WELCOME TO NPPSS Lorem ipsum dolor sit amet, consectetur adipiscing elit. Fusce viverra sit amet velit eget tincidunt. Donec volutpat non nibh vel mollis. VESSELS TRANSFORMED, BEAUTY UNCOVERED In collaboration with Plastic Scientific Club (P.S.C) Malaysian Society of Plastic & Reconstructive Surgery (MSPRS) Ministry of Health 2nd National Plastic & Reconstructive Surgery, Hospital Kuala Lumpur Organised by #NPPSS2023 Scan QR for e-booklet: PAEDIATRIC PLASTIC SURGERY SYMPOSIUM 2023 HOSPITAL TUNKU AZIZAH, KUALA LUMPUR 19 - 20 SEPTEMBER 2023
NPPSS TABLE OF CONTENT 2nd National Paediatric Plastic Surgery Symposium 2023 Introduction ……………………………………………………………………………….….3 Welcome Messages ……………………………………………………………….…4 Organising Committee …………………………………………………………….…7 Main Speakers ………………………………………………………………………….….9 Programme …………………………………………………………………………………..19 Topic Highlights ..................................................................................27 Oral and Poster presenters ............................................................39 Sponsors and Exhibitors ……………………………………………………………42 Exhibition booths …………………………………………………………………........44 Notes............................. …………………………………………………………………..45
NPPSS INTRODUCTION 2nd National Paediatric Plastic Surgery Symposium 2023 Welcome to the 2nd National Paediatric Plastic Surgery Symposium 2023! Our symposium, focused on paediatric plastic surgery, promises to be an enlightening experience. We've gathered experts and dedicated professionals to advance our field and enhance the lives of our young patients. Within this program, you'll find everything you need – schedules, speakers, presenters, and more. Our heartfelt thanks go to our speakers, sponsors, partners, and volunteers for making this event possible. Please engage actively, share ideas, and build connections that can shape the future of paediatric plastic surgery. Your presence reflects your commitment to our mission. We hope you leave with fresh insights and new connections. Let's embark on this transformative journey together. Enjoy the symposium!
NPPSS WELCOME MESSAGES 2nd National Paediatric Plastic Surgery Symposium 2023
NPPSS YBRS. MR. DR. MOHAMMAD ALI BIN MAT ZAIN 2nd National Paediatric Plastic Surgery Symposium 2023 WelcomeMessages Mr. Dr. Mohammad Ali B Mat Zain Advisor 2nd National Paediatric Plastic Surgery Symposium 2023 Dear Colleagues and Participants, I'm thrilled to welcome you to the 2nd National Paediatric Plastic Surgery Symposium 2023. This event gathers professionals and enthusiasts dedicated to advancing paediatric plastic surgery for the benefit of our young patients. As the Conference Advisor, I'm proud to witness the symposium's growth. Our commitment to improving children's care through innovation and research remains strong. This year, we've assembled outstanding speakers and experts to share insights and advancements. This symposium fosters knowledge exchange and community building. It's a chance to connect, learn, and collectively enhance paediatric plastic surgery. Let's keep our focus on improving the lives of our young patients. I thank our speakers, sponsors, and volunteers for making this event possible. Embrace this opportunity to learn, connect, and advance our field. Welcome to the 2nd National Paediatric Plastic Surgery Symposium 2023. May it be a source of knowledge, inspiration, and lasting connections.
NPPSS YBRS. MR. DR. KOH KHAI LUEN 2nd National Paediatric Plastic Surgery Symposium 2023 WelcomeMessages Mr. Dr. Koh Khai Luen President 2nd National Paediatric Plastic Surgery Symposium 2023 Welcome to the 2nd National Paediatric Plastic Surgery Symposium 2023. We're delighted to have such a diverse and esteemed group here, all sharing a passion for pediatric plastic surgery. This event is a celebration of knowledge and innovation. Over the next two days, we'll engage in insightful discussions, share groundbreaking ideas, exchange knowledges and forge connections. Our theme, "Vessels transformed, beauty uncovered," reflects our commitment to addressing key issues and opportunities in our field. I extend my gratitude to speakers, sponsors, partners, and volunteers. Your contributions are vital. Please actively participate, network, and explore workshops and exhibits. Make the most of this knowledge-sharing platform. Thank you for being here; your presence enriches this conference. Let's make it a resounding success!
