5th International Conference on Advances in Skin, Wound Care and Tissue Science October 15-16, 2018 Rome, Italy

Biography:

Han is a Professor of Plastic Surgery at the Korea University College of Medicine. He received BS degree from the Korea University College of Medicine and MSc degree and PhD degree in medicine from the Korea University Graduate School of Medicine. He is Director of the Diabetic Wound Center and the Cell Therapy Laboratory at the Korea University Guro Hospital. He specializes in the diabetic wound healing and cell therapy. He continues to provide state of the art skin and soft tissue reconstruction for skin cancers. He is an author for 4 books (Innovations and Advances in Wound Healing, Management of Diabetic Wound, Advances in Wound Repair, Asian Rhinoplasty), 8 book chapters, and over 200 scientific articles including 62 articles published in the SCI journals as a principal author. He has also edited 5 books. He is Founding Member and current President of the Korean Wound Management Society.

Abstract:

The art and science of tissue restoration are complex and intriguing. During the last 20 years, the speaker has been interested in the development of new techniques and materials that can improve functional and aesthetic results in wound repair and/or soft tissue restoration through a procedure of the least degree of invasiveness based on cell therapy. The aim of the talk is to share the speaker's clinical experience with cell therapy for skin and soft tissue restoration. This talk is organized into three major sections. First part covers cell therapy to repair acute wounds on the face and the hand. Especially, cases of skinand soft tissue restoration after removal of skin cancer, fingertip reconstruction, and phalangeal bone reconstruction after trauma will be presented. Second part presents treatment options to successfully close non- and/or delayed- healing chronic wounds, diabetic foot ulcers in particular. Diabetic wounds respond poorly to conventional treatments due to the involvement of multiple factors. It is imperative that the most problematic matters should be identified in each patient so that patients can receive patient-customized treatments. The speaker's personal experience of cell transplantation for stimulation of wound healing with a variety of cells is presented. Last part addresses soft tissue augmentation using injectable tissue.

Biography:

John Greenwood AM is an English-trained plastic surgeon who graduated from the University of Manchester in 1989 and now working full-time in burn care as the Medical Director of the Adult Burn Centre of the Royal Adelaide Hospital in Adelaide, South Australia. He has been developing skin replacement products, utilising the NovoSorb biodegradable polyurethane platform, since 2004. He was appointed Member of the Order of Australia (AM) following his work leading Australia’s only Burns Assessment Team after the carnage of the 2002 Bali Bombings which killed 202 civilians. He was the 2016 South Australian of the Year.

Abstract:

Introduction: NovoSorb BTM is a completelysynthetic, bilayer ‘active’ temporizer. It buys time for patient and surgeon to allow recruitment of resources for definitive closure whilst improving the wound bed for definitive closure.
Methods/Results: We had noticed consistently improved surgical course and outcomes in burn patients treated with BTM and subsequent skin grafting. However, we had not fully appreciated the differences side to side until the 13th patient. In this 29 year old with 71% TBSA burns, initial complete debridement on Day 0 was followed by 1:2 meshed split skin graft to the
chest and abdomen 3 days post burn. With insufficient donor sites, BTM was applied to his limbs at the same time. On Day 38 (5 weeks later), 1:2 meshed graft was applied to the integrated BTM on Day 38. At 9 months, markedly reduced mesh pattern and a softer, more supple result where BTM was implanted, even better by a year. This finding changed our practice. The
next two big burn patients had similar courses. A 150Kg man with 70% TBSA full thickness burns injury to bilateral hands, forearms, arms, chest, abdomen, posterior trunk, thighs and circumferential left leg underwent tangential excision on Day 0. BTM was applied to all wounds on Day 3. Four serial grafting operations occurred between Day 42 to Day 72. He was
discharged to inpatient rehabilitation at Day 91 and went home (converted to outpatient rehabilitation) three weeks later.
Conclusions: A better functional and cosmetic result with delayed grafting on BTM at 5 weeks compared to early grafting on fat made us question the traditional wisdom of early wound closure at all costs. Additionally, if a delay is desirable, definitive closure using autologous composite cultured skin becomes a viable option, raising the possibility of not needing skin grafts at
all for closure!

Biography:

Kirkland-Kyhn Graduated from University of California, San Francisco, with major studies in obesity, geriatrics, and wound care. She currently works as the
Director of Wound Care, at UC Davis Medical Center. Her phenomenon of interest includes wound care in low resource settings, prevention of pressure ulcers in hospital and in the community. She has worked in England, Ireland, and the US with additional wound experience in Cameroon, Belize and Haiti. Her research has  continued in the occurance of pressure ulcers in poorly perfused patients. Presently she has been working on pressure ulcers as compared to community acquired pressure ulcers

Abstract:

