Day 1 :
Serena Group| USA
Time : 09:15-10:00
Thomas E. Serena is the Founder and Medical Director of SerenaGroup™, a family of wound, hyperbaric and research companies. Serena completed his residency in Surgery at the Hershey Medical Center. To date he has opened and operates wound care centers across the United Sates and globally. He has been the lead or Principal investigator in over 100 clinical trials and is recognized internationally as an expert in the fi eld of wound healing: He has more than 100 published papers and has given more than 1000 invited lectures throughout the world. He has been a member of the Board of Directors of the Wound Healing Society and served two terms on the board of the Association for the Advancement of Wound Care (AAWC) and is now the President-Elect. He has also been Vice-President of the American College of Hyperbaric Medicine and President of the American Professional Wound Care Association
Clinical research is an essential component of SerenaGroup’s ™ Center-of-Excellence model for wound and hyperbaric centers. We are one of the world’s leaders in clinical research on wound care and hyperbaric medicine, having conducted over 100 clinical trials involving growth factors, gene therapy, bioengineered skin products, and novel pharmaceuticals. In 2011 SerenaGroup™ clinics conducted the research that led to the fi rst diagnostic in wound care. Th e ensuing manuscript
named the diagnostic procedure the Serena Technique©. In conjunction with Harvard’s Wellman Institute we developed and performed the initial clinical studies on a painless, bedside epidermal skin-harvesting device that is functioning not only in hospitals in the US but in third-world clinics as well. Our emphasis on clinical research over the years has drawn a group of young clinicians and scientists to participate in our research projects in the US and internationally, who are dedicated to advancing the science of wound healing. We formed the nation’s fi rst wound healing cooperative group consisting of more than 30 centers in the US and worldwide that now conducts entire multi-national clinical trials. In 2015 SerenaGroup Innovation™ opened a laboratory at the Northeastern Ohio Medical School to conduct preclinical studies in wound healing. Th e research team has fi led numerous patents as a result of these efforts
University of Pittsburgh| USA
Keynote: A critical review of the clinical experience on autologous cell-spray grafting for deep-partial thickness burns
Time : 10:00-10:45
Dr. Gerlach was recruited to the University of Pittsburgh after the Washington-based non-profit World Technology Evaluation Center (WTEC) report, “Tissue Engineering and Research 2002", identified him as one of the experts worldwide addressing 3-D perfusion high-density culture design for medical devices. Dr. Gerlach holds an MD and two PhDs with a background in surgery, experimental surgery, and bioengineering. With his dual appointment, he directs the interdisciplinary Bioreactor Group at the McGowan Institute for Regenerative Medicine within the University of Pittsburgh and contributes to the Schools of Medicine and Engineering. Most of his projects focus on cell biology methodology and bioengineering technology developments are designed to contribute to knowledge on controlling cell behavior for anticipated patient treatments. His working hypotheses, consequently, relates mostly to the behavior and function of progenitor cells in an in vitro environments that he developed. Dr. Gerlach´s general interest is in technologies for the clinical translation of stem cell biology research, and he concentrates on the development of innovative cell-based therapies. In the area of skin he developing active wound dressings and cell spray grafting technologies. His “Skin Gun” development was broadcasted on National Geographic TV and is posted on YouTube under the key word “skin gun”.
Innovative skin stem cell-based therapies in burn and trauma surgery are described, that of interest to reduce the significant complication rate of acute non re-epithelializing skin wounds.
An interdisciplinary team of cell biologists, experimental surgeons and bioengineers at the University of Pittsburgh; clinical experts in burns and trauma patients (University of Pittsburgh Medical Center, UPMC Mercy Hospital Burn and Trauma Units); the original developer of the technology (StemCell Systems, Berlin, Germany) and an industry partner that enables commercialization and marketing (RenovaCare, NY); is working on implementing skin cell-spray grafting, using the patient´s own skin stem cells, in an autologous on-site setting of isolation and grafting in one operation room.
We could introduce cell isolation techniques and spray grafting of single non-cultured stem cells from the epidermis and the dermis. This contribution explains the experience of treating over 44 patients with deep partial-thickness burns in Pittsburgh and provides an analysis of problems, pitfalls and remedies, with overall very satisfying clinical results.