NPPSS ORGANISING COMMITTEE 2nd National Paediatric Plastic Surgery Symposium 2023 PAEDIATRIC PLASTIC SURGERY SYMPOSIUM 2023 Head of Department: Mr (Dr.) Mohammad Ali bin Mat Zain Advisor: Mr (Dr.) Mohammad Ali bin Mat Zain Chairman: Mr (Dr.) Koh Khai Luen Scientific Chairman: Miss (Dr.) Kasthuri Shamugam Secretary: Dr. Nur Aniessa bt Abd Rahman Treasurer: Dr. Satbir Singh Gill Co-treasurer: Dr. Eryana Susantri Bt A. Bakar Effendie PPP Shamsuri Idris
NPPSS ORGANISING COMMITTEE 2nd National Paediatric Plastic Surgery Symposium 2023 Protocol Committee: Dr. Eryana Susantri A. Bakar Effendie KUP Noraini binti Ibrahim Scientific Programme Committee: Dr. Yew Chun Kai Dr. Nandhini Ramasenderan Dr. Lam Hui Yuan Dr. Farid bin Mohd Amin Publication and Media Committee: Dr. Mohd Fikrillah Mohd Arif Kor Dr. Yap Wai Hoong Dr. Matthew SN Gwendolyn Nara SN Zulaikha Rahil binti Md Asri Sponsorship Committee & Booth: Dr. Rebecca Choy Xin Yi Dr. Nur Aniessa bt Abd Rahman PPP Shamsuri Idris SN Nabilah Food Committee: Dr. Yap Wai Hong Public Relation, Logistic and Technical Committee: Dr. Yap Wai Hoong SN Norhashimah bt Abdul Aziz SN Suriati binti Mohammad Hospitality: Dr. Muhammad Shahril Amri bin Shaharani Dr. Farid bin Mohd Amin Technical: Dr. Mohd Fikrillah bin Mohd Arif Kor MA Arthur Awet
NPPSS INTERNATIONAL SPEAKERS 2nd National Paediatric Plastic Surgery Symposium 2023
NPPSS PROFESSOR ANTHONY (TONY) PENINGTON 2nd National Paediatric Plastic Surgery Symposium 2023 Prof. Dr. Anthony (Tony) Penington Jigsaw Professor of Paediatric Plastic and Maxillofacial Surgery Royal Children’s Hospital AUSTRALIA Tony Penington is the Jigsaw Professor of Paediatric Plastic and Maxillofacial Surgery in the University of Melbourne Department of Paediatrics at the Royal Children’s Hospital. He is a specialist in the treatment of vascular anomalies, particularly vascular malformations. He oversees research in the Facial Sciences group at the Murdoch Children’s Research Institute and clinical research in all areas of paediatric plastic surgery including cleft lip and palate and craniofacial surgery. Until recently he was President of the International Society for the Study of Vascular Anomalies. PROFESSOR TEDDY O.H. PRASETYONO Prof. Dr.Teddy O.H. Prasetyono Professor Division of Plastic Surgery Department of Surgery University of Indonesia INDONESIA Theddeus O.H. Prasetyono, M.D., PhD. is a Hand and Microsurgery Consultant in Plastic Surgery, Cipto Mangunkusumo Hospital/ Universitas Indonesia. He is also the chairman of ICTEC (Indonesian Clinical Training & Education Center). He did his training in plastic surgery at the Universitas Indonesia and took fellowship training in Reconstructive Microsurgery & Hand and Microsurgery in the United States. His main area of interest and research are in the field of non-tourniquet technique of hand surgery and flap surgery, besides aesthetic surgery, and training & education. Currently, he is an active member and official bearer of several national and international organizations, such as Indonesian Society for Surgery of the Hand, OSAPS (Oriental Society of Aesthetic Plastic Surgery), and ISAPS (International Society of Aesthetic Plastic Surgery). He is the founding member of ASBPRS (Asian Society of Breast Plastic Reconstructive Surgeons).
NPPSS DR JACUB PANDELAKI 2nd National Paediatric Plastic Surgery Symposium 2023 Dr. dr Jacub Pandelaki, M.D, Ph.D Interventional Radiologist Fakultas Kedokteran Universitas Indonesia Dr. Cipto Mangunkusumo National General Hospital INDONESIA Dr. Jacub holds the position of Interventional Radiology Consultant at Department of Radiology, Faculty of Medicine, Universitas Indonesia. With a remarkable career marked by exceptional achievements and extensive expertise in interventional radiology, he consistently dedicates himself to providing precise diagnoses and timely treatments for his patients. His impressive clinical track record has earned him frequent invitations to speak at various medical conferences. Additionally, his strong academic foundation is evident through his numerous publications in prestigious international journals. DR ALFONSO ECHEVERRIA Dr. Alfonso Echeverria Plastic & Reconstructive Surgeon Department of Plastic & Reconstructive Surgery, General Hospital Mexico City MEXICO Dr. Alfonso Echeverria is a renowned Plastic and Reconstructive Surgeon at General Hospital Mexico City, known for his innovative contributions to plastic surgery, hand surgery, microsurgery, and peripheral nerve surgery. He actively engages in international conferences and is a member of the American Association of Hand Surgery. His recent groundbreaking publication, "Unifying Surgical Resection and Superselective Embolization for Treating High-Flow Arteriovenous Malformations in the Extremities," revolutionizes the treatment of these challenging conditions, offering new hope to patients globally and advancing the field of plastic and reconstructive surgery.