Background: Why do Deep Tissue Injuries (DTIs) develop in critically ill patients, despite all Braden risk related interventions implemented on admission?
Methods: Twenty-five variables were collected over a 5-year period on all DTIs that evolved into pressure ulcers; 10 variables were identified as risk factors for the development of DTIs. The variable data was collected for patients with sacral DTIs (n=47) that evolved into stage 3, 4 or unstageable pressure ulcers. The general adult ICU patient data was collected for comparison (n=72). The analysis of the data was compared to determine specific parameters of patient related risk factors in patients who developed DTIs that evolved into stage 3, 4 or unstageable pressure injuries. Once all variables were entered into the model, a backwards regression was performed to find the most significant risk factors in the development of a DTI in ICU patients.
Results: We found a decrease in perfusion (hypotension) as the most significant contributor to DTI. Patients with diastolic blood pressure below 49mmHg had 10 times greater chance of developing a DTI. Patients on dialysis had 4 times greater chance of developing a DTI. Surgical patients were at higher risk of DTI; for every 1 hour in surgery the likelihood of a DTI
increased by 20%. We did not find any significant difference in the Braden Score between those patients that developed DTI and those patients who did not develop DTI
Conclusion: This study found that patients with low perfusion developed DTIs despite all Braden related nursing interventions

Biography:

Laurence MICHEL is a team research group manager at Inserm Unit U976, Paris Saint-Louis Hospital. She works in the Skin Research Center conducted by Professor Martine BAGOT, head of the Saint-Louis Dermatology Department and director Armand BENSUSSAN, U976 director. During her carrier, she has been carried out clinical research in collaboration with the hospital Clinic Investigative Center, studying mechanisms of allergic and inflammatory cutaneous diseases in patients and providing her expertise in pharmacology for in vivo testing of new therapies in collaboration with pharmaceutics/cosmetics laboratories. She also worked as a fundamental researcher studying the mechanism of signalling pathways involved in inflammatory skin disorders and cutaneous cell resistance to treatment. Focus has been done on skin aging, dermal fibrosis, xerosis (dry skin), hair greying, depigmentation and hair loss, besides cutaneous pathologies (atopy,
cutaneous T cell lymphoma). External expert in national and international academic institutions. Author of 68 articles and 3 patents.

Abstract:

The process of cutaneous healing/repair is characterized by three major phases, closely related: Coagulation (A) and inflammation (B) during the first hours involving immune cells of the innate response, followed over time by a regeneration phase and a remodeling/maturation phase (C) mainly conducted by dermal fibroblasts. To promote tissue repair, there is a multitude of dressings targeting the different phases of healing including calcium alginates and high absorbency fibers. The aim of the present study was to determine the effects of these wound dressings subtypes on human dermal fibroblasts, knowing that some of them do act on the coagulation and hemostasis phase as well as on the wound debridement Primary cultures of dermal fibroblasts were established from human surgical normal skin residues (n=6 to 12) and were studied for their molecular and functional responses to conditioned media from three wound dressings: Calcium alginate Algosteril®, Biatain® Alginate and UrgoClean®. The results showed that Algosteril® dressing among the 3 dressings significantly promoted the cell migration and consequently the closure of the dermal wounds as demonstrated by scratching experiments. No alteration of the viability of dermal fibroblasts was depicted with Algosteril® and Biatain® Alginate, whereas UrgoClean® did. Concerning gene macro-arrays induced in TGFβ-activated fibroblasts, Algosteril® significantly increased the synthesis of main collagens, extracellular matrix-remodeling enzymes, cytokines promoting fibroblast migration and proliferation, as well as allowing the recruitment of immune cells and thus promoting the development of an innate response that ensures the debridement of  the wound. Biatain® Alginate was less efficient than Algosteril® Stimulation of pro-inflammatory cytokine production was also significantly increased with Algosteril® whereas it was not with other studied dressings. Altogether, our results about these different parameters pointed out that Algosteril® among other dressings will facilitate the repair of the tissue matrix and prepare an effective healing phase

Biography:

Rachael Moses completed her PhD at Cardiff University in 2016 and is currently a Postdoctoral Research Associate at Cardiff University, UK. Her research focuses on elucidating the mechanisms underlying the novel epoxy-tigliane pharmaceuticals exceptional dermal wound healing responses. She was awarded a travel bursary to visit a medical research institute in Queensland, Australia, to undertake Microarray Analysis determining key genotypic changes following epoxy-tigliane treatment. She has filed patents with an industrial partner in this sector (QBiotics Ltd.); and has been awarded conference prizes relating to this area

Abstract:

Novel epoxy-tiglianes, EBC-46 and EBC-211, are sourced from seeds of the Fountain’s Blushwood Tree, indigenous to Queensland. EBC-46 possess potent tumouricidal properties, through classical PKC activation, and is under development by our industrial partner, QBiotics Ltd., as a human and veterinary anti-cancer pharmaceutical. In clinical studies, EBC-46 also
stimulated exceptional dermal healing, manifested as accelerated wound re-epithelialisation, closure and minimal scarring. This work describes epoxy-tigliane effects on keratinocyte wound healing responses and their underlying mechanisms of action. Immortalized human epidermal keratinocytes (HaCaTs) were treated with EBC-46 or EBC-211 (0-10μg/ml). Cell cycle progression/proliferation were assessed by FACS analysis and MTT assay. HaCaT migration was assessed using in vitro scratch wound assays. Global gene expression changes induced by epoxy-tiglianes were quantified by Microarray analysis, with differentially expressed genes confirmed by protein level analysis. As epoxy-tiglianes mediate responses via classical protein
kinase (PKC) activation, mechanistic studies were performed with BIM-1 (pan-PKC), Gö6976 (classical-PKC) and LY317615 (PKC-βI/PKC-βII) inhibitors. Western blotting confirmed phospho-PKC activation following epoxy-tigliane treatment. Both epoxy-tiglianes induced significant HaCaT cell cycle progression and proliferation; and also promoted significant HaCaT
scratch wound closure. Microarray analyses identified key genes differentially expressed in EBC-46/EBC-211-treated HaCaTs, which contribute to their stimulatory effects on keratinocyte proliferation and migration. Enhanced proliferative and migratory responses were significantly abrogated by BIM-1 and Gö6976, although LY317615 exhibited minimal inhibitory effects. PKC
activation increased following epoxy-tigliane treatment. Such findings explain the enhanced re-epithelialization responses in epoxy-tigliane-treated skin; and provide justification for their translational development as novel therapeutics for impaired wound re-epithelialisation.

Biography:

John Greenwood AM is an English-trained plastic surgeon who graduated from the University of Manchester in 1989 and now working full-time in burn care as the Medical Director of the Adult Burn Centre of the Royal Adelaide Hospital in Adelaide, South Australia. He has been developing skin replacement products, utilising the NovoSorb biodegradable polyurethane platform, since 2004. He was appointed Member of the Order of Australia (AM) following his work leading Australia’s only Burns Assessment Team after the carnage of the 2002 Bali Bombings which killed 202 civilians. He was the 2016 South Australian of the Year.

Abstract:

Introduction: The NovoSorb BTM is a completely synthetic bilayer material comprising a dermal component (2mm thick biodegradable polyurethane foam) bonded to a pseudoepidermis of non-biodegradable polyurethane film. Its primary function is to ‘temporise’ wounds, buying time for a definitive closure option to become available. Since the dermal foam becomes integrated and creates a neodermis, it is an ‘active’ temporiser, improving the wound bed for definitive closure.
Methods: During a pilot trial of BTM in 5 significant burn injured patients, and in 13 patients subsequently, several complex problems emerged. With careful planning and meticulous surgical technique, BTM has been used to overcome these problem wounds. Where bone has been exposed, denuded of periosteum or paracranium, two strategies have allowed BTM use, integration and successful closure with split skin grafts. Either the cortex has been drilled to allow granulation from the medulla within) or dermabraded off (exposing medulla, or calvarial diploie). BTM has also been used to reconstruct amputation stumps, where the extent of the burn has left poor coverage (allowing more distal amputation) and providing a significantly better and
more robust stump for prosthesis application. Additionally, in several patients, part of, or the whole back, have been treated by BTM application, integrating despite allowing the patient to lie on them continually. Since the BTM is not yet regulated in Australia, these were treated under the Therapeutic Goods Administration (TGA) Authorised Prescriber Scheme. In all cases a photographic (and sometimes video) record has been taken at every procedure and review and each case will be discussed.
Results/Conclusions: The matrix integrated completely in all cases and graft take was uniformly excellent. There was noincidence of loss or problems with infection. Using BTM the matrix avoided major flap reconstructions in some patients, and yielded a far better result than graft alone in others

Biography:

Regina Folster-Holst completed her PhD in 1984 from Christian-Albrechts-University, Kiel, Germany. After a Medical Assistant time in a children's clinic for Cystic Fibrosis and Allergy at Amrum, Germany, she began her specialist training for dermatologists at the Department of Dermatology, Kiel, Germany, in November 1985. In 1992, she was recognized as a Specialist in Dermatology and Allergology. Her habilitation was in 2003, at the Medical Faculty of the Christian-Albrechts-University of Kiel and the appointment as a Professor took place in 2007. Since 1992, she works as a Senior Physician at the University Medical Center Schleswig-Holstein, Department of Dermatology in Kiel, Germany. Clinical activity and research are priority for her, primarily in the area of Atopic Dermatitis, Pediatric Dermatology, Exanthems in Childhood
and Parasitosis.

Abstract:

Pediatric dermatology shows a very broad spectrum. This includes infections, inflammatory dermatoses, allergies, autoimmune diseases, auto-inflammatory syndromes and tumors. Some diseases, such as the erythema toxicum neonatorum, occur only in neonatal age. The many diverse diseases all have a specific pattern, which includes morphology, distribution, history (of the patient and the family), cutaneous and extracutaneous symptoms. The pediatric dermatology quiz will reflect these patterns.

