There is a high unmet medical need for alternative antimicrobial treatments and test systems due to the growing rate of antibiotic resistances. A promising approach is the use of CAP. For investigation of antimicrobial efficacy and biocompatibility ex ovo, a shell-less hen's egg test on the chick area vasculosa (HET-CAV) was established. Methods An argon plasma jet (kINPen ® 09) and a DBD (dielectric barrier discharge) plasma source based on low temperature cofired ceramic technology (IlmPlas) were compared. Fertilized hen"s eggs were incubated for 72 h and transferred into petri dishes. Plasma was directly applied on the vessel system CAV for different exposure times to investigate irritative effects (hemorrhage, vascular lysis, thrombosis, lethality) up to 24 h. P. aeruginosa (PA) was further co-cultivated on the CAV, followed by CAP treatment to determine survival rate over 68 h. PA was cultivated on MH2-agar plates and treated with CAP to evaluate antimicrobial activity in vitro by formation of zones of inhibition (agar diffusion test). Results Treatment of hen's egg with the plasma jet caused hemorrhagic events and vascular lysis followed by lethal events, whereas the DBD plasma demonstrated high compatibility with only sporadic hemorrhagic reactions. Hence, further antimicrobial studies were performed with the DBD plasma. Without treatment, co-cultivation of PA on the CAV caused strong hemorrhagic reactions and embryonic lethality within 24 h. Treatment of PA with the DBD plasma increased the survival rate of the chick embryo depending on exposure times. The in vitro agar test confirmed the good antimicrobial efficiency. Conclusions The modified hen's egg test allows the determination of antimicrobial activity and biocompatibility of novel CAP sources for biomedical applications in a complex biological system. An efficient antimicrobial activity accompanied with a good biocompatibility was observed for the DBD plasma source.
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