NPPSS NATIONAL SPEAKERS 2nd National Paediatric Plastic Surgery Symposium 2023
NPPSS DR INTAN ZARINA FAKIR MOHAMED 2nd National Paediatric Plastic Surgery Symposium 2023 Dr. Intan Zarina Fakir Mohamed Consultant Paediatric Anaesthesiologist Department of Paediatric Anaesthesia Hospital Tunku Azizah, Kuala Lumpur MALAYSIA Dr. Intan Zarina Fakir Mohamed, a Consultant Paediatric Anaesthesiologist at Hospital Tunku Azizah in Kuala Lumpur, holds an MD from the University Science Malaysia and an Anaesthesiology Master's from the National University of Malaysia (UKM). She completed her Paediatric Anesthesia Fellowship from 2005 to 2008. Intan Zarina has served in various healthcare institutions, including Muar Hospital, Sarawak General Hospital, Hospital Kuala Lumpur, & Hospital Sultanah Bahiyah. She also gained international experience at The Children's Hospital at Westmead, Australia, in 2007. Intan Zarina is a Supervisor for the Ministry of Health Malaysia's Paediatric Anaesthesia Fellowship program, an Examiner for the parallel FCAI pathway, and a dedicated Facilitator for Paediatric Perioperative Life Support (PPLS). DR CHE ZUBAIDAH CHE DAUD Dr Che Zubaidah Che Daud Consultant Pediatric Radiologist Department of Radiology Hospital Tunku Azizah, Kuala Lumpur MALAYSIA Dr Che Zubaidah is a Senior Consultant Paediatric Radiologist at Hospital Tunku Azizah (Hospital Wanita Dan Kanak-Kanak) Kuala Lumpur. She received her Medical Degree and Master in Radiology from the National University of Malaysia UKM), and was an MOH fellow in Paediatric Radiology at Institute of Paediatric, Hospital Kuala Lumpur. She had more than 15 years experienced in paediatric imaging. She is actively involved in presenting papers and as an invited speaker for local and international conferences. Her field of interest is paediatric GI ultrasound, chest imaging, vascular anomalies and fetal imaging.
NPPSS DR LEONG KIN FON 2nd National Paediatric Plastic Surgery Symposium 2023 Dr. Leong Kin Fon Consultant Paediatric Dermatologist Department of Paediatric Dermatology Hospital Tunku Azizah, Kuala Lumpur MALAYSIA Dr Leong Kin Fon, Consultant Paediatric dermatologist has been active in medical research, and has presented in numerous local & international conferences. Dr Leong has also authored and co-authored numerous scientific publications and books such as The Faces of Atopic Eczema among Malaysian Children and the Atlas of Paediatric Diseases series. Dr Leong is the president of the Malaysian Dystrophic Epidermolysis Bullosa Research Association (DEBRA Malaysia) since 2013 and he actively volunteers with various national & international humanitarian organizations such as MERCY, TIMA and Medecen San Frontier. Dr Leong has special interest in eczema, acne, psoriasis, birthmarks, portwine stain, nevus of Ota hemangioma, vascular lesions andcommon skin problems in children, adolescent and young adults. He was given ILDS humanatarian award in 2017 . DR NIRMALA PONNUTHRAI Dr Nirmala Ponnuthrai Consultant Pediatric Dermatologist Department of Paediatric Dermatology HospitalTunku Azizah, Kuala Lumpur MALAYSIA Dr Nirmala is a Paediatrician and Paediatric dermatologist currently serving at Hospital Tunku Azizah Kuala Lumpur. She obtained her medical degree from India and her paediatric membership from Royal college Of Paediatrics and Child Health UK . She has served as a general paediatrician at tertiary and district hospitals followed by paediatric dermatology training at Hospital Kuala Lumpur. Subsequently she completed her dermatology fellowship program at Westmead Children’s Hospital Sydney. Being in a main paediatric dermatology tertiary referral and training centre she has vast experience in managing children with various dermatological diseases. She also has presented at numerous regional and local conferences as invited speaker.
