied for wound analgesia, ten cases for wound healing, and four cases for disease modulation. Etiologies represented within the cohort understudy included: pyoderma gangrenosum, leukocytoclastic vasculitis, cryoglobulinemia, antiphospholipid syndrome, sickle cell disease, Bowen’s disease, and squamous cell cancer. Clinically significant analgesia, wound healing, and disease was noted in all cases. The TMC medicines were applied directly applied to wound beds. TMC was very well tolerated and no adverse reactions were observed.
 
 
Conclusion & Significance: The highly positive results observed in a cohort of the most challenging recalcitrant cases provoke realistic interpolation that TMC based medicines may be effective for a broader context within wound management. The endocannabinoid system is a viable epigenetic target and platform for exploring therapeutic options for skin and wound conditions. Therapies based on topical medical cannabis that interact at the level of the endocannabinoid system have significant potential to improve the three main target outcomes in wound management, namely, wound analgesia, wound healing and disease modulation that includes antineoplastic action.
 
 
 

Biography

Adam J Singer has completed his MD from Ben-Gurion University and his Residency in Emergency Medicine from Stony Brook University. He is the Vice-Chair in the Emergency Department of Emergency Medicine at Stony Brook University. He has published more than 400 papers in reputed journals and has been serving as an Editorial Board Member of repute. He has received millions of dollars in funding from the NIH, DoD and industry.

Abstract

Study of human keloids and hypertrophic scars has been limited by the lack of a large animal model. While transplantation of human scars onto nude, athymic mice has been used for many years, these models are limited by the small size of mice and the major difference in the anatomy and healing of wounds between mice and humans. A severe combined immunodeficiency (SCID) pig has recently accidentally been discovered. The authors tested the hypothesis that human cadaver skin would be rapidly rejected by immune competent pigs and accepted by SCID pigs. In each of two normal and two SCID pigs, created ten partial thickness dermatomal wounds were created onto which split thickness skin grafts from human cadavers were transplanted. Wounds were followed with digital imaging and periodic full thickness biopsies for 28 days. On each pig created two additional partial thickness wounds were also created which were covered with autografts from the same pig, which served as controls. In normal pigs, all of the autografts survived throughout the entire study period while all of the xenografts were rejected, mostly by T-cells, and sloughed within 5-11 days. In contrast, all autografts and xenografts survived the 28-days study period with minimal if any inflammatory response. At the end of the study period, it was difficult to distinguish between the autografts and xenografts based on gross visual inspection. This study concluded that the SCID pig is appropriate for transplantation of human skin and are further developing this humanized skin model using keloid and hypertrophic scars. 

 

Biography

Fabio Fantozzi has received his Doctor of Medicine Degree from Sapienza University of Rome, one of the oldest and most esteemed universities in Europe. He also has completed his Residency in General Surgery at this Distinguished University. He has completed a Plastic Surgery Residency with Professor Ivo Pitanguy at Carlos Chagas University in Rio de Janeiro, Brazil-the oldest plastic surgery college in the world. This unique training gave him hands-on experience that many other schools do not provide and has led to the opportunity to work with some of the leading surgeons in the field of Cosmetic and Reconstructive Surgery.

Abstract

Background: Reconstructive plastic surgery has clinically integrated fat grafting for breast, facial and other reconstructive and restorative surgeries, with high success. Now, the power that fatty tissue holds is beginning to be understood. In this article, we studied the technique of fat grafting in the face, explaining all the steps taken and including a number of illustrative case studies. 
 
Method: This study covers over 15 years of practical experience in applying fat grafting techniques to face. The cases studies cover the use of fat grafts in reshaping and rejuvenation of the face. The fat tissue is taken from the flanks, umbilical region or knee area, after decantation, it is injected into face to treat wrinkles, depressions, improve zygomatic area during a surgery of the face to improve the results post op.
 
Results: The proposed technique has been applied in practice to 120 patients. The progress of each patient treated has been followed for a minimum of 12 months. Over this period, their contour changes have been analysed, along with the effects of the procedure(s) on the skin. There were no long-term complications. The quantities of fat vary from 5 cc to 30 cc. 
 
Conclusion: The cases studies cover the use of fat grafts in reshaping and rejuvenation of the face. Autologous fat grafting is a good method because it presented a long-lasting result after a one year follow-up. Evident rejuvenation of the skin was seen, because new subcutaneous tissue rich in fat cells was created. A large presence of fat cells produces beneficial effects on the deep and superficial tissue (skin). Absences of allergic reactions as the patient’s own fat cells are used. Less expensive option as there is no payment for the biologic filler (fat tissue). 
 

