The repetitive use of non-thermal dielectric barrier discharge plasma boosts cutaneous microcirculatory effects

Kisch, Tobias; Schleusser, Sophie; Helmke, Andreas; Mauss, Karl L.; Wenzel, Eike; Hasemann, Benedikt; Mailaender, Peter; Kraemer, Robert

doi:10.1016/j.mvr.2016.02.008

Cited by 64 publications

(51 citation statements)

References 30 publications

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“…The detailed process of selection is summarised in Figure . Nine studies encompassing 268 patients, randomised either to treatment with AP or control, were identified . Four studies investigated the effect of AP on wound healing compared with conventional standard treatment, and five studies presented data on reduction of bacterial burden in wounds after AP application .…”

Section: Resultsmentioning

confidence: 99%

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Effects and safety of atmospheric low‐temperature plasma on bacterial reduction in chronic wounds and wound size reduction: A systematic review and meta‐analysis

Assadian

Ousey

Daeschlein

et al. 2018

International Wound Journal

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The use of atmospheric low‐temperature plasma (AP) on chronic wounds and its effect on microbial bioburden in open wounds has not been explored with a systematic review and meta‐analysis. PRISMA guidelines were followed and PubMed, Embase, CENTRAL, and CINAHL databases searched for randomised controlled trials (RCTs), which compared AP with no AP for the management of open, chronic wounds. The primary outcomes of reduction of bioburden or wound size were included. Meta‐analyses were performed; odds ratio (OR) and 95% confidence intervals (CIs) were extracted and pooled in a random effects model. Four RCTs investigated the effect of AP on chronic wound healing. Chronic wounds treated with AP did not show a significant improvement in healing (AP vs control: OR = 1.46; 95% CI = 0.89‐2.38; P = 0.13). Five further RCTs investigated the reduction of bioburden in wounds, but AP demonstrated no significant reduction of bioburden (AP vs control: OR = 0.85; 95% CI = 0.45‐1.62; P = 0.63). All nine RCTs recorded the presence of any severe adverse events (SAEs) in the 268 patients studied, with only one unrelated SAE identified in each group (AP vs control: OR = 1.00; 95% CI = 0.05‐19.96; P = 1.00). Use of AP in wound care is safe, but the retrieved evidence and meta‐analysis show that there is no clinical benefit of AP in chronic open wounds using currently available AP device settings.

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Section: Resultsmentioning

confidence: 99%

“…The present meta‐analysis includes one cohort study and eight prospective randomised trials. While RCTs are usually the focus of a meta‐analysis because of the least risk of bias, the same methodology used for randomised trials can be applied to cohort studies .…”

Section: Discussionmentioning

confidence: 99%

Effects and safety of atmospheric low‐temperature plasma on bacterial reduction in chronic wounds and wound size reduction: A systematic review and meta‐analysis

Assadian

Ousey

Daeschlein

et al. 2018

International Wound Journal

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“…As stated by the manufacturer, the measuring depth of the applied probe LFX‐29 (LEA Medizintechnik GmbH) in this study is 1‐2 mm. The O2C system has been successfully applied before to measure diCAP‐induced changes in skin microcirculation …”

Section: Methodsmentioning

confidence: 99%

“…Recent studies have revealed a significant impact of short‐term diCAP application (up to 90 seconds) on the microcirculation of skin . However, in the literature, the role of mechanical pressure induced by the diCAP device was not addressed.…”

Section: Introductionmentioning

confidence: 99%

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

Borchardt¹,

Ernst

Helmke

et al. 2017

Microcirculation

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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.

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“…by inflammatory 45,46 and proliferation-supporting stimuli 47,48 , including stimulation of neovascularization. 29,49,50 However, while the medical applications of CAP are promising, it is vital to ensure the safety and reliability of applied CAPs in humans before it may be considered for routine clinical…”

mentioning

confidence: 99%

Cold atmospheric pressure plasma for treatment of chronic wounds: drug or medical device?

et al. 2017

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Objective: The use of cold atmospheric pressure plasma (CAPP) as a new therapeutic option to aid the healing of chronic wounds appears promising. Currently, uncertainty exists regarding their classification as medical device or medical drug. Because the classification of CAPP has medical, legal, and economic consequences as well as implications for the level of preclinical and clinical testing, the correct classification is not an academic exercise, but an ethical need. Method: A multidisciplinary team of physicians, surgeons, pharmacists, physicists and lawyers has analysed the physical and technical characteristics as well as legal conditions of the biological action of CAPP. Results: It was concluded that the mode of action of the locally generated CAPP, with its main active components being different radicals, is pharmacological and not physical in nature. Conclusion: Depending on the intended use, CAPP should be classified as a drug, which is generated by use of a medical device directly at the point of therapeutic application.

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The repetitive use of non-thermal dielectric barrier discharge plasma boosts cutaneous microcirculatory effects

Cited by 64 publications

References 30 publications

Effects and safety of atmospheric low‐temperature plasma on bacterial reduction in chronic wounds and wound size reduction: A systematic review and meta‐analysis

Effects and safety of atmospheric low‐temperature plasma on bacterial reduction in chronic wounds and wound size reduction: A systematic review and meta‐analysis

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

Cold atmospheric pressure plasma for treatment of chronic wounds: drug or medical device?

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