NPPSS DR NORAINI BINTI MOHD DUSA 2nd National Paediatric Plastic Surgery Symposium 2023 Dr. Noraini Mohd Dusa Consultant Pathologist (Anatomic Phatology) Department of Pathology Hospital Kuala Lumpur MALAYSIA Dr. Noraini Binti Mohd Dusa is a Consultant Pathologist specializing in Anatomic Pathology and currently heads the Histopathology Unit in the Department of Pathology at Hospital Kuala Lumpur. She earned her Medical Doctor degree from the National University of Malaysia (UKM) in 1992 and her Master of Pathology (Anatomic Pathology) from the same university in 2001. In 2017-2018, Dr. Noraini completed a fellowship program in bone and soft tissue pathology at the University of Manchester and the Royal Orthopaedic Hospital in Birmingham, United Kingdom. She has been a dedicated pathologist at Hospital Kuala Lumpur since 2001 and was appointed as the Head of the Histopathology Unit in 2021. PROFESSOR HAMZANI ABDUL HAMID Professor Hamzaini Abdul Hamid Pediatric Radiologist Department of Radiology, Faculty of Medicine Universiti Kebangsaan Malaysia MALAYSIA Professor Hamzaini Abdul Hamid is a distinguished medical professional holding the position of Professor at the Faculty of Medicine, Universiti Kebangsaan Malaysia, in Kuala Lumpur. His illustrious career includes graduating from the Royal College of Surgeons in Ireland in 1995 and earning a Master's in Medicine in Radiology (MMed) from the National University of Malaysia (UKM) in 2004. Furthermore, he honed his expertise through a Fellowship in Paediatric Body Imaging at the Hospital for Sick Children in Toronto, Canada. Professor Hamzaini's commitment to excellence in the field of radiology is wellrecognized, making him a respected figure in the medical community.
NPPSS DR ZOSIMO KEN L. JIMENO IV 2nd National Paediatric Plastic Surgery Symposium 2023 DR ZOSIMO KEN L. JIMENO IV Plastic and Reconstructive Surgeon Hospital Queen Elizabeth Kota Kinabalu, Sabah Malaysia Dr. Zosimo Ken L. Jimeno IV is a dedicated Plastic & Reconstructive Surgeon based at Hospital Queen Elizabeth in Kota Kinabalu, Sabah. His impressive medical journey includes earning his MBBS degree from IMU in 2008, followed by the completion of his Masters in Surgery (Plastic) from USM in 2018. Dr. Jimeno's commitment to advancing healthcare is underscored by his presentation titled "Setting Up of a Vascular Anomaly Clinic – In Resource-Limited Center." In this presentation, he highlights the critical role of multidisciplinary collaboration in managing patients with vascular anomalies, especially in settings with limited resources, emphasizing the importance of establishing a structured approach for their continuous care. DR LEE WAI QUEN DR LEE WAI QUEN Consultant Pediatric Dermatologist Department of Paediatrics Hospital Tunku Jaafar Negeri Sembilan MALAYSIA Dr Lee Wai Quen is a paediatric dermatologist working in Hospital Tuanku Ja’afar, Seremban. She covers the southern region including Negeri Sembilan, Malacca and Johor Bharu. She received her subspecialty training in Hospital Tunku Azizah, Kuala Lumpur and pursued further international fellowship in Paediatric Dermatology and Paediatric Allergy in Korea University, Anam Hospital, Seoul, South Korea. Dr Lee has special interests in laser therapy, allergies, vitiligo and alopecia.
NPPSS PROFESSOR DR DAYANG ANITA ABDUL AZIZ 2nd National Paediatric Plastic Surgery Symposium 2023 Professor Dayang Anita Abdul Aziz Consultant Paediatric Surgeon Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM) Malaysia Professor Dr. Dayang Anita Abdul Aziz from holds the position of Professor of Paediatric Surgery at the Faculty of Medicine UKM. She has played pivotal roles in various leadership positions, including serving as the Head of the Paediatric Surgery Programme, the Head of the Paediatric Surgery Unit, and the Head of the Multi-disciplinary Team for Paediatric Vascular Anomaly at UKM. She also formerly directed the Tun Fatimah Hashim Women’s Leadership Centre at UKM. Her presentation, titled "ISSVA Classifications in Paediatrics: Experience at Universiti Kebangsaan Malaysia," reflects her significant contributions to the field, in which she has transformed the management of Paediatric Vascular Anomaly cases, shifting from an individual surgeon-based approach to a multidisciplinary team effort. PROFESSOR DR WAN AZMAN WAN SULAIMAN Professor Dr Wan Azman Wan Sulaiman Consultant Plastic Surgeon Reconstructive Sciences Unit School of Medical Sciences Universiti Sains Malaysia (USM) MALAYSIA Dr. Wan Azman earned his postgraduate qualifications in Masters of Surgery (Plastic Surgery) from Universiti Sains Malaysia. He is currently a Consultant Plastic Surgeon and a Lecturer at Hospital USM Kelantan. He also serves as a Visiting Consultant Plastic Surgeon at Kota Bharu Medical Centre, Kuala TerengganuSpecialistHospital,andKPJPahangHospital.In2008,heundertookclinicalattachmentsat Sydney Children's Hospital in the craniofacial unit under the supervision of Dr. Mark Gianotsus and completed fellowship training in craniofacial and aesthetic surgery at Chulalongkorn Craniofacial Center in Bangkok. Since 2009, he has held the role of Coordinator and Program Chairman for the Masters of Surgery (Plastic Surgery) program at USM Health Campus. Dr. Wan Azman has extensive experience in performing complex microvascular reconstructions for head and neck, limb, and breast cancers, aswell as surgeries for childrenwithcleft lipandpalate.He alsospecializes incosmeticplastic surgery,particularlyinbodycontouring,breast,eyelid,nose,andearsurgeries.
