Library Subscription: Guest
Plasma Medicine

Published 4 issues per year

ISSN Print: 1947-5764

ISSN Online: 1947-5772

SJR: 0.216 SNIP: 0.263 CiteScore™:: 1.4 H-Index: 24

Indexed in

Accelerated Healing of Chronic Wounds under a Combinatorial Therapeutic Regimen Based on Cold Atmospheric Plasma Jet Using Contact and Noncontact Styles

Volume 11, Issue 2, 2021, pp. 1-18
DOI: 10.1615/PlasmaMed.2021039083
Get accessDownload

ABSTRACT

One critical element for applying atmospheric pressure plasma jet for medical purposes is that it is possible to construct a combinatorial therapeutic regimen based on contact and noncontact styles for the cold atmospheric plasma jet. This study evaluates plasma jet effectiveness for bacteria-infected wounds in a small animal model. In this investigation, we test a novel combinative treatment using contact and noncontact style for plasma jet that was generated at high voltage of ~ 9 kV. We use medical-grade argon gas as a single carrier gas. The object of plasma treatment is BALB/c mouse skin wounds that were infected with Staphylococcus aureus. We use four plasma jet treatments, namely, C (control), CP-CP (contact), NCP-NCP (noncontact), and CP-NCP (contact-noncontact). For CP-NCP, from days 0 to 7 we apply a contact style of plasma jet treatment to wounds to kill bacteria; from days 8 to 13, a noncontact style of plasma jet is applied to stimulate wound healing. Our results show that with CP-CP, contact plasma treatment can remove the biofilm layer, but after the biofilm layer disappears contact plasma treatment inhibits the wound-healing process. NCP-NCP is not effective in eliminating bacterial biofilms and impedes the wound-healing process. With CP-NCP, contact plasma exposure during days 0 to 7 is able to remove bacterial biofilms, and irradiation of noncontact plasma during days 8 to 14 accelerates wound healing. Finally, CP-NCP significantly accelerates healing. The combinatorial therapeutic regimen based on contact and noncontact styles of cold atmospheric plasma jet is recommended for chronic wound management, because it effectively removes bacterial biofilms and accelerates wound healing.

REFERENCES
  1. Stotts NA. Wound infection: Diagnosis and management. In: Bryant RA, Nix, DP, editors. Acute & chronic wounds: Current management concept. 4th ed. St. Louis: Mosby Elsevier; 2011. p. 270-8.

  2. Rolstad BS, Bryant RA, Nix DP. Topical management. In: Bryant RA, Nix, DP, editors. Acute & chronic wounds: Current management concept. 4th ed. St. Louis: Mosby Elsevier; 2011. p. 289-306.

  3. Fridman G, Friedman G, Gutsol A, Shekhter AB, Vasilets VN, Fridman A. Applied plasma medicine. Plasma Proc Polym. 2008;5:503-33.

  4. M. Laroussi. Low-temperature plasmas for medicine? IEEE Trans Plasma Sci. 2009;37(6):714-25.

  5. Soneja A, Drews M, Malinski T. Role of nitric oxide, nitroxidative and oxidative stress in wound healing. Pharmacol Rep. 2005;57(Suppl.):S108-19.

  6. Bartosz G. Reactive oxygen species: Destroyers or messengers? Biochem Pharmacol. 2009;77:1303-15.

  7. Weltmann K-D, Woedtke T. Plasma medicine-current state of research and medical application. Plasma Phys Control Fusion. 2017;59:014031-42.

  8. Jiang C. Emerging applications of plasma in medicine: Fashion versus efficacy. In: Chu PK, Lu X, editors. Low temperature plasma technology. Boca Raton: CRC Press; 2014. p. 421.

  9. Lu X. Guest editorial: Atmospheric pressure plasma jets and their applications. IEEE Trans Plasma Sci. 2015;43:701-2.

  10. Nasruddin N, Nakajima Y, Mukai K, Rahayu HSE, Nur M, Ishijima T, Enomoto H, Uesugi Y, Sugama J, Nakatani T. Cold plasma on full-thickness cutaneous wound accelerates healing through promoting inflammation, re-epithelialisation and wound contraction. Clin Plasma Med. 2014;2:28-35.

