Effect of direct cold atmospheric plasma (diCAP) on microcirculation of intact skin in a controlled mechanical environment

Abstract

ObjectiveThe microcirculatory response of intact human skin to exposure with diCAP for different durations with a focus on the effect of implied mechanical pressure during plasma treatment was investigated.MethodsLocal relative hemoglobin, blood flow velocity, tissue oxygen saturation, and blood flow were monitored noninvasively for up to 1 hour in 1‐2 mm depth by optical techniques, as well as temperature, pH values, and moisture before and after skin stimulation. The experimental protocol (N = 10) was set up to differentiate between pressure‐ and plasma‐induced effects.ResultsSignificant increases in microcirculation were only observed after plasma stimulation but not after pressure stimulus alone. For a period of 1 h after stimulation, local relative hemoglobin was increased by 5.1% after 270 seconds diCAP treatment. Tissue oxygen saturation increased by up to 9.4%, whereas blood flow was doubled (+106%). Skin pH decreased by 0.3 after 180 seconds and 270 seconds diCAP treatment, whereas skin temperature and moisture were not affected.ConclusionsdiCAP treatment of intact skin notably enhances microcirculation for a therapeutically relevant period. This effect is specific to the plasma treatment and not an effect of the applied pressure. Prolonged treatment durations lead to more pronounced effects.

A single application of cold atmospheric plasma (CAP) improves blood flow parameters in chronic wounds

“…Consistently elevated parameters even at the end of measuring period indicated that effects may possibly persist for a longer period of time. Borchardt et al found that microcirculation parameters stayed elevated for up to one hour after application of CAP in healthy skin 39 . How long those effects stay elevated in chronic wounds may be subject to upcoming studies.…”

Hyperspectral Imaging of Wounds Reveals Augmented Tissue Oxygenation Following Cold Physical Plasma Treatment in Vivo

“…While most of the optical techniques for measuring of oxygenation parameters such as laser Doppler fluxometry with transcutaneous oxygen-monitoring [56,57], as well as tissue oximeters [58], penetrate up to 1-2 mm from wound surface, HSI has the archives deeper layers up to 6 mm similarly to NIR spectroscopy [10]. HSI technology was translated into medicine in several medical applications in recent years.…”

Antibacterial and safety tests of a flexible cold atmospheric plasma device for the stimulation of wound healing

“…Similar results have been reported in other studies. Plasma increased the skin temperature with 2°C (Borchardt et al 2017 ; Fluhr et al 2012 ) or resulted in a sensation of heat score of 0–5 (Daeschlein et al 2012a ; Daeschlein et al 2012b ). Application of 42°C for 30 seconds could be well tolerated by volunteers (Oliveira et al 2014 ) and stimulated blood flow, while fast heating resulted in a higher endothelial activity (Del Pozzi et al 2016 ; Hodges et al 2017 ).…”

“…The erythema index is proportional to the haemoglobin content of the upper layers of the dermis and thus might be considered an indirect measure for microcirculation, although in scars a correlation between microcirculation as measured by laser Doppler imaging and erythema was not found (Jaspers et al 2017b ). Plasma can stimulate microcirculation of healthy skin beyond the treatment time (Borchardt et al 2017 ; Fluhr et al 2012 ; Heuer et al 2015 ; Kisch et al 2016a ; Kisch et al 2016b ), which can improve the healing potential especially of chronic wounds. The enhanced microcirculation is probably mediated by plasma-produced nitric oxide (NO) (Heuer et al 2015 ), which easily penetrates the skin (Ganzarolli de Oliveira 2016 ; Vercelino et al 2013 ).…”