Biography

Daniel A Weisz is a Podiatrist, Medical Director and Entrepreneur. He was graduated podiatrist who has been practicing podiatry for the past 25 years and has been involved in the hands-on, clinical research, medical and consumers' worlds in order to keep people up on their feet. Amongst his experience, he has founded and medically directed the Wisefeet-Foot and wound treatment centres. He was Co-Founder and CMO-Invertex whose technology was recently purchased by Nike. He is President and Founder of the Israeli Association of Podiatrists and Chiropodists, Adviser to Footwear industry worldwide, acts as Chief Podiatrist of Israel Defence (reserve) Forces, Chief National Podiatrist at Maccabi Medical Health Services, is treasurer of the international branch of the UK podiatry college and was Head of the Foot clinic at Bikur-Holim Medical centre in Jerusalem.

Abstract

According to the IDF, every thirty seconds a foot is amputated due to diabetes. The prevalence of diabetic feet can reach 13% in some regions and facts indicate that in addition to patient’s mental health, social implications etc. the feet complications are among the most costly in the health budget. Global diabetes is expected to increase to an average of 50% until 2045, therefore the need to use modern technology to treat and avoid these ailments are a must nowadays and should be implemented worldwide to prevent and salvage diabetic related amputations. Treatments using topical hyperbaric chambers and low level laser therapy have proven to salvage lower limbs, with a success rate of 76% in severe cases which were due to be amputated and 95% in those of vascular related. The use of modern technology to prevent pre-ulceration and other feet ailments is mainly from the consumer retail high tech world. Using state-of-the-art technology that corrects footwear fitting can prevent disastrous outcomes and modern medical technology can save legs and eliminate amputations.

Tracks

  • Traditional medicine on wound healing, tissue transplants, nursing, regenerative medicine, plastic surgery
Location: Captain C
Speaker

Fabio Fantozzi

Clinic Fantozzi, Italy

Chair

Speaker

Vincent Maida

University of Toronto, Canada

Co Chair

Biography

Graduated Medical faculty in Riga, Latvia, MD, PhD. Author of several international patents and ageing scales. Studied in several Europian countries on skin dermato-oncology, endocrinology and genetics, such as Paris, Prague, Graz, Düsseldorf . One of the first and leading experts in the Baltic and European countries, specializing in regenerative, preventive, anti-aging medicine, physician, dermatologist, dermatologist and leading scientific researcher in the field of dermato-endocrinology, epigenetics and nutrigenetics, as well as the owner of several International Patents on anti-aging compositions and skin aging scales. The recognized lecturer who has received international recognition at the world level, congresses and symposiums, in particular, on the training of doctors and alumnis on the intellectual methods of preserving health and beauty.

Abstract

Introduction: During skin aging, cumulative photodamage, exhaustion of endogenous stem cell populations, mechanical stress, and increased fibrosis lead to skin with decreased epidermal thickness and compromised dermal integrity (Maciej Nowacki et al, 2018). Stem cell-based therapies have been widely used for their abilities to repair and regenerate different types of tissues and organs in cosmetic and plastic surgeries. Despite the fact, that most treatments involving stem cells are new and have very little evidence based efficacy, stem cell treatments for skin rejuvenation are already being hailed as the preferred method by which to perform a facelift non-surgically (Odunze M et al 2011). Mesenchymal stem cells (MSCs) seem to be an ideal source for tissue engineering application due to the lack of ethical concerns, high availability and increasing number of methods for isolation and expansion of such cell types (Davood Mehrabani et al).

 

Aim: Our aim of the study so as to analyze effectiveness of autologous fibroblasts application on skin post fractional laser rejuvenation.

 

Materials & Methods: Both Gender Caucasian patients were revealed, aged 35-55 years. Punch biopsies 5 mm and skin excision were done. Punch biopsy has sterilized in 70% ethanol for 2 min. Wash the biopsy pieces in 0.9% sodium chloride by centrifugation at RT for 5 min at 2000xg. After washing, using the sterile forceps put the piece of skin in T25 cm2 flasks and add DMEM media with 10% of HyClone supplement and 1% of Penecilin/Streptomicin. Place the flask in 37 ºC incubators and incubate approximately for 2 weeks till 80-90% of cell confluence. Once the fibroblasts are confluent, transfer them to more T75 cm2 flasks till get 5x106 for freezing and checking the fibroblast sterility to bacterial and fungi contamination, mycoplasma contamination, karyotype and cell surface markers-CD105, CD90, CD73, CD44.