  11. Nasruddin N, Nakajima Y, Mukai K, Komatsu E, Rahayu HSE, Nur M, Ishijima T, Enomoto H, Uesugi Y, Sugama J, Nakatani T. A simple technique to improve contractile effect of cold plasma jet on acute mouse wound by dropping water. Plasma Proc Polym. 2015;12:1128-38.

  12. Nasruddin N, Putri IK, Kamal S, Rahayu HSE, Lutfiyanti H, Pribadi P, Kusuma TM, Muhlisin Z, Nur M, Nurani LH, Santosa B, Ishijima T, Nakatani T. Evaluation the effectiveness of combinative treatment of cold plasma jet, Indonesian honey, and micro-well dressing to accelerate wound healing. Clin Plasma Med. 2017;5-6:14-25.

  13. Wahyuningtyas ES, Iswara A, Sari Y, Kamal S, Santosa B, Ishijima T, Nakatani T, Putri IK, Nasruddin N. Comparative study on Manuka and Indonesian honeys to support the application of plasma jet during proliferative phase on wound healing. Clin Plasma Med. 2018;12:1-9.

  14. Mai-Prochnow A, Murphy AB, McLean KM, Kong MG, Ostrikov K, Atmospheric pressure plasmas: Infection control and bacterial responses. Int J Antimicrob Agents. 2014;43:508-7.

  15. Daeschlein G. Antimicrobial activity of plasma. In: Metelmann H-R, Woedtke TV, Weltmann K-D, editors. Comprehensive clinical plasma medicine. Berlin: Springer International; 2018. p. 113-25.

  16. Nishime TMC, Borges AC, Koga-Ito CY, Machida M, Heina LRO, Kostov KG. Non-thermal atmospheric pressure plasma jet applied to inactivation of different microorganisms. Surf Coatings Technol. 2017;312:19-24.

  17. Darmawati S, Rohmani A, Nurani LH, Prastiyanto ME, Dewi SS, Salsabila N, Wahyuningtyas ES, Murdiya F, Sikumbang IM, Rohmah RN, Fatimah YA, Widiyanto A, Ishijima T, Sugama J, Nakatani T, Nasruddin N. When plasma jet is effective for chronic wound bacteria inactivation, is it also effective for wound healing? Clin Plasma Med. 2019;14:100085.

  18. Daeschlein, G, Napp M, von Podewils S, Lutze S, Emmert S. Lange A, Klare I, Haase H, Gumbel D, Woedtke T, Junger M. In vitro susceptibility of multidrug resistant skin and wound pathogens against low temperature atmospheric pressure plasma jet (APPJ) and dielectric barrier discharge plasma (DBD). Plasma Proc Polym. 2013;11(2):175-83.

  19. Daeschlein G, Scholz S, Arnold, A, von Podewils S, Haase H, Emmert S, Woedtke T, Weltmann K-D, Junger M. In vitro susceptibility of important skin and wound pathogens against low temperature atmospheric pressure plasma jet (APPJ) and dielectric barrier discharge plasma (DBD). Plasma Process Polym. 2012;9(4):380-9.

  20. Darmawati S, Nasruddin N, Kurniasiwi P, Mukaromah AH, Iswara A, Putri GSA, Rahayu HSE, Wahyuningtyas ES, Lutfiyati H, Kartikadewi A, Rejeki S, Ishijima T, Nakatani T, Sugama J. Plasma jet effectiveness alteration in acute wound healing by binahong (Anredera cordifolia) extract. Plasma Med. 2020;10(4):259-71.

  21. Teschke M, Kedzierski J, Finantu-Dinu E, Korzec D, Engemann J. High-speed photographs of a dielectric barrier atmospheric pressure plasma jet. IEEE Trans Plasma Sci. 2005;33:310-11.

  22. Carpenter JW. Exotic animal formulary. 4th ed. St. Louis: Elsevier; 2013.

  23. Davis S, Ricotti C, Cazzaniga C, Welsh A, Eaglstein AWH, Mertz PM. Microscopic and physiologic evidence for biofilm-associated wound colonization in vivo. Wound Repair Regen. 2008;16(1):23-9.

