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17th National Conference of Association of Cutaneous Surgeons (I) (ACSICON 2019)––Conference Report
Address for correspondence: Prof. Chander Grover, Department of Dermatology and Sexually Transmitted Diseases, University College of Medical Sciences (UCMS), Guru Teg Bahadur Hospital (GTB), Dilshad Garden, Delhi-110095, India. E-mail: chandergroverkubba76@gmail.com
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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
Keywords
Cadaveric surgery
conference
hands-on workshop
skill lab
workshop
3D show
The 17th Annual National Conference of the Association of Cutaneous Surgeons (I) was held from April 18 to 21, 2019 at Delhi. The whole scientific program was designed in keeping with the theme for the Conference “Cutaneous and Aesthetic Surgery: Minimizing Risks, Maximizing Outcomes.” The program focused more on “showing how” rather than “telling how.” The Conference’s highlight were 32 workshops, which focused on niche areas in dermatosurgery. They were designed to provide varying learning experiences (inside operating room live demonstration, video demonstration, hands-on experience, simulated settings, cadaver training, and mannequin training), so as to cater to different types of learners. There were 14 preconference workshops, held on Day 1, whereas 18 Conference Workshops were held on Day 2.
The preconference workshops included Cadaveric surgery workshops conducted the first time ever in an ACSICON. The two cadaveric workshops focused on demonstrating filler and toxin injections; and flap and graft technique [Figure 1]. Participants understood facial anatomy and tissue planes like never before. For other preconference workshops, the focus was on providing the participants with an inside operating room perspective and totally practical tips regarding various types of surgeries [Figure 2]. For this, many centers of excellence across Delhi-NCR chipped in by graciously opening their doors for enthusiastic learners. This set of workshops included those focusing on basic dermatosurgery techniques, nail surgery, hair transplantation, vitiligo surgery techniques, acne scar management, aesthetic dermatology techniques including toxin and filler injections, and thread lift procedure. There were 189 registered delegates for these 14 workshops at various leading centers spanning the length and breadth of Delhi-NCR. This massive exercise, on the first day of the conference itself, was unprecedented and highly appreciated.
- Cadaveric surgical workshop in progress
- Live demonstration surgical workshop inside AIIMS OT
Day 2 was more consolidated (all 18 workshops at the same venue!), but more elaborate (in terms of number of participants––318, topics covered, as well as the teaching techniques adopted!). The highlights were the two skill labs and four hands-on workshops. the skill labs created a simulated atmosphere for practical learning. Participants learnt operation theater etiquettes and preparation along with basic suturing techniques on artificial skin models in the morning skill lab. The afternoon skill lab focused on handling of dermatologic emergencies where the participants were taught basic life support, anaphylaxis management, intubation, management of lignocaine toxicity, and intra-osseus injections on eight different stations. The teachings were through mannequins, charts, role play, and tissue specimens. The hands-on workshops gave an opportunity to practice toxin injections, filler techniques, thread lifts, and chemical peels to enthusiastic learners under the direct supervision of trained faculty. These workshops were a major draw for the enthusiastic delegates. A novel three-dimensional show demonstrating principles and practice of periorbital aesthetics was another major highlight. Apart from this, there were nine video-demonstration-based workshops demonstrating surgical nuances of various techniques in a stepwise fashion. Participants got to choose from basic cutaneous surgery, vitiligo surgery, ablative and non-ablative laser surgery, Platelet rich plasma (PRP) and platelet rich fibrin, scar and keloid surgery, nail surgery, liposuction and fat transfer surgery, acne scar surgery, and hair restoration. Master classes on Research methodology and Tips on publishing completed the list.
In the evening, there was a formal inauguration ceremony graced by the Chief Secretary, Government of National Capital Territory of Delhi (GNCT of Delhi), Shri Vijay Kumar Dev, IAS who spoke eloquently about the need to recognize dermatosurgery as an important subspecialty [Figure 3]. The Registrar, Delhi Medical Council, Dr. Girish Tyagi apprised the house about ethics in medical practice, especially dermatosurgery. He also brought up important issues about the statutory support required by individual dermatosurgery practices in terms of biomedical waste management. The Key note speaker, Dr. Patrick Mwamba, USA elaborated his experience on the art, science, and commerce of hair restoration. He emphasized the need for proper training in the field of hair restoration to help master the basics of hair transplant surgery and avoid harm to our patients. He said that innovation and technology in this field will allow hair transplantation to achieve results and to confirm its position as a full-fledged branch of aesthetic medicine.
