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Joachim Dissemond

Publications and source records attributed to Joachim Dissemond.

At least 19 recordsLinked to original sources
PubMed2006

Influence of pH on wound-healing: a new perspective for wound-therapy?

Wound healing is a complex regeneration process, which is characterised by intercalating degradation and re-assembly of connective tissue and epidermal layer. The pH value within the wound-milieu influences indirectly and directly all biochemical reactions taking place in this process of healing. Interestingly it is so far a neglected parameter for the overall outcome. For more than three decades the common assumption amongst physicians was that a low pH value, such as it is found on normal skin, is favourable for wound healing. However, investigations have shown that in fact some healing processes such as the take-rate of skin-grafts require an alkaline milieu. The matter is thus much more complicated than it was assumed. This review article summarises the existing literature dealing with the topic of pH value within the wound-milieu, its influence on wound healing and critically discusses the currently existing data in this field. The conclusion to be drawn at present is that the wound pH indeed proves to be a potent influential factor for the healing process and that different pH ranges are required for certain distinct phases of wound healing. Further systematic data needs to be collected for a better understanding of the pH requirements under specific circumstances. This is important as it will help to develop new pH targeted therapeutic strategies.

Debridement↗
PubMed2006

[Biologics in the treatment of psoriasis].

Currently, psoriasis is seen as a T-cell-mediated autoimmune disease that is characterized by an increased expression of pro-inflammatory cytokines. The clarification of this pathogenetic cascade uncovered a number of points of departure for the development of causal therapy and led to the introduction of new medications--the so-called biologics. The following have already been approved in Germany: infliximab, etanercept, efalizumab and adalimumab. These are described, and their advantages and disadvantages in the clinical setting are discussed.

Adalimumab↗
PubMed2006

Leg ulcer in a patient associated with hydroxyurea therapy.

Hydroxyurea is a hydroxylated derivate of urea commonly used in the treatment of various hematologic disorders. Cutaneous side-effects such as alopecia, diffuse hyperpigmentation, scaling, poikiloderma, atrophy of the skin and subcutaneous tissues or nail changes can develop after long-term treatment with hydroxyurea. Painful leg ulcers in association with hydroxyurea have only rarely been reported. We present a report of a 52-year-old patient with essential thrombocythemia suffering from painful leg ulcers 3 years after starting therapy with hydroxyurea. We decided to treat the leg ulcers following a modern phase-adapted wound-healing strategy and continued hydroxyurea therapy until complete healing of the ulcers. In conclusion, cutaneous ulceration of the leg is one adverse effect in patients with essential thrombocythemia during hydroxyurea therapy. Healing does not necessarily require discontinuation of the drug. Therefore, therapists should first optimize a conservative and systematic wound-healing strategy. If these interventions fail, discontinuation of hydroxyurea therapy is advisable.

Alginates↗
PubMed2006

[Differential diagnoses in leg ulcers].

In Germany about 0.7% of the adult population have a chronic leg ulcer. Although chronic venous insufficiency accounts for at least 80% of all chronic leg ulcers, knowledge of the relevant differential diagnostic considerations is of crucial importance, in particular for patients who are refractory to therapy. In addition to vascular disease, other causes include neuropathic, metabolic, hematologic and exogenous factors as well as neoplasias, infections, drugs, genetic defects and some primary skin disorders. For the long-term successful treatment of patients with chronic leg ulcers, it is necessary to identify all relevant factors, in order to enable a pathogenesis-oriented, interdisciplinary therapeutic approach.

Diagnosis, Differential↗
PubMed2006

Three-dimensional documentation of wound healing: first results of a new objective method for measurement.

BACKGROUND: The objective assessment of wound healing is one essential parameter of quality assurance in a modern chronic wound management program. In the past assessment has been based exclusively on a two-dimensional measurement of the wound surface with planimetry or digital photo documentation in combination with such measurements. An objective method for measuring the volume of chronic wounds has not yet been available. PATIENTS AND METHODS: In cooperation with the company RSI, we linked digital photography, optical raster by means of digital scanner, and picture processing software (DigiSkin) for an exact three-dimensional image of chronic wounds. The generated point clouds allow the visual, computer-assisted three-dimensional quantification and can document the course of healing of chronic wounds. RESULTS: In comparison to currently available systems, our new method makes possible the objective measurement of volume changes and wound healing course in chronic wounds.We demonstrate the utility of the system in reference to three patients with chronic venous leg ulcers. CONCLUSIONS: Using this new, objective three-dimensional wound measurement system,it is possible to reliably quantify changes in wound healing for the first time. Future clinical studies have a new option for the gathering of data which will facilitate evidenced-based conclusions.

Aged↗
PubMed2005

Adaptive cellular protection against UVA-1-induced lipid peroxidation in human dermal fibroblasts shows donor-to-donor variability and is glutathione dependent.

Photo-oxidative stress and subsequent lipid peroxidation (LPO) is one of the major mechanisms of UVA-related skin pathology. The skin's protection system against photo-oxidative stress involves low molecular scavengers as well as highly specialised antioxidant enzymes like glutathione peroxidase (GPX). Against repetitive UVA-1 exposures in vitro it is partly adaptive, as recent studies have shown exemplarily for antioxidant enzymes. We now investigated in vitro by repetitively irradiating human dermal fibroblasts with UVA-1 whether this adaptive response might reflect itself in reduced cellular membrane damage, that is, LPO. Our experiments show that the degree of cellular protection against LPO and the adaptive potential of the cells against a repetitive UVA-1 exposure varies from donor-to-donor and depends highly on glutathione.

Buthionine Sulfoximine↗