NPPSS MISS (DR) SURYASMI DUSKI 2nd National Paediatric Plastic Surgery Symposium 2023 Miss (Dr) Suryasmi Duski Consultant Orthopaedic Oncology Surgeon Orthopedic Oncology Unit, Department of Orthopedic and Traumatology Hospital Kuala Lumpur Malaysia Dr. Suryasmi Duski, an Orthopaedic Oncology Surgeon, practices at the Orthopaedic Oncology Unit within the Department of Orthopaedic & Traumatology at Hospital Kuala Lumpur. Her presentation, titled "Mimicry 2: Soft tissue tumour," addresses a critical aspect of her field. Suryasmi sheds light on the diagnostic challenges posed by soft tissue sarcomas in pediatric patients, which often closely resemble benign vascular tumors like Infantile Hemangioma both clinically and radiologically. She shares insights through the presentation of three cases with varying initial clinical diagnoses, emphasizing the importance of considering biopsy for suspicious atypical lesions before making definitive decisions or surgical interventions. Her expertise in Orthopaedic Oncology is vital for accurate diagnosis and effective treatment in this specialized area of medicine. DR. NURUL AIDA BINTI SELAMAT @ KELIWON Dr. Nurul Aida Binti Selamat @ Keliwon Radiologist (General and Musculoskeletal) Department of Radiology, Hospital Kuala Lumpur MALAYSIA Dr. Nurul Aida Binti Selamat is specializing in General and Musculoskeletal Radiology, practicing at Hospital Kuala Lumpur. She earned her medical degree at the University of Otago Medical School in New Zealand and completed her radiology training at the National University of Malaysia. With subspecialty training in Musculoskeletal Radiology in 2018, she now contributes her expertise to the Musculoskeletal Radiology team at Hospital Kuala Lumpur and serves as a visiting Musculoskeletal Radiologist at Hospital Putrajaya. Dr. Nurul Aida actively participates in Musculoskeletal Radiology courses and serves as a demonstrator in the Global Musculoskeletal Ultrasound with Basic MRI Correlation Course and Workshop, showcasing her commitment to advancing radiological knowledge.
NPPSS PROGRAMME 2nd National Paediatric Plastic Surgery Symposium 2023
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 TENTATIVE PROGRAMME
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 TENTATIVE PROGRAMME
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 TENTATIVE PROGRAMME
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 TENTATIVE PROGRAMME
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 TENTATIVE PROGRAMME
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 TENTATIVE PROGRAMME
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 TENTATIVE PROGRAMME
NPPSS TOPIC HIGHLIGHTS 2nd National Paediatric Plastic Surgery Symposium 2023
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 A NEW CLASSIFICATION OF VASCULAR ANOMALIES The ISSVA Classification has recently been revised to accommodate new developments in the understanding of vascular anomalies. This talk will briefly review how our understanding of tumors and malformations has changed, and why this has led to a revision of the classification. It will also briefly look at how the classification may evolve in the future IMAGING AND INTERVENTION IN PAEDIATRIC VASCULAR ANOMALIES Vascular Anomalies discussed in this lecture are based on ISSVA classification. It is divided into 2 main entities, which are: a) Vascular tumour and b) Vascular Malformation. Each entity has a long list of anomalies. However, in this lecture, I will highlight imaging options and imaging features of a few relatively common vascular tumours and vascular malformations. In vascular tumours which include: i) Haemangioma, which is further divided into infantile haemangioma and congenital haemangioma, ii) Karposiform Haemangiendothelioma. In vascular malformation, the common entities include i) lymphatic malformation, ii) venous malformation, iii) arteriovenous malformation and iv) mixed venolymphatic malformation. Imaging features of ultrasound, CT scan and MRI that differentiate between these entities will be highlighted. The management of these lesions which include: Reassurance and observation, sclerotherapy and embolization will be discussed in this lecture. At the end of my lecture, I will discuss a few challenges that we encounter during the treatment of vascular anomalies.