Biography:

Abstract:

Biography:

Abstract:

Introduction: Cold atmospheric pressure plasma (CAP) is a promising tool for biomedical and clinical application. Cold physical plasma are partially ionized gases that mediate biological response generating ROS and RNS species.1-3In this study, we used the medical device class 2a kINPen MED®; it is clinically approved atmospheric argon plasma jet. Typical active agents being generated include ions, electrons, and reactive oxygen and nitrogen species (ROS/RNS). Electric and magnetic fields, light (visible, in-frared, UV), and neutral particles are being generated 4. It is well known, that wound oxygenation is an
important factor of wound healing and scavenging reactive species could impair wound healing In this study, we examined the extent of wound healing and the underlying cellular mechanism in vitro induced by CAP. Our group had also collected wound exudates before and after CAP treatment from 7 ambulant diabetic patients with chronic wounds from ‘Competence Center Diabetes’ in Karlsburg. These wound exudates were also analyzed.
Methods: For our studies, we incorporated dermal keratinocytes, fibroblasts and co culture. An indirect treatment where
CAP treated media (RPMI) was added and a direct CAP treatment on the cells (different time points) were performed and
the migration assay was monitored. Matrix metalloproteinase play a pivotal role in wound re epithelization. The amount of
metalloproteinase and several cytokines (especially Interleukins) in the patient exudates were also monitored by ELISA.
Results and future direction: Short-term CAP treatment induces enhanced cell migration than longer treatment and
compared to untreated control. Co culture studies show an improved cell migration upon CAP treatment compared to
keratinocytes alone. Matrix metalloproteinases and Interleukins were also reduced in wound exudates after CAP treatment
which indicates improved wound healing. It was also evident with an average of more than 80 % reduction in the wound size
of the patients undergoing CAP treatment. Also, the signaling machinery of wound healing involving inflammatory (mediated
by interleukins) and regenerative pathways (mediated by HIPPO signaling) are currently being checked by quantative PCR and
western blot to identify an autocrine/paracrine signaling pathway induced by CAP.

Biography:

A Polak PT, PhD is a physiotherapist, lecturer and specialist in wound healing physical therapies.

Abstract:

Introduction: Electrical stimulation (ES) is recommended for treating Stage II-IV pressure ulcers (PUs) but optimal ES protocols for wound treatment have yet to be established.
Aim of study: To evaluate the effect of high-voltage monophasic pulsed current (HVMPC) on periwound skin blood flow (PSBF) and PU size reduction.
Methods: 38 individuals with Stage II-IV PUs were randomly assigned to anodal and cathodal ES groups (AG, CG), andplacebo ES group (PG). All groups received standard wound care. The AG and CG received additionally respectively anodal and cathodal HVMPC (154 μs; 100 Hz; 360 μC/sec), 50 minutes a day, five days per week, for 4 weeks. Wounds of the PG were
treated with sham ES. PSBF was measured at baseline and at weeks 2 and 4. Wound surface areas were measured at baseline,
and at week.
Results: 12 patients were treated in the AG (mean age of 52.83), 13 in the CG (mean age of 52.00), and 13 in the PG (meanage of 54.46). PSBF at weeks 2 and 4 was higher by, 105.71%±92.51) and 128.23% (SD 108.34) respectively, in the AG; 108.53% (SD 75.53) and 92.67% (SD 153.90) in the CG; 30.88% (SD 53.37) and 28.82% (SD 42.53) in the PG. The differences between
AG : PG and CG : PG were statistically significant at week 2 (p=0.038, p=0.037 respectively), and at week 4 (p=0.041, p=0.048 respectively). Wound percentage area reduction calculated at week 4 for the AG (58.25%; SD 32.29) and the CG (53.92%: SD 16.15) was significantly greater statistically than that obtained by the PG (26.46%; SD 19.29), p=0.036 and p=0.048. Changes in
PSBF and wound size reduction between the AG and CG were not statistically significant (p>0.05).
Conclusions: Anodal and cathodal HVMPC proved effective in improving PSBF and reducing the size.

Biography:

Vincent Maida is a consultant in Palliative Medicine & Wound Management at the William Osler Health System in Toronto. He obtained his medical degree from the University of Toronto. He was promoted to Associate Professor at the University of Toronto in 2011. He completed his MSc in Wound Management in 2010, his Medical Teachers Certificate in 2011, and his certificate in Patient Safety and Quality Improvement in 2014, all 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 4 textbook chapters, over 30 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 5 continents, 14 countries, and over 50 cities

Abstract:

Statement of the Problem: Wound Pain generates significant suffering, reduced quality of life, and reduced productivity for patients. At present, opioids are the commonest modality. Systemic opioids have recently come under scrutiny given the world wide epidemic of accidental overdoses. Topical opioids have demonstrated only marginal analgesia in 3 of 8 randomized
controlled studies, and their onset of action occurs 60 minutes of their application. Furthermore, recent studies are demonstrating that opioids also inhibit wound healing. The discovery of the endocannabinoid system throughout the integumentary provides a valid and logical scientific platform to consider the use of TMC based medicines in wound management.
Methodology & Theoretical Orientation: A series of n=1 trials of patients with painful wounds reporting greater than 5/10 pain were offered treatment with TMC based medicines that were applied directly to their wound beds. More than 20 patients were treated and their wound etiology’s included Pyoderma Gangrenosum, Venous leg ulcers, ischemic ulcers, vasculitis, acute
zoster, burns, and skin cancers. All patients experienced more than 50% pain relief within 5-10 minutes of topical instillation onto their wound beds. The duration of analgesia ranged between 4-6 hours. An opioid sparing effect was noted in the majority of cases. No adverse reactions, neither systemic nor local, were observed or reported by patients.
Conclusion & Significance: As a safe, inexpensive, self-titrated, and non-invasive treatment modality, TMC based medicines hold great potential in wound management and may help to curb the current world-wide opioid crisis. TMC based medicines may be useful in all wound classes. TMC based medicines have the potential to deal with both baseline wound pain and wound-related breakthrough pain such as procedural pain.

Biography:

John Greenwood AM is an English-trained plastic surgeon who graduated from the University of Manchester in 1989 and now working full-time in burn care as the Medical Director of the Adult Burn Centre of the Royal Adelaide Hospital in Adelaide, South Australia. He has been developing skin replacement products, utilising the NovoSorb biodegradable polyurethane platform, since 2004. He was appointed Member of the Order of Australia (AM) following his work leading Australia’s only Burns Assessment Team after the carnage of the 2002 Bali Bombings which killed 202 civilians. He was the 2016 South Australian of the Year.

Abstract:

Introduction: The NovoSorb BTM is a completely synthetic bilayer material comprising a dermal component (2mm thick biodegradable polyurethane foam) bonded to a pseudoepidermis of non-biodegradable polyurethane film. Its primary function is to ‘temporise’ wounds, buying time for a definitive closure option to become available. Since the dermal foam becomes integrated and creates a neodermis, it is an ‘active’ temporiser, improving the wound bed for definitive closure.
Methods: BTM has become a solution for complex wound surgical reconstruction, both acutely and long-term. The first four patients were post-necrotising fasciitits. The first (neck) had serial debridement, which left the muscular structures of the neck and the left submandibular gland exposed. The second required upper limb amputation through the shoulder and had extensive flank wounds with exposed ribs. The third had a large lower limb wound down to muscle. The fourth was an elderly dialysis patient with an open axilla, flank wound and exposed ribs. The fifth in the series was the degloved dorsum of foot The sixth has a carcinoma resection over radiotherapy-treated calvarium on which a graft repair failed. The seventh was a very extensive post-necrotising fasciitis wound involving neck and chest. The eighth and ninth were reconstructions for poor function in adults who had been burned as children. Since the BTM is not yet regulated in Australia, these were
treated under the Therapeutic Goods Administration (TGA) Authorised Prescriber Scheme. In all cases a photographic (and sometimes video) record has been taken at every procedure and review and each case will be discussed.
Conclusions: The matrix integrated completely in all cases and graft take was uniformly excellent. There was no incidence of loss or problems with infection. Using BTM the matrix avoided major flap reconstructions in some patients, and yielded a farbetter result than graft alone in others.

Biography:

Jeffrey Blake Stricker is a Dermatologist and Dermatopathologist practicing in Dothan, Alabama. He completed both his Bachelors in Medical Technology and Doctor of Osteopathic Medicine at Michigan State University in East Lansing, Michigan (USA). He completed a combined Anatomic Pathology and Laboratory Medicine Residency at Texas A&M University College of Medicine (USA), a Dermatopathology Fellowship at the University of Texas Southwestern Medical School (USA), and a Clinical Dermatology and Mohs Surgery Fellowship at the Skin Cancer and Cosmetic Dermatology Center in Georgia (USA). He is a Clinical Professor of Dermatology and Pathology and has served on three specialty certification boards.

Abstract:

Superficial radiation therapy (SRT) is a clinical treatment modality where ionizing radiation is used as a viable, non-surgical option for most Non Melanoma Skin Cancers (NMSC) as well as keloids. The science behind superficial radiotherapy in dermatology practice is reviewed, as are indications, dosing strategies, and comparisons to surgical treatment.

Biography:

Tomasz Ziach achieved his master's degree in Stomatology from Warsaw Medical University. He has completed postgraduate internship in Maxillo -Facial Surgery Department where he has achieved degree in Oral Surgery. From 2006 he attended numerous courses in School of Dentistry in Birmingham UK and has completed postgraduate Diploma in Oral Implantology in Cambridge University of United Kingdom. In 2010 he started his postgraduate course in Bristol University and Reading Bob Khana advanced integrated Aesthetic Medicine. In the meantime, he has completed lots of postgraduate courses in Facial Aesthetics: Stomygen postgraduate Master Diploma -POIESIS provided by prof. Ezio Costa, ECLEST- certified by EBBA. - Warsaw University, Diet and Nutrition Diploma in Oxford University in 2014. Since 2015 qualified member of American Academy of Aesthetic Medicine and Facial Aesthetics in London. He has provided and participated in lots of Congresses and Training courses in Warsaw, Vienna, Sienna, Berlin, Miami, Bristol and London. One of the propagators of application of PRF and PRP in Facial Aesthetic,Trichology, Facial traumatology as intra oral and extra oral -integrated Stomatology - Cambridge University -provided by Joseph Choukron postgraduate course. Course provider in Aesthetic Medicine Training Centre London -Centre for Medical Science and Research.

