Treatment of Ulcerations and Wounds

Abstract

Chronic wounds comprise a quite heterogeneous group of diseases. The prevailing causes of skin wounds include venous and/or arterial circulatory disorders, diabetes, or constant pressure to the skin (decubitus), which often lead to the development of skin ulceration. Thus, chronic wounds predominately are leg ulcers (with venous leg ulcers prevailing), diabetic foot syndrome, and decubitus on the lower back. Wound debridement, superficial germ reduction, modern wound dressings that keep the wound moist but still allow air exchange, and compression stockings or bandages are the hallmarks of modern wound treatment. The application of biocompatible, cold atmospheric pressure plasma (CAP) is an innovative addition to these treatments, because CAP combines several treatment modalities within one application. Firstly, plasma treatment supports wound healing via its effective and broad antimicrobial activity, as germs often hamper the healing process. Secondly, the unique plasma composition mediates different effects, which positively affect the wound milieu within the different phases of wound healing (e.g. pH reduction, enhanced microcirculation, and cell stimulation). The international study landscape including our own studies reveal that plasma application is safe, effective, and medically applicable. As a consequence of the development of more and more medical plasma devices, standardization of such devices is mandatory to allow for a comparison between devices and to ensure patients’ as well as operators’ safety. To this end, a first DIN-Specification was developed in Germany describing some basic test systems to allow for the general evaluation of safety and efficacy aspects of plasma devices; the DIN-SPEC 91315 (DIN SPEC 91315: General requirements for plasma sources in medicine, 2014).