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 ROLE OF PAEDIATRIC ANAESTHESIOLOGY IN SURGICAL MANAGEMENT OF VASCULAR ANOMALIES ADVANCES IN SURGICAL MANAGEMENT OF VASCULAR ANOMALY Paediatric vascular anomalies are abnormal formations or growths within the vascular system.lymphatic, capillary, venous and arteriovenous malformation make up the majority of vascular malformation with a morbidity of about 2.5%, most of the lesions occur in oral and maxillofacial regions. Preoperative evaluation and preparation of paediatric patients involves coordination of anaesthesiologist, surgeon and paediatrician . Most of the procedure for children need general anaesthesia.Anaesthesia for the lesion may be complicated due to the proximity to the airway, size, presence of congestive heart failure, thrombocytopenia and blood loss. Differentiating between high flow and low flow lesions is vital to diagnosis and therapy.May require multiple treatments and multi disciplinary approach. Managing vascular anomalies is challenging, especially when there are complex malformations and surgery is not the best option. Since its discovery in 1972, sirolimus has been used as an anti-fungal, antitumour, and post-organ transplant immunosuppression. Sirolimus is an mTOR (mammalian target of rapamycin) inhibitor that has recently emerged as a new medical treatment option for vascular anomalies caused by inappropriate activation of the PIK3CA/AKT/mTOR pathway. Sirolimus reduces vessel ectasia and secondary inflammation, which can significantly improve the pain and quality of life of patients. A combination of sirolimus with or without surgery and sclerotherapy is best used until we have definitive medical treatment to eradicate these lesions. ROLE OF SIROLIMUS IN VASCULAR MALFORMATIONS
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 ISSVA CLASSIFICATIONS IN PAEDIATRICS: EXPERIENCE AT UNIVERSITI KEBANGSAAN MALAYSIA (UKM) Prior to 2012, Paediatric Vascular Anomaly cases at UKM were managed in a rather disorganised manner; solely based on the experience of individual surgeons within each team. Following training in Malmo Sweden in 2011, most paediatric vascular anomaly cases were revisited, reclassified and discussed extensively within the multidisciplinary teams which comprise Paediatric Surgeons, Paediatric Radiologists, Paediatric Haematologists, Paediatric Oncologists, Paediatric Clinical Geneticist, Paediatric ENT Surgeons, Adult Haematologist, Pathologist and Pharmacist. Treatment strategies were better planned and instituted for both paediatric and adult patients. This experience has brought about much improvement in patients’ care and increased the confidence level of everyone in the team in managing both paediatric and adult vascular anomalies. The author shares some of the interesting paediatric cases encountered in the last decade. Benign skin lesions in children encompass a diverse range of conditions, including pyogenic granulomas, hemangiomas, dermatofibromas, spider angiomas, and venous malformations. Accurate diagnosis and appropriate management are crucial for optimal outcomes. Treatment options vary depending on the specific lesion and its characteristics, ranging from observation and topical/oral medications to various procedural interventions such as laser therapy, surgical excision, and embolization. Healthcare professionals should carefully assess each case to ensure timely and effective management while considering factors such as symptomatology, location, potential complications, and cosmetic impact. BENIGN SKIN DISEASE
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 SOFT TISSUE TUMOUR IMAGING AS DIAGNOSTIC TOOLS IN VASCULAR ANOMALIES Soft tissue sarcomas in the paediatric age group are rare unlike benign vascular tumour Infantile Haemangioma. Diagnosis of soft tissue sarcomas in this age group is challenging due to its close similarities to tumours of vascular origin both in clinical presentation and radiological findings. We present 3 cases of soft tissue sarcoma in the paediatric age group with different initial clinical diagnoses. Managing clinicians should be aware of the possibility of soft tissue sarcoma mimicking infantile haemangioma. Biopsy of any suspicious atypical lesion is to be considered before deciding on definitive procedures or surgical intervention. Vascular Anomalies comprise a wide, heterogeneous spectrum of lesions that often represent a diagnostic and therapeutic challenge. Although most vascular anomalies are diagnosed based on clinical findings, a thorough evaluation often requires additional imaging tests to determine the nature, extension, and prognosis of these lesions. Ultrasound imaging is usually the first diagnostic tool performed on patients with VA given that it is harmless, quick, and readily available in many centers. Magnetic resonance (MR) imaging is the most valuable modality for the classification of vascular anomalies because it accurately demonstrates their extension and their anatomic relationship to adjacent structures as well as the assessment of treatment success and establishment of a long-term management strategy. This presentation will highlight features of Vascular Anomalies, particularly in Ultrasound and MRI.
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 THE ROLE OF DIGITAL SUBTRACTION ANGIOGRAPHY (DSA) AND MAGNETIC RESONANCE ANGIOGRAPHY (MRA) IN VASCULAR ANOMALIES Magnetic Resonance Angiography (MRA) is a non-ionizing radiology modality that has an important role in establishing a diagnosis of vascular anomalies. An extension of a lesion into nearby critical organs, such as the involvement of a neurovascular bundle, can be assessed using contrast-enhanced magnetic resonance imaging (MRI). The Time-Resolved MRA sequence, which is non-invasive and comparable to DSA, can demonstrate dynamic contrast passage from the arterial phase to the venous phase in real-time. Digital Subtraction Angiography (DSA) not only used to assess vascular abnormalities from the arterial phase to the venous phase but also used to treat high-flow vascular anomalies. For each type of peripheral arteriovenous malformation (AVM) categorized as highflow, the selection of a specific interventional radiology procedure is guided by the YAKES and Cho-Do classification. As a tool for guiding endovascular management, Digital Subtraction Angiography (DSA) can be employed in both venous and arterial systems, and it can even guide direct percutaneous embolization of vascular anomalies. For various types of vascular malformations, the use of particles, coils, and liquid materials as embolic materials should be taken into consideration. In conclusion, Time-Resolved MRA and DSA have a critical role in the overall management of vascular anomalies.