 

Results:  Once the cells from punch biopsy get confluent, fibroblasts are passaged to two more passages to get more cells for cryopreservation and for characterization. As flow cytometer data shows isolated fibroblasts from all five patients are more than 95% positive to CD105, CD90, CD44, CD73 and 0% positive to negative cell surface markers - CD19, CD34, CD45, CD11b, HLA-DR. Sterility test for bacterial and fungal contamination were negative for all patients sample. Mycoplasma contamination test were negative for all five patients sample. For autologous fibroblasts application on skin were used 15x106 cells in 1% Natrosol gel.

 

Conclusion: Cellular therapy based on autologous dermal fibroblast holds enormous promise to the field of regeneration medicine. It offers a safe, immunologically acceptable and simple alternative for tissue regeneration applications. Cellular therapy based on autologous dermal fibroblast holds enormous promise to the field of regeneration medicine. 

Biography

Giacomo Clerici has graduated in Medicine and Surgery of the University of Pavia and specialized in Internal Medicine, trained in diabetic foot care and diabetic foot surgery. He was Former member of the Italian Diabetes Associations, SID and AMD and The European Diabetic Foot Study Group (DFSG) of EASD. He is current Member of the Association of Diabetic Foot Surgeons; Author of several papers listed in PubMed and chapters in books dedicated to the Diabetic Foot Syndrome; Speaker at many international conferences and courses, worldwide (US, Mexico, India, China, Brasil, Saudi Arabia, Israel, etc.). He organized several international wound care/DF meetings including WOUNDS at VEITH symposium in the US (www.veitsymposium.org), the Multidisciplinary International Limb and Amputation prevention conference (MILAN) in Europe and the Winter/Summer school of diabetic foot surgery in Milan and Bergamo. He was a Co-programme Director of iLegx (www.ilegx.com). Currently, he is the Chief of the Amputation Prevention Centre Humanitas Gavazzani Hospital in Bergamo and Humanitas Pio X Hospital in Milan, Italy.

Abstract

There is a long clinical tradition in the use of footwear and offloading techniques for the prevention and healing of plantar foot ulcers in the diabetic patient. Unfortunately, ulcers in the plantar aspect of the foot represent just a part of the entire wounds that we are use to see in our clinical daily practice. It is important for these reasons to use a sort of offloading algorithm in order to offer the best offloading methods according to the site lesion. This algorithm could allow the health care providers to talk the same language everywhere and to offer the same treatment worldwide

Biography

Joy Kong is a triple board-certified Physician (American Board of Psychiatry and Neurology, American Board of Addiction Medicine, American Board of Anti-Aging and Regenerative Medicine). She is very passionate about Regenerative Medicine and believes it is the medicine of the future. She is the Founder of Chara Biologics with the goal of providing the best regenerative medicine products in the country, inspired by the remarkable results she saw in her own patients. She also founded American Academy of Integrative Cell Therapy, to provide physician education and training, so that regenerative medicine can be practiced safely and effectively, with sound knowledge of the science behind it.

Abstract

The history and characteristics of MSCs are discussed, as well as MSC's therapeutic properties. The effect of age is discussed in detail as to how it affects MSC's quality and their ability to proliferate, differentiate and exert therapeutic effects. Evidence of the effects of lifestyle and illness on MSC quality is discussed as well. The presentation will also cover direct comparative studies on differences between umbilical cord derived MSCs vs. bone marrow-derived MSCs vs. adipose-derived MSCs, including differences in their growth profile, cellular senescence and anti-inflammatory properties. Comparisons of MSC's from above different tissue sources are also discussed in specific areas such as orthopaedics, cancer, angiogenesis and neuroprotection. Specifically regarding umbilical cord-derived MSC's, their primitivity, differentiation potentials and gene expressions are discussed. Lastly, the advantages and disadvantages of autologous vs. perinatal allogeneic stem cell therapies are discussed.

Biography

Rose has received a BS in Physical Therapy from the University of North Carolina, Chapel Hill, and an MS and Post-graduate DPT from the University of Southern California.  She is currently an Adjunct Assistant Professor of Clinical Physical Therapy at the University of Southern California, as well as Adjunct Professor at Western University of Health Sciences. She is a Certified Wound Specialist and a Fellow in the College of Certified Wound Specialists.  She has written several book chapters and journal articles on wound healing and is the Editor of Text and Atlas of Wound Diagnosis and Management published by McGraw Hill Education. She has lectured on negative pressure wound therapy, wound dressings, diagnosis of atypical wounds, lower extremity edema management, and current concepts in wound management to interdisciplinary groups in a variety of settings. She is a Member of the APTA Academy of Acute Care and Academy of Clinical Electrophysiology and Wound Management, the American Academy of Wound Management, and the Association for the Advancement of Wound Care. Rose is passionate about the care of patients with wounds and about teaching students the role of physical therapy in caring for patients with wounds.