  24. Liang D, Lu Z, Yang H, Gao J, Chen R. Novel asymmetric wettable AgNPs/chitosan wound dressing: In vitro and in vivo evaluation. ACS Appl Mater Interfaces. 2016;8(6):3958-68.

  25. Kapusta A, Kuczynska B, Puppel, K. Relationship between the degree of antioxidant protection and the level of malondialdehyde in high-performance Polish Holstein-Friesian cows in peak of lactation. PLoS One. 2018;13(3):e0193512.

  26. Sibbald RG, Goodman L, Woo KY, Krasner DL, Smart H, Tariq G, Salcido R. Special considerations in wound bed preparation. Adv Skin Wound Care. 2011;24(9):415-36.

  27. Thana P, Wijaikhum A, Poramapijitwat P, Kuensaen C, Meerak J, Ngamjarurojana A, Boonyawan D. A compact pulse-modulation cold air plasma jet for the inactivation of chronic wound bacteria: Development and characterization. Heliyon. 2019;5(9):e02455.

  28. Alkawareek MY, Algwari QT, Gorman SP, Graham WG, O'Connell D, Gilmore BF. Application of atmospheric pressure nonthermal plasma for thein vitroeradication of bacterial biofilms. FEMS Immunol Med Microbiol. 2012;65(2):381-4.

  29. Dunnill, C, Patton T, Brennan J, Barrett J, Dryden M, Cooke J, Georgopoulos NT. Reactive oxygen species (ROS) and wound healing: The functional role of ROS and emerging ROS-modulating technologies for augmentation of the healing process. Int Wound J. 2015;14(1):89-96.

CITED BY
  1. Bekeschus Sander, Kramer Axel, Schmidt Anke, Gas Plasma-Augmented Wound Healing in Animal Models and Veterinary Medicine, Molecules, 26, 18, 2021. Crossref

3567 Article views 2127 Article downloads Metrics
3567 VIEWS 2127 DOWNLOADS 1 Crossref CITATIONS Google
Scholar
CITATIONS

Articles with similar content:

TNF-α Expression and New Epithelial Thickness in the Skin of Mice (Mus musculus) Infected MRSA by Medical Plasma Treatment Plasma Medicine, Vol.12, 2022, issue 4
Defi Nurul Hayati, Sri Darmawati, Gela Setya Ayu Putri, Mudyawati Kamarudin
Plasma Jet Effectiveness Alteration in Acute Wound Healing by Binahong (Anredera cordifolia) Extract Plasma Medicine, Vol.10, 2020, issue 4
Nasruddin Nasruddin, Sri Darmawati, A. Kartikadewi, Eka Sakti Wahyuningtyas, Toshio Nakatani, Putri Kurniasiwi, S. Rejeki, A. H. Mukaromah, H. S. E. Rahayu, Tatsuo Ishijima, H. Lutfiyati, Gela Setya Ayu Putri, Arya Iswara, Junko Sugama
Deep Penetration into Tissues of Reactive Oxygen Species Generated in Floating-Electrode Dielectric Barrier Discharge (FE-DBD): An In Vitro Agarose Gel Model Mimicking an Open Wound Plasma Medicine, Vol.2, 2012, issue 1-3
Gregory Fridman, Danil Dobrynin, Alexander A. Fridman, Gary Friedman
Surfatron-Produced Atmospheric-Pressure Plasma Jet Applied to Candida Biofilms Plasma Medicine, Vol.8, 2018, issue 4
Homero S. Maciel, Fernanda R. Figueira, Anelise C.O.C. Doria, J. S. B. Lima, Sonia Khouri, S. Pessoa
Physico–Chemical Characterization of Dentinal Surface Treated with Atmospheric- Pressure Plasma Plasma Medicine, Vol.8, 2018, issue 4
Victor Ivan Vargas, J. Rodriguez-Rojas, Erika Alfaro-Mayorga, M. Bonilla, J. R. Vega-Baudrit, D. Chavarria-Bolaños
Begell Digital Portal Begell Digital Library eBooks Journals References & Proceedings Research Collections Prices and Subscription Policies Begell House Contact Us Language English 中文 Русский Português German French Spain