Clinical use of cold atmospheric pressure argon plasma in chronic leg ulcers: A pilot study

Ulrich, Ch.; Kluschke, Franziska; Patzelt, Alexa; Vandersee, Staffan; Czaika, V.; Richter, Heike; Боб, А. О.; Hutten, Johanna von; Painsi, Clemens; Hüge, R; Krämer, Axel; Assadian, Ojan; Lademann, Jürgen; Lange‐Asschenfeldt, Bernhard

doi:10.12968/jowc.2015.24.5.196

Cited by 140 publications

(114 citation statements)

References 23 publications

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“…Moreover, application time should be another target of further studies, since longer exposure is known to reduce bacterial load more effectively (Shimizu et al, 2011;Ermolaeva et al, 2011). Furthermore, immediate bacteria reduction in leg ulcers has been shown after a single use of CAP, but later an increase in bacteria density was observed (Ulrich et al, 2015). In mice repetitive treatments significantly increased the rate of wound closure (Ermolaeva et al, 2011;Nasruddin et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Improvement of cutaneous microcirculation by cold atmospheric plasma (CAP): Results of a controlled, prospective cohort study

Kisch

Helmke

Schleusser

et al. 2016

Microvascular Research

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Section: Discussionmentioning

confidence: 99%

Improvement of cutaneous microcirculation by cold atmospheric plasma (CAP): Results of a controlled, prospective cohort study

Kisch

Helmke

Schleusser

et al. 2016

Microvascular Research

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“…As with the introduction of portable laser technology and associated innovations, the development of mobile devices [244,253] allows multiple local plasma applications. At the moment, these are focused around the therapy of chronic wounds [245,246,247,248,249], tumors [250], and eliminating biofilm on implants [251,252,253]. …”

Section: Future Perspectivesmentioning

confidence: 99%

Consensus on Wound Antisepsis: Update 2018

Krämer

Dissemond²,

Kim³

et al. 2017

Skin Pharmacol Physiol

243

215

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Wound antisepsis has undergone a renaissance due to the introduction of highly effective wound-compatible antimicrobial agents and the spread of multidrug-resistant organisms (MDROs). However, a strict indication must be set for the application of these agents. An infected or critically colonized wound must be treated antiseptically. In addition, systemic antibiotic therapy is required in case the infection spreads. If applied preventively, the Wounds-at-Risk Score allows an assessment of the risk for infection and thus appropriateness of the indication. The content of this updated consensus recommendation still largely consists of discussing properties of octenidine dihydrochloride (OCT), polihexanide, and iodophores. The evaluations of hypochlorite, taurolidine, and silver ions have been updated. For critically colonized and infected chronic wounds as well as for burns, polihexanide is classified as the active agent of choice. The combination 0.1% OCT/phenoxyethanol (PE) solution is suitable for acute, contaminated, and traumatic wounds, including MRSA-colonized wounds due to its deep action. For chronic wounds, preparations with 0.05% OCT are preferable. For bite, stab/puncture, and gunshot wounds, polyvinylpyrrolidone (PVP)-iodine is the first choice, while polihexanide and hypochlorite are superior to PVP-iodine for the treatment of contaminated acute and chronic wounds. For the decolonization of wounds colonized or infected with MDROs, the combination of OCT/PE is preferred. For peritoneal rinsing or rinsing of other cavities with a lack of drainage potential as well as the risk of central nervous system exposure, hypochlorite is the superior active agent. Silver-sulfadiazine is classified as dispensable, while dyes, organic mercury compounds, and hydrogen peroxide alone are classified as obsolete. As promising prospects, acetic acid, the combination of negative pressure wound therapy with the instillation of antiseptics (NPWTi), and cold atmospheric plasma are also subjects of this assessment.

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“…Using the highly-sensitive chorioallantoic membrane of fertilized chicken eggs both jets have been shown to be tolerated well, suggesting the plasma’s compatibility with tissues [36]. Studies using porcine and human tissues underlined this notion [37, 38] which was a prerequisite for first observational studies in humans [2]. To complement the risks assessment made with the kINPen MED and kINPen 09, we here investigated their genotoxic potential.…”

Section: Introductionmentioning

confidence: 99%

Investigating the Mutagenicity of a Cold Argon-Plasma Jet in an HET-MN Model

et al. 2016

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ObjectiveSo-called cold physical plasmas for biomedical applications generate reactive oxygen and nitrogen species and the latter can trigger DNA damage at high concentrations. Therefore, the mutagenic risks of a certified atmospheric pressure argon plasma jet (kINPen MED) and its predecessor model (kINPen 09) were assessed.MethodsInner egg membranes of fertilized chicken eggs received a single treatment with either the kINPen 09 (1.5, 2.0, or 2.5 min) or the kINPen MED (3, 4, 5, or 10 min). After three days of incubation, blood smears (panoptic May-Grünwald-Giemsa stain) were performed, and 1000 erythrocytes per egg were evaluated for the presence of polychromatic and normochromic nuclear staining as well as nuclear aberrations and binucleated cells (hen’s egg test for micronuclei induction, HET-MN). At the same time, the embryo mortality was documented. For each experiment, positive controls (cyclophosphamide and methotrexate) and negative controls (NaCl-solution, argon gas) were included. Additionally, the antioxidant potential of the blood plasma was assessed by ascorbic acid oxidation assay after treatment.ResultsFor both plasma sources, there was no evidence of genotoxicity, although at the longest plasma exposure time of 10 min the mortality of the embryos exceeded 40%. The antioxidant potential in the egg’s blood plasma was not significantly reduced immediately (p = 0.32) or 1 h (p = 0.19) post exposure to cold plasma.ConclusionThe longest plasma treatment time with the kINPen MED was 5–10 fold above the recommended limit for treatment of chronic wounds in clinics. We did not find mutagenic effects for any plasma treatment time using the either kINPen 09 or kINPen MED. The data provided with the current study seem to confirm the lack of a genotoxic potential suggesting that a veterinary or clinical application of these argon plasma jets does not pose mutagenic risks.

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Clinical use of cold atmospheric pressure argon plasma in chronic leg ulcers: A pilot study

Cited by 140 publications

References 23 publications

Improvement of cutaneous microcirculation by cold atmospheric plasma (CAP): Results of a controlled, prospective cohort study

Improvement of cutaneous microcirculation by cold atmospheric plasma (CAP): Results of a controlled, prospective cohort study

Consensus on Wound Antisepsis: Update 2018

Investigating the Mutagenicity of a Cold Argon-Plasma Jet in an HET-MN Model

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