Abstract

Caring for patients with chronic, recalcitrant wounds requires a multi-disciplinary approach that focuses on why does this patient have a wound? Why is this wound not healing? Once those questions are answered, a care plan that addresses the whole patient can be developed.  The focus of this presentation is the role of physical therapy (PT) in an academic hospital setting in treating patients with the four basic wound types (arterial, venous, pressure, and diabetic). Discussion will include how PTs can assist in diagnosis, as well as interventions that focus on promoting wound healing, preventing recurrence, and optimizing function for each of the wound types.

Biography

Independent TVNC Sylvie Hampton has 25 years of experience in wound care: four years as Enthusiast, five years as Specialist Nurse in a hospital and 16 years as Independent Consultant running a private wound healing centre commissioned by the NHS to care for chronic wounds. She has written 400 articles and two books on wound care. She was a Trainer and advising nursing homes, District Nursing Teams, Practice Nurses and Hospital Nurses and also acting as an Expert witness. She has been working as a Specialist Adviser for CQC. She undertakes research in wound care /pressure ulcer prevention. She is a Consultant for Lindsay Leg Club Foundation and Marie Curie Hospice movement. Educator, organising study days and conferences.

Abstract

Pseudomonas) which resulted in large black ulcers across his back and scrotum. Because of the MDS, he should not have healed and the potential of infection, due to low white cell count, should have been a very high risk and yet he healed. Three dressings were used in healing these wounds. The first was a dressing pad that contained Ringer’s solution. Used on the sacrum from commencement to healed. The second used on the abscess over the back was the pad that contained Ringer’s solution, used to debride the wound and clean it. Then an activated carbon dressing used until healed. The third was a sheet gel dressing. This was used on all abscesses over the scrotum as it was the only dressing that would remain in situ. All of these wounds healed very successfully with this treatment. It is vital that the condition of the patient is taken into account when deciding on dressings. One dressing would not have cured all wounds.

 

Biography

Areej Mubarak Alqatifi is a Wound Ostomy Nurse at King Fahad Specialist Hospital Dammam, Kingdom of Saudi Arabia caring for wound, stoma, enterocutaneous fistula, and faecal incontinence patients.She Graduated from Imam Abdulrahman Bin Faisal University (University of Dammam) College of Nursing in 2007 with Bachelor’s degree in Nursing. After completing the Internship training, she joined KFSH-D in 2009 and worked as Registered Nurse (RN) in the surgical unit. In the mid-2013, she moved to more challenging position and joined the stoma and wound care team. She obtained her Postgraduate High Diploma of Enterostomal Therapy Diploma Program from KFSH&RC Riyadh in 2016 which is recognized from the World Council of Enterostomal Therapy (WCET). She is a Member in Wound Ostomy and Continence Nurses Society (WOCN) and World Council of Enterostomal Therapists (WCET).

Abstract

Enterocutaneous fistulas (particularly draining ones) can present a tremendous challenge for patients, family and clinicians. However, management may be quite rewarding when the effluent is contained effectively, odor is controlled and the patient is comfortable. Management requires assessment skills, knowledge of pathophysiology, competent technical skills, persistency and knowledge of management alternatives. Fistulas classified by its complexity into two main types: simple and complex fistula. Management of enterocutaneous fistula is divided into three main aspects: medical, surgical, and nursing. In the medical treatment, the main goal is conservative management, in order to allow for spontaneous closure by two main methods: decreasing gut secretions and nutritional support, when this approach failed or patient’s condition deteriorated the surgical intervention will be considered. Nursing management goals include: protection of the perisfistular skin, containment of the fistula output, quantification of the output, implementation of a cost-effective system, promote patient comfort, optimize physical function, and controlling the odour. Nursing management selection options depends on: anatomic location and origin of the fistula, condition of the perifistular skin and effluent’s consistency and volume. Choices for fistula management include: type of skin protection (solid, powder, or paste skin barrier), type of containment devices (pouches, suction catheters, or drain), patient’s activity level, and location, size and characteristics of the fistula. Low-output fistulas can be managed with dressing and protecting the perifistular skin with skin barrier, while the medium- to high-output fistulas will be managed similar to ordinary ostomies by using pouches or by using other options such as suction catheters and drains.