Prof. Joachim Dissemond, Dr. M. D.
Ulcus Cruris Expert
Professor Joachim Dissemond, Dermatology and Venerology Consultant with the additional discipline of Allergology, has practised at the Dermatology Clinic, Essen University Hospital, since 1999, initially as an Assistant Physician and then as a Senior Physician since 2003. A Wound Outpatient Clinic was set up at Essen University Hospital on Professor Dissemond’s initiative. The Dermatology Clinic is nowadays recognized as an interdisciplinary wound center.
His specialist areas are:
- The diagnosis and treatment of Ulcus cruris (“open leg”)
- Chronic wounds
- Immunological wounds
Prof. Joachim Dissemond is actively involved in several societies, including the Arbeitsgemeinschaft für Wundheilung [Wound Healing Working Party], the Deutsche Gesellschaft für Wundheilung [German Society for Wound Healing] and the Dreiländer Wund D.A.CH-Verband [Three State Wound Association]. He is also a member of the Editorial Board of various journals on wound healing, and the author of several books including, “Ulcus cruris - Genese, Diagnostik und Therapie” [origin, diagnosis and treatment].
Since chronic wounds, and especially Ulcus cruris, can have numerous causes, Dissemond is an advocate of thorough diagnosis and overall patient assessment.
“We treat patients, not results”. (Joachim Dissemond)
1975 – 1979 Primary school Erftstadt Lechenich-Nord
1979 – 1988 Secondary school Erftstadt Lechenich
10/1988 – 12/1989 Budel/NL, Nörvenich
WS 1989 – SS 1997 Faculty of medicine at the University of Cologne
03/1996 – 03/1997 University Hospital of Cologne
Doctor in practical training
01/1998 - 06/1999 Dermatology at the University Hospital of Cologne
07/1999 – 12/2002 Dermatology at the Essen University Hospital
Specialist for Dermatology and Venereology
Since 05/2002 Dermatology at the Essen University Hospital
12/2000 Dermatology at the University Hospital Cologne
Credentialing: magna cum laude
Since 01/2003 Dermatology at the Essen University Hospital
01/2005 Dermatology at the Essen University Hospital
Provisional representative of the professorship of dermatology and venereology
06/2007 - 07/2008 Dermatology at the Essen University Hospital
Unscheduled professorship for dermatology and venereology
05/2010 Dermatology at the Essen University Hospital
1997 – 2000 Additional qualification sports medicine
2001 – 2003 Additional qualification allergology
04/2007 – 04/2009 Secretary of the working group for wound healing (AGW) by the DDG (German diabetes society)
Since 04/2009 1. Chairman of the working group for wound healing (AGW)
06/2009 – 10/2010 Vice president of the German society for wound healing (DGfW)
Since 12/2010 founding and board member of the three countries wound D.A.CH-association
11/2006 – 06/2009 Zeitschrift für Wundheilung (journal for wound healing)
Editorial Board Member
Since 2006 Zeitschrift für Wundheilung (journal for wound healing)
Since 2009 Ulcers Since
2010 Wundforum (wound forum)
Since 2011 Wundmanagement (wound management)
Since 2011 Journal der Deutschen Dermatologischen Gesellschaft (JDDG; journal by the German dermatologic society)
Since 2011 World Journal of Dermatology
Rewards of my working group
March 2001 Graduate student award by the Werner G. Gehring foundation for the promotion of scientific trainees.
December 2002 Poster award of the 5th meeting of the dermatologic science and further education academy NRW, Cologne.
June 2003 1. Poster award of the 7th meeting of the German society for wound healing and management (DGfW), Augsburg.
November 2003 Poster award of the 6th meeting of the dermatologic science and further education academy NRW, Cologne.
September 2005 Poster award at the 9th meeting of the German society for wound healing and management (DGfW), Stuttgart.
November 2006 Poster award at the 9th meeting of the dermatologic science and further education academy NRW, Cologne.
March 2007 Poster award at the 10th meeting of the German society for wound healing and management (DGfW), Berlin.
May 2008 Poster award at the 18th Conference of the European Wound Management Association, Lissabon.
June 2008 Viktor von Bruns award, 11th meeting of the German society for wound healing and management (DGfW), Coblenz.
October 2008 1. Hartmann award, distributed by the German Society of Phlebology (DGP), 50th annual meeting of the DGP, Bochum.
December 2008 Poster award at the 11th meeting of the dermatologic science and further education academy NRW, Cologne.