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 PATHOLOGY OF VASCULAR ANOMALIES Vascular anomalies can form anywhere in human body characterized by the abnormal development or growth of blood and/or lymphatic vessels. Vascular anomalies are further classified into vascular malformation and vascular tumors. Diagnosis of these entities can be challenging as they often demonstrate heterogenous and overlapping histologic features. Correlation with clinical and radiological findings is pertinent for diagnostic accuracy. EMERGING THERAPY IN VASCULAR ANOMALIES The discovery that vascular malformations are caused by somatic mutations and that those variants are already known to cause a variety of cancers has opened a new chapter in the management of vascular anomalies. Beginning with the use of rapamycin to treat slow flow malformations, targeted therapies are rapidly evolving as a treatment modality for vascular malformations. Although surgery and interventional radiology are likely to remain the standard treatment for most lesions in the foreseeable future, medical therapies are becoming important adjuncts, and in some cases will replace ablative therapies. SETTING UP A VASCULAR ANOMALY CLINIC – MELBOURNE EXPERIENCES The vascular anomalies multidisciplinary clinic at the Royal Children’s Hospital in Melbourne has been running for over twenty years. This talk will discuss our experience, what works and what doesn’t work in running an effective clinic. It will also review what specialist input is ideal, and what are the minimum requirements
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 SETTING-UP A VASCULAR ANOMALY FORUM – INDONESIA EXPERIENCE SETTING UP A VASCULAR ANOMALY CLINIC – MALAYSIA EXPERIENCE 1st Challenge: inconsistent terminologies among clinicians, pathologists, geneticists & radiologists. Some patients have been over-investigated and overtreated based purely on histological or radiological findings and reports without clinical correlation 2nd Challenge: lack of funding for comprehensive clinico-genomic diagnosis and targeted therapy. e.g. Alpelisib , Sirolimus, etc. 3rd Challenge: Lack of coordination between the clinician, interventional radiologist, and surgeon regarding the long-term treatment plan Before 2012, the management of paediatric vascular anomaly primarily relied on the individual experience of surgeons within each team. However, there has been a significant shift. Most paediatric vascular anomalies are extensively discussed within multidisciplinary teams. These teams included paediatric surgeons, paediatric radiologists, paediatric haematologists, paediatric oncologists, paediatric clinical geneticists, paediatric ENT surgeons, adult haematologists, pathologists, and pharmacists. As a result of this collaborative approach, treatment strategies were better planned and implemented for both paediatric and adult patients significantly improving patient care. SETTING-UP A VASCULAR ANOMALY FORUM – MALAYSIA (INSTITUTIONAL EXPERIENCE : UKM)
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 CONGENITAL VASCULAR TUMOUR Vascular skin tumors are common during the infantile period, but congenital onset is relatively rare It's crucial for clinicians to be able to recognize, classify, and treat vascular tumors in infants. Though the vast majority of pediatric vascular tumors are benign and diagnosed clinically, it may be difficult to determine the diagnosis and predict the risk of a particular lesion, so further imaging or biopsy for tissue diagnosis may be warranted, and clinico – pathological – radiological correlation is important. Depending on the type of vascular tumor, they may appear as a congenital lesion or develop at any time during infancy and childhood. They frequently have a predictable clinical course. The majority of vascular tumors occurring in children are benign, but even benign lesions may be associated with significant morbidity. i.e. anatomical risk, ulceration, bleeding, consumptive coagulopathy, high output cardiac failure, and malignant potential. It is crucial to be able to identify the high-risk characteristics of each type of tumor. Treatment of paediatric vascular tumors is often multidisciplinary and is influenced heavily by individual risks and benefits. Effective treatment modalities include systemic sirolimus, prednisolone, Vincristine, and surgical excision. Multi-disciplinary involvement in the management of patients with vascular anomalies is crucial, albeit with limited specialties and facilities. Establishing a cohesive algorithm of approach is monumental to initiate and ensure continuous care of patients. SETTING UP OF A VASCULAR ANOMALY CLINIC – IN RESOURCE-LIMITED CENTER INFANTILE HEMANGIOMA: WAIT & SEE OR TO TREAT
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 LASER THERAPY FOR CAPILLARY AND MIXED VASCULAR MALFORMATIONS Laser therapy is commonly used to treat capillary and mixed vascular malformations in children. Lasers used alone or in combination with other medical and surgical modalities can be tailored according to the size, depth, and location of vascular malformations. Repeated treatment sessions with pulsed dye lasers (PDL), Nd:YAG or other lasers improve the appearance and texture of the skin and alleviate pain or bleeding, thus enhancing the quality of life of patients. malformations. The proper selection of lasers minimizes damage to surrounding healthy tissues and improves the overall safety and efficacy of the treatment. ND-YAG LASER FOR VASCULAR MALFORMATION – HUSM EXPERIENCE ND-Yag laser for vascular malformation treatment is a wellestablished method. It is meant for superficial vascular lesions. Introducing ND-Yag laser intralesionally to reach deep vascular malformation is an alternative to already well-established embolization treatment. We will share our experience utilizing intralesional ND-Yag laser treatment as an alternative mode of treatment in problematic cavernous hemangioma.
