Abstract
Skin regeneration is a quite complex process. Epidermal differentiation alone takes about 30 days and is highly regulated. Wounds, especially chronic wounds, affect 2% to 3% of the elderly population and comprise a heterogeneous group of diseases. The prevailing reasons to develop skin wounds include venous and/or arterial circulatory disorders, diabetes, or constant pressure to the skin (decubitus). The hallmarks of modern wound treatment include debridement of dead tissue, disinfection, wound dressings that keep the wound moist but still allow air exchange, and compression bandages. Despite all these efforts there is still a huge treatment resistance and wounds will not heal. This calls for new and more efficient treatment options in combination with novel biocompatible skin scaffolds. Cold atmospheric pressure plasma (CAP) is such an innovative addition to the treatment armamentarium. In one CAP application, antimicrobial effects, wound acidification, enhanced microcirculations and cell stimulation can be achieved. It is evident that CAP treatment, in combination with novel bioengineered, biocompatible and biodegradable electrospun scaffolds, has the potential of fostering wound healing by promoting remodeling and epithelialization along such temporarily applied skin replacement scaffolds.
Highlights
In acute wounds, for example, surgery or trauma, a primary wound closure via sutures is desired
New insights into wound healing leading to new therapeutic approaches are urgently needed, as chronic wounds pose a high burden in elderly populations
Its efficacy in accelerating wound healing in vivo has been demonstrated in several prospective human trials
Summary
For example, surgery or trauma, a primary wound closure via sutures is desired. With the HHP method, human skin tissue may be devitalized gently thereby maintaining its biomechanical properties in the sense of devitalized allogenic skin tissue scaffolds [24] This may even be extended by bioprinting stem cells or platelet-rich plasma or disinfectants or drugs or other wound healing enhancers into the scaffolds via 3D printing technologies [25]. Sick leave (ulcers cause 1.2% of all sick leave days) and early retirement costs have to be taken into account, too, as well as hospitalization as in-patients [3] These cost considerations contribute to the need for new skin allografts, scaffolds and treatment modalities to enhance wound healing and treatment efficacy
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