Case Report: Cold Atmospheric Plasma as a Treatment Option for Superficial Wound Healing Disorders after Heart Transplantation

Abstract

Introduction Superficial wound healing disorders (SWD) after heart transplantation (HTx) remain challenging due to continuous immunosuppression. Cold atmospheric plasma (CAP) is a partially ionized plasma, which has shown to have a beneficial effect on skin regeneration and microbial inactivation. The aim of this case report is to demonstrate an example of successful use of CAP as a supportive treatment for SWD after HTx. Case Report We present our single-center experience of two female patients (18 and 39 years) with SWD three and eight weeks after HTx. Both patients were transplanted due to dilatative cardiomyopathy and immunosuppression consisted of a combination of tacrolimus, mycophenolate mofetil and steroids for both patients. HTx was performed according to institutional guidelines and the early postoperative course was uneventful. Starting on the day of SWD diagnosis, CAP was performed as a standard therapy scheme of 5 minutes per treatment twice weekly for a total of three weeks. Both patients were schooled for adequate wound management including daily change of wound dressings.Both SWD presented as a superficial apical dehiscence of the midline incision and wound swabs showed no growth throughout the treatment. After three weeks of CAP treatment, the wounds were completely epithelialized and showed no more signs of infection without need for additional local or systemic antibiotic or surgical treatment. There were no adverse side effects of CAP therapy observed and the therapy was tolerated well by both patients. Summary CAP showed to be a safe and feasible treatment option for superficial SWD despite immunosuppressive therapy with no need for further surgery, anti-infective therapy or reduction of immunosuppression. Due to convincing results, CAP could be a safe treatment option for SWD after HTx and should be investigated further.