March 2009 Springer publication award for dermatology, awarded on the 45th meeting by the German society for dermatology (DDG), Dresden.
June 2009 2nd award by the foundation Fondation de Lous, awarded at the 12th meeting of the German society for wound healing and management (DGfW), Kassel.
November 2009 Poster award at the 12th meeting of the dermatologic science and further education academy NRW, Cologne.
May 2011 Two research awards by the foundation Fondation Urgo, awarded on the Deutschen Wundkongress (German wound congress), Bremen.
“Often the diagnosis lacks”
Interview with Prof. Dr. Joachim Dissemond, senior physician at the clinic for dermatology, Essen University Hospital, about the complex clinical picture of ulcus cruris and why patients should preferably early consult a specialist.
Prof. Dissemond, colloquially it is called an open leg, you talk about the ulcus cruris. Why do such wounds at the lower leg heal so poorly?
Dissemond: The main problem is that many patients are not treated with regard to the causes. Admittedly symptoms are treated, however often a curing approach is missing. In this way the disease continues for months, years and decades.
Why is that the case?
Dissemond: A lower leg sore can have totally different origins. Generally it is exclusively associated with vein damage and then on the off chance taken care of with compression therapy and some wound care. This might be right in many cases, but it simply is not always sufficient. In addition: At least one third of the patients don’t have a vein damage, or at least this is not the single cause.
Which causes are then possible for the open leg?
Dissemond: About 50 percent of ulcers are exclusively caused venously, this is the biggest group. Approximately 15 percent are solely arterially caused, for a further 15 percent exists a combination of venous and arterial defect. And the remaining 20 percent have completely different causes, e.g. vascular inflammation, neoplasia or autoimmune disease. Those causes have to be diagnosed so that the ulcus cruris can be successfully treated. However, in the daily practice often the basic diagnosis is already failing.
Therefore the diagnosis is the main problem?
Dissemond: In my opinion far too much attention is directed to the treatment and way too little to diagnostics. In our wound ambulance we see patients, who are in treatment for over 30 years because of a wound, but virtually never had an examination performed.
Where is the catch in the system?
Dissemond: On the one hand it is up to the patients. Venous disorders cause only little suffering over many years and the patients do not see a doctor. They ignore the first signs as for example the so-called warning veins in the area of the ankle and later the change of the skin in form of change in color. Only when the mostly painful sore appears they see the doctor.
And the family physician prefers in this case a compression bandage to the diagnosis?
Dissemond: I do not want to generalize, but I do know from my patients that this is the way in many cases. A good clinical examination connected with a simple taking the pulse and a duplex or Doppler sonography most times is adequate to see, if the patient has a vein disorder or if he needs a further diagnosis with regard to arterial damage. Unfortunately I only notice little willingness of the family doctors to transfer their patients to specialists at an early stage.
In your opinion the family physician should transfer the patients more quickly?
Dissemond: If the treatment does not show any results after three months, I consider the wound chronic. At this point at the latest the patient should see a wound specialist. It would be even better already after eight weeks of unsuccessful treatment.
You are a renowned wound specialist. Can you even help all patients with an ulcus cruris?
Dissemond: We can help many patients. Treatment options are available sufficiently and fortunately mostly are paid for by the insurances. But naturally we see at our hospital especially the really critical and rare cases. They include cases which even pose a mystery for us. However, those are exceptions.
There are indeed wound centers in Germany, but they are rarely certified, and wound specialists do not exist. This does not really make things easy for the pilot family doctor…
Dissemond: For now “wound center” is an unprotected term. However, the German society for dermatology is going to create a certification catalogue until the end of this year. Then there will be certified dermatologic wound centers in Germany. The additional qualification “wound physician” is discussed at present. The medical care is an example with its common “wound managers”. In this sense I think that currently there are already centers with good expertise especially for “treatment failures” in many parts of Germany.
But will the treatment of patients indeed be improved through such titles and certificates.
Dissemond: A tendency to building centers can be seen currently in almost all areas of medicine, and this for a good reason. For the diabetic foot syndrome by now there are certified centers and more and more family doctors refer their patients there. I hope the trend will continue in such manner for lower leg sores because the chronic ulcus cruris poses a medical challenge which should be approached interdisciplinary and interprofessional.
The conversation was conducted by Beatrice Hamberger
Updated 04/2011 412 original works, case histories, reviews
15 pieces for books
221 published abstracts
Prof. Dr. med. Joachim Dissemond