Abstract:

Aesthetic Medicine as a multidisciplinary subspecialty of medicine plays important role in skin rejuvenation and anti-aging prophylaxis. As a integrated medical procedures they are aimed to at using non -invasive to minimal invasive medical intervention. Today’s studies show that skin quality is not be addressed as much it could be at doctor clinics. Many patients complain about skin fatigue -the words being used by patients are less radiant, gull, tired, dry and exhausted.

1. Skin Quality injections:

Microinjections on the surface of the skin, previously called Skin Boosters. More focused on skin Hydration. It was positioned as a alternative to Mesotherapy (NCTF) has been launched by Allergan -Jouvederm Volite -to treat great quality - hyaluronic acid injection to give a skin elasticity and hydration. Results last for 9-12 months.

2. Regenerative medicine

The new aesthetic medicine Aesthetic medicine can be divided into two types of treatment:

The Corrective treatments like Botox and Fillers

The Regenerative treatments

The most spectacular example is Platelet Rich Plasma and Platelet Rich Fibrin. It is a most Widespread of autologous cell grafting procedures. The future is having them both in one treatment: Corrective and regenerative. The whole idea is not to fill a wrinkle but to stimulate fibroblasts and the grow factors to produce a new collagen, regenerate the dermis, improve hydration and renew a skin and consistency. Second generation of Plasma called by his inventor Dr. Joseph Choukron Platelet Rich Fibrin has been commonly successfully used in dentistry, oral surgery, dental implantology maxilla-facial surgery, traumatology, sport injuries, TMJ disorders orthopaedics.

3. Sub mental fullness is now being addressed with fat-reduced injectable

New treatment of double chin has been launched in 2017 -Kybella R Belkyra R

Chin reducing injections. It is made from deoxycholic acid-a naturally occurring molecule. It breaks down a wall of fatty tissues. The body can then to eliminate unwanted tissue. The fat cells die off and do not return. It has mainly been used to treat double chin, buttocks, neck and arms.

4. Lifting threads with rejuvenating effects are all the range

The lifting effect is an immediate and discreet as a result of compressing the tissue and the skin at the time of implanting the suture. There is also tissue stimulating effect which comes from following example: Poly-lactic acid (PLA) the principal component of the threads acts on deeper layers of the skin and stimulate to produce collagen type II and IV. The regenerating affect is gradual. It is used in Silhouette Soft Threads like Princess lift from Chroma (PDO thread).

5. Bespoke cosmeceuticals is the way forward

Universe- skin provided by French cosmeceuticals brand with a mission to revolutionize cosmeceuticals industry by providing successful one-the-spot bespoke skin care. The doctor will assess your skin concern based on a questionnaire which then Colour codes the outcome to match specific ingredients. A tailor-mdi serum called Nexultra P will be created. All three specific actives come in a powder form and are mixed in the serum base in the centrifuge-type machine.

The choice of three specific compounds following the patient’s exact skin needs:

Mono function Actives: Ferulic, DMAE, rutin, Vit B5, glycolic acid, arbutic kojic acid.

Duo Function Actives: Superoxide dismutase, azelaic acid, madecassoside.

Multi-Function Actives: Vit. B3, aloe vera, isoflavones, retinol, L-ascorbic acid. Product has its shelf-life 6 weeks’ time. It must be stored into a fridge.

5. Laser Tattoo removals

6. Combination of eyes treatment

Latest application of the fillers for the tear trough, Botox, Radio-frequency, Ultrasound for instant tightening and longer-term collagen boost.

Biography:

Danijela Semenič has been graduated from University Ljubljana, Medical Faculty as Medical Doctor. Later on she obtained her post-graduation from University of Ljubljana. She is a specialist of general surgery on Department of Surgical Infections at the University Medical Centre Ljubljana, Slovenia. From 2015 she is a head of outpatient division of the Department of surgical infections, and for 5 years assistant on Medical Faculty Ljubljana. She is interested in complicated wound healing, necrotizing fasciitis cases, chronical wounds, renerative medicine and NTPW techniques. She is a member of Slovenian Surgical Club.

Abstract:

Statement of the Problem: Complex chronic wounds that do not heal sufficiently after applying the relevant modern dressing, deserve new healing options. Theoretical bases and clinical cases of patients treated with new methods of regenerative medicine are presented. Wound care with allogeneic platelet gel, authologous platelet rich fibrin, negative pressure wound therapy, and treatment with flowable acellular matrix are the opptions of choice. The new possibilities offered by regenerative medicine are accessible, effective, safe and painless for the patient.

