Cold atmospheric pressure plasma for the treatment of acute and chronic wounds

Abstract

Besides acute wounds (through trauma or surgical interventions), chronic wounds comprise arelatively large and heterogeneous group of diseases. These include leg ulcers with venous disease greatly prevailing arterial disease, diabetic foot syndrome, and pressure ulcers. Due to aconsiderable treatment resistance against such therapies, new and effective, additive treatment options especially for chronic wounds are needed. Wound treatment with cold atmospheric plasma (CAP) constitutes such an innovative option. Current research regarding the efficacy of cold plasma for healing of acute and chronic wounds is summarized. The literature on CAP applications in wound healing has been screened and reviewed. With CAP, several effects that promote wound healing can be simultaneously applied in one application. On the one hand, CAP exerts astrong and broad antimicrobial activity against biofilm. On the other hand, the plasma cocktail, which consists of reactive nitrogen and oxygen species, UV, and charged particles (electrical current), mediates tissue-stimulating, blood flow-promoting, and anti-inflammatory effects. Marked germ reduction on wounds and accelerated wound healing have already been convincingly demonstrated in controlled clinical studies. Thecomprehensive CAP study landscape with structured case report summaries and randomized case-control studies allows the conclusion that CAP is safe, effective, and easy to handle for wound treatment. The utilization of CAP in addition to standard wound treatments is starting to enter routine clinical practice.