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 SCLEROTHERAPY FOR VENOUS AND LYMPHATIC MALFORMATION: ADVANCING MINIMALLY INVASIVE TREATMENT Venous and lymphatic malformations, both classified as vascular malformations according to the ISSVA classification, are characterized by abnormal vascular structures and development of venous and lymphatic vessels. They can affect various anatomical locations, including the head, neck, trunk, and extremities, often manifesting in superficial or exposed skin areas. Therefore, these abnormalities pose significant challenges in terms of patient’s symptoms, aesthetic concerns, and quality of life. Interventional Radiology (IR) delivers a significant role in the treatment of venous and lymphatic malformations through the application of sclerotherapy procedure. Sclerotherapy, as a minimally invasive IR procedure, involves the injection of sclerosing agent into the venous and lymphatic malformations, inducing vessel closure, visible signs of malformations, lesion shrinkage and symptom alleviation. Various sclerosing agents are available for the treatment of vascular malformations, with some of the most commonly used agents being bleomycin, alcohol, and polidocanol. Each of these agents possesses unique properties, applications, and potential complications. Sclerosing agents are typically administered intralesionally, usually through direct needle insertion into the malformation, particularly targeting vacuoles or cystic components. Achieving precise needle placement and ensuring accurate delivery of the sclerosing agent is of paramount importance to optimize the outcomes of sclerotherapy. Radiological imaging modalities, such as ultrasound and fluoroscopy, play a crucial role in guiding and facilitating the precise placement of needles, ensuring the effective delivery of sclerosing agents. Recent advancements have introduced a combination of fluoroscopy (Digital Subtraction Angiography (DSA) with Cone-Beam CT technology, supported by specialized needle guidance software. This integration enhances the accuracy of needle placement and the injection of sclerosing agents during sclerotherapy. Ultrasound and fluoroscopy also serve as invaluable tools for enhancing the safety of the procedure. They help prevent inadvertent non-target injections and enable the detection of potential vascular drainage or flow to vital organs in close proximity. This dual role of ensuring both precision and safety underscores the significance of radiological imaging in optimizing the outcomes of sclerotherapy for vascular malformations. In conclusion, sclerotherapy, as minimally invasive IR procedures, offers promising treatment for patients afflicted by venous and lymphatic malformations. With a thorough understanding of sclerotherapy techniques, sclerosing agents, and guidance from imaging modalities, we can achieve the best outcomes possible for these patients.
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 UNIFYING SURGICAL RESECTION AND SUPER-SELECTIVE EMBOLIZATION TO TREAT HIGH-FLOW ARTERIOVENOUS MALFORMATIONS IN THE EXTREMITIES An important fraction of high-flow arteriovenous malformations (AVM) in the extremities are complex to treat due to their multicentricity, size, and risk of compromising the distal circulation, and are therefore considered "inoperable". We report our experience on multifocal recurrent AVMs treated in conjunction with the interventional radiology service performing intra-arterial embolization with Gelatin, and on our side, immediate excision, and immediate distal microvascular revascularizations to make up for the consequent arterial deficit. Our novel approach may be a reliable therapeutic option to manage AVMs currently considered inoperable. SURGICAL MANAGEMENT OF ARTERIOVENOUS MALFORMATIONS Excision of AVM is one of the most challenging operations in vascular anomalies surgery. This will be a practical talk on operative techniques for AVM. Although most surgeons worry about the risk of bleeding, achieving an adequate margin is the biggest challenge in excising an AVM.) SURGERY FOR ARTERIOVENOUS MALFORMATIONS - HKL EXPERIENCE Management of AVM includes a multidisciplinary approach. Main aim is to achieve complete blockage or resection of the nidus and functional restoration. A combination of embolization and surgical resection has become the treatment of choice over the last years. It requires technical experience and availability of supportive services.
NPPSS ORAL& POSTER PRESENTERS 2nd National Paediatric Plastic Surgery Symposium 2023
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 ORAL PRESENTERS
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 POSTER PRESENTERS
NPPSS SPONSORS & EXHIBITORS 2nd National Paediatric Plastic Surgery Symposium 2023
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 SPONSORS / EXHIBITORS
NPPSS EXHIBITION BOOTHS PLAN 2nd National Paediatric Plastic Surgery Symposium 2023
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023 FLOOR PLAN FOR BOOTHS
NPPSS NOTES 2nd National Paediatric Plastic Surgery Symposium 2023
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023
NPPSS 2nd National Paediatric Plastic Surgery Symposium 2023