Winner of the 2nd Bauerfeind Phlebology Award
- Dr. Susanna Heising
The Bauerfeind Phlebology Award is granted for special achievements in compression therapy. In 2003, an international jury granted the award to Dr. Susanna Heising from the Clinic and Policlinic for Dermatological Diseases of the Ernst-Moritz-Arndt University in Greifswald. The official presentation of the award (endowed with a prize money of Euro 20,000 Euro) took place during the IUP World Congress Chapter Meeting in San Diego. During this congress, the winner of the first Bauerfeind Phlebology Award, Dr. Yared Herouy, presented the final results of his award-winning study.
Dr. Susanna Heising summarized the design of her study as follows: “Around one to three per cent of the adult population is affected by venous ulcers in the lower extremities. Such ulcers are often recurrent, chronic, and thus of high socio-economic importance. Venous and capillary hypertension leads to the formation of trophic skin damage, even atrophy blanche and ulcers. We studied the connection between the haemodynamic disorder in the form of cutaneous microcirculation, the extra-cellular matrix and the apoptosis in epidermis and dermis.”
Now Dr. Susanna Heising presented intermediate results of her study.
Using capillary microscopy she was able to show that the number of capillaries is considerably reduced with increasing severity of the venous disease, in particular along the periphery of the ulcer. Furthermore the partial oxygen pressure is significantly reduced in these tissue zones. Laser Doppler measurements were used to demonstrate high flux values as an indication of a congestion-induced increase in erythrocyte concentrations.
Immunohistochemical staining showed that the proapoptotic proteins Fas-L, Bax and c-myc as well as the effector caspases 3, 6, and 9 were expressed in all three Widmer stages and in all leg localizations studied (thigh, trophically damaged skin, ulcer edge or internal knuckle). The expression of tenascine and fibronectine was confirmed at the ulcer edge and in the transition area in patients in Widmer stage III. On the other hand, the translation of the bcl-2 gene into the corresponding protein was reduced at the edge of the ulcer.
“Cutaneous microcirculation is increasingly restricted with the severity of venous insufficiency“, Dr. Susanna Heising summarized her results so far. A subsequent study is going to show which influence compression therapy has on the apoptosis-associated expression of proteins and on microcirculation in the case of chronic venous insufficiency.
Dr. Susanna Heising will present her final results during the IUP World Congress in Rio de Janeiro in October this year.