Our cell isolation and clinical application success rate improved over time, reducing to a 10% failure rate after treating the first 10 patients, to a 0% clinical failure rate in the patients group of patients 21-30 and 31-40 and 41-47. No patient died of burn treatment. The rate of overall fully satisfying procedures increased by time as well. All initial factors that contributed to technical issues could be identified and addressed. Our rate of technical issues during the procedure decreased significantly over time by 75% to a current 20% technical issue rate. A current rate of 20% technical issues in patients 41-47 occurred only after changing a technical practice, and we could fully address the issue by identifying an education gap when training new technical assistants. This also indicates that staff training, timely quality control and thorough quality management is important, while changes in the procedure need to be carefully monitored.
The overview concludes with therapy suggestions for expediting and enhancing the wound healing process in acute burn and trauma patients, reducing scar formation and complications in deep partial-thickness burns.
A further development of such technologies may result in a paradigm shift in acute burn wound treatment, towards autologous stem cell- based grafting therapy for patient-tailored treatments.
Networking and Refreshment 11:00-11:20 @ Foyer
University of Chicago Medicine| USA
Keynote: Subatmospheric Pressure Wound Therapy (SAWT) in the management of wounds with small bowel fistulae in neonates and infants. Preparing the patient for successful wound closure
Time : 11:20-12:05
Mieczyslawa Franczyk has completed her master's degree in PT and post graduated study for PhD from the University of Physical Education in Poland. She graduated from University of Illinois Public School of Health. She is a member of the American Physical Therapy Association. She is author or co-author 8 papers, 7 in the arena of subatmospheric pressure wound therapy
Background: Subatmospheric pressure wound therapy (SAWT) has revolutionized the management of complicated wounds in adults and pediatric population. Abdominal wounds with fistulae and stomas in infants and neonates presents the additional challenge of managing fistulae/stomas output. Using SAWT for treating wounds with an enterocutaneous fistulae in adults is well described in literature. Review of literature does not demonstrate the widespread use of SAWT in the presence of a fistulae in this population. There is, however, a paucity of evidence to support such use of SAWT in the presence of a fistula in the neonatal population.
Methods: From 2008 to 2015 10 neonates/infants with an abdominal wound in the presence of fistulae were treated with SAWT along with stoma pouch or urine collection bags.
Results: All wounds went on to heal or were adequately prepared for surgical closure.
Conclusion: Our clinical experience suggests that neonatal abdominal wounds in the presence of stomas and fistulae can be effectively treated with SAWT.
Peskin Pharmaceuticals| USA
Brian Peskin, is a theoretical research scientist specializing in lipids based pharmacognosy, and CEO of Peskin Pharmaceuticals. His research focuses specifically on physiologically targeted Essential Fatty Acids (EFAs) and their eicosanoid metabolites. Being a translational science expert with a long-term interest in diabetes and its underlying pathophysiology, extensive work in oncology and cardiology preceeded his applications into diabetic foot ulcers. His work is focused on pathways maximizing oxygen delivery and blood flow to the human cell and maximizing tissue functionality. Focus is on supporting and optimizing the patient's natural physiologic processes - not blocking or impeding metabolic pathways
Clinicians all know of the unmet need for a new solution to chronic wounds; in particular, Diabetic Foot Ulcers (DFUs). They present the most challenge to even the best wound care specialists because of the significant added complications of diabetes. Their 50% recurrence rate (after 3 years) and 42% 5-year mortality rate exemplify the underlying causes aren’t sufficiently treated and solved. Genetic research offers great promise, but an effective solution is needed today. This presentation will utilize a physiologic approach for advancing healing of all wounds; in particular, the most difficult to heal DFUs. Interdisciplinary discoveries will be explored and integrated into a powerful, new physiologic approach for healing diabetic wounds/ulcers.
Neurropathy and ischemia are primary underlying risk factors for diabetic ulcers. Discoveries in cardiology are presented and utilized because more than 50% of patients have microvascular or macrovascular complications. Discoveries in oncology are utilized because cancer is now considered a “wound that doesn’t heal.” Utilizing state-of-the art interdisciplinary translational science, the solution is completely epigenetic, easy to clinically implement, and applicable and complementary to all patients regardless of particular underlying etiology or existing treatment.
Participants will learn how to modulate key eiconsanoids with correct plant-based lipids to significantly speed wound healing:
a) increase cellular oxygenation (decreasing hypoxia) via enchanced mitochondrial and cellular efficiency
b) decreasing inflammation and increasing blood flow through increased PGE1 & PGI2
c) reducing blood glucose levels
d) accelerating underlying tissue repair.
Case Studies will be reviewed to support the recommendations.