- Opening ceremony of ACSICON 2019
Third day onwards, the conference started with six parallel halls catering to different topics. As a mark of respect and gratitude, the six halls were named after eminent dermatosurgeons and dermatologists including Lawrence Field, PN Behl, Rafael Falabella, Satish Savant, Yvon Gauthier, and Hemangi Jerajani. There was a lot to choose from between 30 different focused sessions and six plenary hours with talks by eminent national and international dermatosurgeons [Table 1]. The first day witnessed plenary talks by Jaishree Sharad (Rational use of injectables: need based, not greed based); Venkatram Mysore (Publications that have influenced me); Bertrand Richert, Belgium (Management of nail tumors); Mario Goisis, Italy (Facial rejuvenation with fat grafting, micro-fat, stem cells, and PRP); Thomas Knackstedt, USA (Nasal reconstruction); and Satish Savant (Difficult cases and innovative solutions). The talks were full of newer and useful learning points [Table 1]. Dr Subrata Malakar delivered the prestigious PN Behl Oration as he shared his experience on the utility of dermoscopy in dermatosurgery. The next-day plenary talks were by Ganesh Pai (Picosecond versus nanosecond lasers); Eckart Haneke, Germany (Cosmetic aspects of cutaneous tumor surgery); Andrew R Christie, UK (Principles and applications of microneedling); and Marc Roscher, South Africa (Dermatosurgery in 2019). The plenary talks were futuristic, inspiring, and showcased years of experience of the eminent speakers.
| • Picosecond Q-switched lasers are high powered lasers which are very useful, especially in pigmentary disorders. They need to be used judiciously to get good results. The advantage is the lesser number of sessions required as compared to nanosecond lasers. |
| • Picosecond lasers work on the principle of laser-induced optical breakdown (LIOB), which leads to dermal hemorrhage and epidermal vesicle formation. This type of injury stimulates growth factors and induces dermal remodeling. |
| • Picosecond lasers are more advanced than nanosecond Q-switched lasers for all pigmentary clinical conditions. They are additionally useful in a broad range of indications including wrinkles, acne scarring, and tattoo removal. |
| • Automated micro-needling delivers procedural safety and predictability for all Fitzpatrick skin types and ethnicities by removing the risk of post-inflammatory hyperpigmentation and pro-fibrotic growth factors |
| • Automated micro-needling delivers pinpoint precision and comfort for innovative delivery of active substances, solutions, and drug combination therapies into the skin. |
| • Regarding surgical approaches toward nail tumors, it was emphasized that nail avulsion is a must for bed and matrix surgery. |
| • Undermining is almost always needed with nail bed surgery. |
| • The operators should not be afraid of large defects on the nail bed and lateral walls as a result of tumor removal as secondary intention healing also gives good results. Bridge flaps can be used for the lateral wall defects. |
| • During nasal reconstruction, a restoration of volume, contour and symmetry with appropriate texture and color match should remain the top priority. |
| • One can consider cartilage grafts to prevent structural collapse of the nasal valve. |
| • Local flaps are preferred for nasal reconstruction given their reliability and reproducibility. |
Rest of the days of the days were kept busy by more than 200 national and international faculty members who were willing to share their knowledge and learning during talks as well as outside them. It was indeed a great learning and networking opportunity with several parallel meetings of the Association of Cutaneous Surgeons (I) as well as other core groups and planners. There were devoted free paper sessions where more than 40 young researchers got to share their research findings. These are the future of dermatosurgery in India and ACSICON 2019 spared no effort in encouraging them for their hard work. On the sidelines were E-poster presentations by more than 80 young colleagues which were viewed enthusiastically, and judged proficiently for subsequent E-poster awards. Clinical studies and interesting case reports were judged as separate categories and awarded suitably. The Annual ACSI Quiz saw enthusiastic participation by 17 national teams who had cleared the zonal online rounds. They competed vigorously for selection for the quiz finals. In the end, four teams made it to the finals and team from INHS Ashwini won the quiz.
The conference also witnessed the first time launch in India of products such as the Soprano Titanium as an advanced solution for laser hair removal and Dermapen as a microneedling device. The products were live demonstrated to the delegates by eminent trainers. The industry support received by ACSICON was visible in the extensive trade area and also in the innovative sessions organized in the Industry Hall. The manufacturers got to showcase their latest technologies that were highly appreciated by the dermatosurgeons. Innovations in dermatosurgery were also honored through a separate devoted session as well as special awards instituted for this very purpose. ACSI also honored the best thesis paper, best surgical video, and young dermatosurgeon. The conference concluded with the valedictory session, with the next executive team of ACSI taking over the reins of this fast-growing society [Figure 4]. The young achievers and those who contributed toward the conference in various capacities were honored during the ceremony.
- Valedictory session and formal closing of the conference in progress
Acknowledgement
The authors wish to acknowledge the support received from Dr. Pooja Arora Mrig, Dr. Khushbu Mahajan, and Dr. Deepak Jakhar in framing the scientific program and compiling the report.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
