Plasma medicine and wound management

TY - JOUR

T1 - Plasma medicine and wound management

T2 - Evaluation of the antibacterial efficacy of a medically certified cold atmospheric argon plasma jet

AU - Plattfaut, Isabell

AU - Besser, Manuela

AU - Severing, Anna-Lena

AU - Stürmer, Ewa K

AU - Opländer, Christian

N1 - Copyright © 2021 Elsevier Ltd. All rights reserved.

PY - 2021/5/5

Y1 - 2021/5/5

N2 - OBJECTIVES: A major problem for wound healing is contamination with bacteria, often resulting in biofilm formation and wound infection, which, in turn, needs immediate intervention such as surgical debridement and through irrigation. A topical treatment with cold atmospheric pressure plasma (CAP) for wound disinfection may present an alternative and less painful approach.METHODS: This study investigated the antibacterial effects of a cold atmospheric pressure argon plasma jet (kINPen® MED) as a CAP source, using the three-dimensional Staphylococcus aureus immunocompetent biofilm system hpBIOM in addition to a standard planktonic test. Furthermore, skin cell compatibility was evaluated using a keratinocyte (HaCat) model.RESULTS: CAP treatment (0-240 s) followed by incubation (15, 120 min) within the CAP-treated media showed slight bactericidal efficacy under planktonic conditions but no effect on biofilms. However, indirect CAP treatment of keratinocytes performed under the same conditions resulted in a significant decrease in metabolic activity. Short CAP treatment and exposure time (30 s; 15 min) induced a slight increase in the metabolic activity; however, longer treatments and/or exposure times led to pronounced reductions up to 100%. These effects could partially be reversed by addition of catalase, indicating a dominant role of CAP-generated hydrogen peroxide.CONCLUSIONS: These results indicate that plasma treatment does not lead to the desired disinfection or significant reduction in the bacterial burden of Staphylococcus aureus in a wet milieu or in biofilms. Thus, treatment with CAP could not be recommended as a single anti-bacterial therapy for wounds but could be used to support standard treatments.

AB - OBJECTIVES: A major problem for wound healing is contamination with bacteria, often resulting in biofilm formation and wound infection, which, in turn, needs immediate intervention such as surgical debridement and through irrigation. A topical treatment with cold atmospheric pressure plasma (CAP) for wound disinfection may present an alternative and less painful approach.METHODS: This study investigated the antibacterial effects of a cold atmospheric pressure argon plasma jet (kINPen® MED) as a CAP source, using the three-dimensional Staphylococcus aureus immunocompetent biofilm system hpBIOM in addition to a standard planktonic test. Furthermore, skin cell compatibility was evaluated using a keratinocyte (HaCat) model.RESULTS: CAP treatment (0-240 s) followed by incubation (15, 120 min) within the CAP-treated media showed slight bactericidal efficacy under planktonic conditions but no effect on biofilms. However, indirect CAP treatment of keratinocytes performed under the same conditions resulted in a significant decrease in metabolic activity. Short CAP treatment and exposure time (30 s; 15 min) induced a slight increase in the metabolic activity; however, longer treatments and/or exposure times led to pronounced reductions up to 100%. These effects could partially be reversed by addition of catalase, indicating a dominant role of CAP-generated hydrogen peroxide.CONCLUSIONS: These results indicate that plasma treatment does not lead to the desired disinfection or significant reduction in the bacterial burden of Staphylococcus aureus in a wet milieu or in biofilms. Thus, treatment with CAP could not be recommended as a single anti-bacterial therapy for wounds but could be used to support standard treatments.

KW - Anti-Bacterial Agents/pharmacology

KW - Argon/pharmacology

KW - Atmospheric Pressure

KW - Biofilms/drug effects

KW - HaCaT Cells

KW - Humans

KW - Keratinocytes/drug effects

KW - Microbial Viability

KW - Plasma Gases/pharmacology

KW - Skin/drug effects

KW - Staphylococcus aureus/cytology

KW - Wound Healing/drug effects

KW - Wound Infection/microbiology

U2 - 10.1016/j.ijantimicag.2021.106319

DO - 10.1016/j.ijantimicag.2021.106319

M3 - SCORING: Journal article

C2 - 33716180

VL - 57

JO - INT J ANTIMICROB AG

JF - INT J ANTIMICROB AG

SN - 0924-8579

IS - 5

M1 - 106319

ER -