Biography:

Badeh Nabil Zraik has completed his master's at the age of 29 years and studied medicine and finished his post graduate studies from Tishreen University, faculty of medicine, Lattakia, Syria.

Abstract:

Vitiligo is a chronic disorder, primarily believed to be of autoimmune origin. The natural course of the disease is characterized by periods of progression and remission, which remains unpredictable in spite of many advances in its pathogenesis and treatment. Medical therapies are considered as first choice to treat all types of vitiligo. However, it is increasingly known and documented that segmental vitiligo, lesions located on glabrous skin and with leukotrichia respond poorly to medical therapies. Surgical methods are useful to restore pigment in such cases and are being used more often. Surgical methods can be divided into tissue grafting such as punch graft, blister graft, and split thickness skin graft and cellular grafting which include cultured and non-cultured cell transplantation. Noncultured melanocyte-keratinocyte transplantation (MKTP) has many advantages over other methods and gives excellent cosmetic results in most of the treated cases. It is available only at select centers due to regulatory issues and lack of training. In addition to vitiligo, post burn leukoderma, piebaldism, chemical leukoderma, halo nevus were treated successfully with MKTP. The technique is being practiced for about 17 years at our center.

Biography:

Human fetal membranes (or amniochorion membranes) are the innermost lining of the intrauterine cavity. Membranes are fetal tissue in origin, start developing when fetal growth begins and are constituted by amnion and chorion connected by collagen rich extracellular matrix forming the innermost layers of the intraamniotic cavity. Extracellular matrix (ECM) made of fibrous proteins embedded in a polysaccharide gel and various collagen types provide the architectural and structural framework of the fetal membranes respectively. From the point of conception, pluripotent stem cells that surround the fetus forming the amniochorion membranes are vital to fetal survival. The amniochorion membranes are composed of multiple cellular and stromal layers containing epithelial and mesenchymal stem cells.

Since the early 19th century, physicians and researchers alike have been using either amniochorion or intact fetal membranes for wound repair, as cell-based wound dressings can be beneficial in many settings. These cells are used in a variety of fields, forming organs in vitro, and improving wound healing in clinics. There are many different forms of commercially available fetal membranes that are both cryopreserved and dehydrated which are useful in various clinical situations due to the abundance of different stimulating factors. In obstetrics, the usefulness of fetal membrane ECM is restricted to filling gaps in the membrane to avoid premature rupture of membranes arising from fetal surgery. This lack of application is partly due to the poor understanding of the properties of amnion epithelial cells and other cells in their extracellular matrix. By understanding where these cells come from and what their uses are in other areas, we can get a better idea of how they will act in vivo.

Abstract:

Laura Fernandes Martin has been Graduated from 2011 as Biologist. In 2013 she received her Master's Degree in Pathology and in 2018 she received the Doctoral’s Degree also in Pathology from Sao Paulo State University, UNESP. During her post-graduation, she Martin had the honor of realize a research internship at University of Texas Medical Branch with Dr. Ramkumar Menon to learn about his tissue science research. Presently she has been working at Sao Paulo State University (UNESP) – BRAZIL and the focus of her researches is on inflammatory and oxidative process in labor and the differences between preterm labor with intact membranes and premature rupture of membranes preterm.

Biography:

Hanaa Galal Ibrahim El Sherbiny is a well experienced general dermatologist who earned her medical degree from Cairo university 1997, Master of Science of Skin & Venereal diseases, Ain Shams University, –2005, she submitted thesis for medical doctorate degree from Al– Azhar University, Egypt –2013. With 20 years’ experience as a general dermatologist in both Egypt and Kuwait. A Member of Kuwait Medical Association, Kuwait Institute for Medical Specialization, Kuwait Society of Dermatologists, GCC League of Dermatologists, Pan Arab Society of Dermatology, International League of Dermatological Societies & Egyptian Medical Syndicate. She has special interest in teaching & education through social media.

Abstract:

Rosacea is a common chronic inflammatory disorder characterized by symptoms of facial flushing and a spectrum of clinical signs, including erythema, dry skin, and an inflammatory papulopustular eruption with periods of exacerbation. The current classification system developed by the National Rosacea Society Expert Committee consists of erythematotelangiectatic, papulopustular, phymatous, and ocular subtypes. Individual subtypes are likely a result of different pathogenic factors and respond best to different therapeutic regimens. Before initiation of therapy, the triggering factors should be identified and avoided. Daily applied sunscreen is a must. The main treatment modalities for rosacea include topical, systemic, laser, and light therapies. Traditional therapies include topical metronidazole or azelaic acid also oral therapy as tetracyclines or isotretinoin. Emerging therapies perhaps are more promising as topical ivermectin 1% cream which is proved to be safe and effective for the treatment of inflammatory lesions from papulopustular rosacea, Brimonidine tartrate and oxymetazoline are novel therapies to treat the erythema associated with rosacea. Other treatments as pimecrolimus 1% cream, clindamycin phosphate 1.2% + tretinoin 0.025% gel, PDL and IPL can also be used. With the advent of novel therapeutic options for the treatment of rosacea such as subantimicrobial anti-inflammatory dose doxycycline, ivermectin and Brimonidine tartrate, there is renewed interest in the study of this disease which was once regarded as a debilitating disorder and now has become a well-known and manageable entity in the setting of these emerging therapeutic options. Herein, we describe the treatments currently available as well as the emerging and combination therapies

