Cold atmospheric plasma for diabetic foot wounds

NewsBot · Mar 17, 2020

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The efficacy and safety of cold atmospheric plasma as a novel therapy for diabetic wound in vitro and in vivo
Rui He Qin Li Wenqi Shen Tao Wang Huijuan Lu Junxi Lu Fendi Lu Ming Luo Jiankang Zhang Haiwei Gao Dong Wang Wanli Xing Weiping Jia Fang Liu
IWJ 13 March 2020

Cold atmospheric plasma (CAP) is a group of various chemical active species, such as ozone and nitric oxide, generated by working gas. CAP was demonstrated to have an effect on tissue regeneration and wound healing. We conducted this study to evaluate the efficacy and safety of CAP as a novel therapy for diabetic wounds in vitro and in vivo. The plasma consists of ionised helium gas that is produced by a high‐voltage and high‐frequency power supply. Eight‐week‐old male db/db mice and C57BL mice were treated with helium gas (control group), 90s' CAP (low‐dose group), and 180s' CAP (high‐dose group). Mice were treated and observed for 2 weeks. Skin samples from around the wound and blood samples were collected. Our in vitro analysis included scratch wound‐healing assays by using human HaCaT immortalised human epidermal cells. After 14 days of treatment, CAP could obviously promote diabetic wound healing. Wound closure rates were significantly higher in the low‐dose group and high‐dose groups compared with the control group. Meanwhile, compared with the control group, the protein expression of IL‐6, tumour necrosis factor‐α, inducible nitric oxide synthase, and superoxide dismutase in two CAP groups significantly decreased, while the protein expression of vascular endothelial growth factor and transforming growth factor‐β in two CAP groups significantly increased (all P < .05); these data show good agreement with the change in mRNA level (all P < .05). In vitro, scratch wound‐healing assays showed that plasma treatment could effectively ensure healing within 3 minutes of exposure (all P < .05). In addition, no difference was found in histological observations of normal skin and the level of serum alanine transaminase, aspartate aminotransferase, blood urea nitrogen, creatinine, and white blood cells among the CAP groups and control group. CAP treatment for 3 minutes every day improves wound healing in diabetic mice by suppressing inflammation, reducing oxidative stress, and enhancing angiogenesis, involving several proteins signalling, and it is safe for the liver and kidney.
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NewsBot · Jun 29, 2020

Cold Atmospheric Plasma as an Effective Method to Treat Diabetic Foot Ulcers: A Randomized Clinical Trial
Shahriar Mirpour et al
Sci Rep. 2020 Jun 26;10(1):10440

Cold atmospheric plasma (CAP) was shown to decrease bacterial load in chronic wounds. It was also presented as a novel approach to healing wounds in both in vitro and in vivo experiments. We aimed to examine the first randomized clinical trial for the use of CAP in diabetic foot ulcers. Patients (n = 44) were randomly double-blinded, and assigned to receive standard care (SC, n = 22) without or with CAP, to be applied three times a week for three consecutive weeks (SC + CAP, n = 22), using block randomization with mixing block sizes of four. The trial was conducted at the Diabetes Research Center in Tehran, Iran. CAP was generated from ionized helium gas in ambient air, and driven by a high voltage (10 kV) and high frequency (6 kHz) power supply. Primary outcomes were wound size, number of cases reaching wound size of <0.5, and a bacterial load after over three weeks of treatment. CAP treatment effectively reduced the fraction of wound size (p = 0.02). After three weeks, the wounds to reach fraction wound size of ≤0.5 was significantly greater in the SC + CAP group (77.3%) compared to the SC group (36.4%) (p = 0.006). The mean fraction of bacterial load counted in each session 'after CAP exposure' was significantly less than 'before exposure' measures. CAP can be an efficient method to accelerate wound healing in diabetic foot ulcers, with immediate antiseptic effects that do not seem to last long
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NewsBot · Oct 27, 2021

The Evaluation of Efficacy of Atmospheric Pressure Plasma in Diabetic Ulcers Healing: A randomized clinical trial
Shirin Samsavar et al
Dermatol Ther. 2021 Oct 21

To evaluate the efficacy and safety of Cold Atmospheric Plasma as a novel therapy for Diabetic Foot Ulcers. This was an investigator-blinded, randomized controlled trial of 14 weeks (6 weeks of treatment and eight weeks of follow-up). Twenty patients with Diabetic Foot ulcers were divided into two groups: the control group receiving standard wound care and the plasma group, which received Cold Atmospheric Plasma twice a week for six consecutive weeks in addition to standard wound care. The ulcer size, amount of exudate, and wound grading were determined weekly. Cold plasma was produced by applying a high voltage (4.5 kV) and a high frequency (22 kHz) to helium gas. Exudate from wounds treated with Cold Atmospheric Plasma showed a significant reduction in the third week after complete treatment (P = 0.039). The wound grading of the ulcers improved by the sixth week (P = 0.019), and the sizes of ulcers significantly decreased in the plasma group at the end of the treatment period (P = 0.007). In this randomized clinical trial, Cold Atmospheric Plasma (CAP) was an effective treatment option for diabetic foot ulcers in terms of wound surface reduction and antibacterial effects. Iranian Clinical Trial Registry (IRCT.ir) identifier is IRCT20181012041317N1 Diabetes mellitus (DM) has been one of the most prevalent medical illnesses, presenting a huge global health threat. Wound healing is a common concern in diabetic patients. Diabetic foot ulcers (DFUs), are a major complication of diabetes and require specialized treatment. Plasma is the fourth state of matter, in addition to solid, liquid, and gas phases. Cold atmospheric plasma (CAP) devices have been tested clinically as an innovative approach in wound healing. In this study, we will extend previous findings in humans by conducting a clinical trial to investigate the safety, efficacy, and applicability of cold atmospheric plasma treatment for diabetic foot ulcers. The advantage of our plasma jet system is the large probe and the ability to treat a large area in comparison to other plasma generators. CAP was found to be an effective treatment modality in wound healing with regards to wound surface reduction and antibacterial effects in DFUs.
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