Abstract
Non-thermal plasma (NTP) has nonspecific antibacterial effects, and can be applied as an effective tool for the treatment of chronic wounds and other skin pathologies. In this study we analysed the effect of NTP on the healing of the full-thickness acute skin wound model in rats. We utilised a single jet NTP system generating atmospheric pressure air plasma, with ion volume density 5 · 1017 m−3 and gas temperature 30–35 °C. The skin wounds were exposed to three daily plasma treatments for 1 or 2 minutes and were evaluated 3, 7 and 14 days after the wounding by histological and gene expression analysis. NTP treatment significantly enhanced epithelization and wound contraction on day 7 when compared to the untreated wounds. Macrophage infiltration into the wound area was not affected by the NTP treatment. Gene expression analysis did not indicate an increased inflammatory reaction or a disruption of the wound healing process; transient enhancement of inflammatory marker upregulation was found after NTP treatment on day 7. In summary, NTP treatment had improved the healing efficacy of acute skin wounds without noticeable side effects and concomitant activation of pro-inflammatory signalling. The obtained results highlight the favourability of plasma applications for wound therapy in clinics.
Highlights
Non-thermal plasma technology and its use in medicine (“plasma medicine”) has become a rapidly developing interdisciplinary field that brings a new innovative approach in a wide range of biomedical applications
In our recent study we demonstrated that chemically distinct plasmas trigger different responses in mammalian cells, and that the extent of biological responses to Non-thermal plasma (NTP) may grossly differ between phenotypically distinct cell lines[27]
The wound closure for each wound was evaluated on days 0–3, 7, 10 and 14 by determining the unclosed wound area in wounds treated with NTP for 1 or 2 minutes; the untreated wounds served as a control (Fig. 2a)
Summary
Non-thermal plasma technology and its use in medicine (“plasma medicine”) has become a rapidly developing interdisciplinary field that brings a new innovative approach in a wide range of biomedical applications. Due to its bactericidal properties, non-thermal plasma (NTP) represents an effective tool for various procedures in human as well as in veterinary medicine, in tissue disinfection and treatment of chronic wounds, such as diabetic foot ulcers, pressure and venous leg ulcers, burns and other skin pathologies with microbial etiology[1,2]. The bactericidal effects of NTP on bacteria can be explained by the deleterious impact of ionized particles on bacterial membranes, while the probable mechanisms could include membrane damage, membrane perforation by etching due to highly reactive gas radicals, or interactions with the negative and positive ions of the plasma, hydrogen peroxide, etc.[8]. The accumulation of ROS/RNS species has been implicated to explain the underlying biological effects of non-thermal plasma[11,12,13]. Randomised clinical trials have proven that NTPs can reduce bacteria load as well as promote the healing of chronic wounds, while no side-effects and good treatment tolerability were reported[20,21,22,23]
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