Biography:

Romashkina Anastasia Sergeevna has completed her PhD from First Moscow State Medical University named after I.M. Sechenov Ministry of Health of the Russian Federation (Sechenov University). She is the Chief Physician of the medical center "AVROMED". She has published more than 30 papers in reputed journals. She is an expert of Skin Disorders of Lyme Disease in Moscow, Russia. She is expert of injections in Hyalual Institute, Switzerland.

Abstract:

Relevance: Many skin diseases, such as atopic dermatitis, seborrheic dermatitis, eczema, acne, rosacea and others, during the reconvalescence need the active participation of both a dermatologist and a cosmetologist with the goal of full physiological epithelization, moisturizing and preventing scarring and pigmentation. After the inflammatory dermatoses, we observe not only deeply dehydrated skin, which is associated with a decrease in the amount of hyaluronic acid, but also changes in the microcirculatory, which manifests itself in the form of impaired tone and vascular permeability. Often during the convalescence of dermatoses, after healing, there remains stable hyperpigmentation or depigmentation, as well as atrophic or hypertrophic scars, which are facilitated by a long process of regeneration at the sites of damage.

Purpose of the Study: To identify improvements in the structure of the epidermis and derma during the procedures performed with the use of the preparation, containg hyaluronic acid and sodium succinate.

Materials & Methods: We observed 20 women aged 30 to 40 years in the stage of remission of atopic dermatitis (two patients), seborrheic dermatitis (seven), rosacea (two), acne (seven), eczema (two). All women underwent procedures, using a combined preparation containing sodium succinate (16 mg/ml) and hyaluronic acid (11 mg/ml or 18 mg/ml). The drug was administered intradermally by the technique of papular injections with a 30 G needle, 2.0 ml per procedure, at intervals of one, every two weeks.

Evaluation: Satisfaction of the results of the procedures was assessed according to the International Global Aesthetic Improvement Scale (GAIS), as well as the questioning of patients before and after the procedures. Control of skin changes at the structural level was carried out by using the method of confocal laser scanning microscopy in vivo (CLSM).

Results: All patients showed a positive dynamic: A reduction in the intensity of hyperpigmentation, a more active skin regeneration (compared to similar areas in the same patient), improved skin turgor and elasticity, increased skin hydration. After the treatment there was a decrease in the severity of telangiectasia (mean score before treatment – 1.2, after treatment – 0.2), pigmentation (1.7 and 0.9 points), dry skin (1.1 and 0.1 points). A good moisturizing effect was noted in 18 (90%) patients, moderate – in 2 (10%). When studying the skin by the method of KLM, a reduction in the area of hyperpigmentation, as well as a reduction in its severity, regression of hyperkeratosis, a more even arrangement of the fibrous structures of the dermis, and improvement of microcirculation were observed. There was also an increase in skin thickness due to the above processes. Allergic reactions to drug administration have not been recorded. Absence of effect and negative dynamics during therapy were not revealed.

Conclusion: The protocol of using hyaluronic acid and sodium succinate has a good tolerance, promotes the acceleration of skin regeneration, restoration of normal skin hydration, normalization of pigmentation.

Biography:

Saied Vejdani graduated from University of Tehran in 2000, Cosmetic dermatology working in the fields of laser and energy base equipment from 2002, 27 international paper in the fields of lasers (all types), hair transplantation, injectables, scars (acne, hypertrophic, depressed, burn). Founder and Director of Tehran Aesthetic Center, Saadatabad Aesthetic clinic, Gundi Aesthetic day clinic, Mollasadra Aesthetic center in Tehran, Iran.

Abstract:

Objectives: Years after years people want more noninvasive procedures to be done specially for their aesthetic problems. New dermal fillers and technical modifications have “revolutionized” the facial aesthetic surgery in recent years. Among them, Hyaluronic Acids are the most reliable ones. It has been mentioned that with these modifications, invasive surgeries have been reduced in all over the world, less trauma, less downtime, less side effect. What are these all about?

Methods: In an attempt to clarify these points, we compare the results in 120 patients, 86 female 34 male with using Hyaluronic Acid as a filler for the patients with after surgery problems such as: Saddle deformity, Dorsal unevenness, Prominent humps, Minor deformity, Minor tip rotation and also Patients who cannot do surgery due to medical or personal reasons and many other indications.

Results: 95% Patients satisfaction. 93% of the patients wanted to do this procedure again after the filler is gone. 29% of patients had bruising for about a week. 65% of the patients mentioned they will never do surgery again.

Conclusions: It’s only a 15 minutes office base procedure with local anesthesia and minimal risk and no downtime, the patients can see the immediate result, so patients prefer to do this procedure than the surgery.