Gas Plasma: Medical Uses and Developments in Wound Care

Non-thermal gas plasmas (NTGPs) are a promising emergent medical technology.a Unlike thermal plasmas, they generate a complex room temperature mix of reactive species which interact with tissues. The characterization of candidate plasmas and their interaction with tissues has shown that they produce a variety of broadly dose dependent effects ranging from fibroblast proliferation to angiogenesis and bacterial destruction. These findings, supported by recent experiments using skin models, suggest that NTGP's could potentially play an important role in both decontaminating acute and chronic wounds and accelerating healing. However, important issues over toxicological and environmental safety remain unanswered and a number of regulatory and technical hurdles will need to be overcome before a NTGP medical device is released.

[1]  T. El-toukhy,et al.  Over one thousand patients with early stage endometriosis treated with the Helica Thermal Coagulator (HELICA): safety aspects , 2006, Archives of Gynecology and Obstetrics.

[2]  Mounir Laroussi,et al.  Inactivation of bacteria by the plasma pencil , 2006 .

[3]  J. Roth,et al.  Use of a one atmosphere uniform glow discharge plasma to kill a broad spectrum of microorganisms , 1999 .

[4]  D W Slaaf,et al.  Electric discharge plasmas influence attachment of cultured CHO K1 cells , 2004, Bioelectromagnetics.

[5]  T. Osler,et al.  Senescence and the healing rates of venous ulcers. , 2001, Journal of vascular surgery.

[6]  P. Thomas Vernier,et al.  Nanosecond Pulsed Plasma Dental Probe , 2009 .

[7]  Philip Drew,et al.  The cost of wound care for a local population in England , 2007, International wound journal.

[8]  N. Law,et al.  Preventing Venous Ulcer Recurrence: The Impact of the Well Leg Clinic , 2002 .

[9]  Michael G. Kong,et al.  Protein destruction by a helium atmospheric pressure glow discharge: Capability and mechanisms , 2007 .

[10]  J. Roth,et al.  An overview of research using the one atmosphere uniform glow discharge plasma (OAUGDP) for sterilization of surfaces and materials , 2000 .

[11]  U. Shah,et al.  Coblation for Tonsillectomy: An Evidence-Based Review , 2007, ORL.

[12]  G. Mills,et al.  Impairment of T cell activation in burn patients: a possible mechanism of thermal injury-induced immunosuppression. , 1986, Clinical and experimental immunology.

[13]  S. Kuo,et al.  Killing of Bacterial Spores Contained in a Paper Envelope by a Microwave Plasma Torch , 2006, IEEE Transactions on Plasma Science.

[14]  Jianjun Shi,et al.  Physical Mechanisms of Inactivation of Bacillus subtilis Spores Using Cold Atmospheric Plasmas , 2006, IEEE Transactions on Plasma Science.

[15]  P. Stewart,et al.  Biofilms in chronic wounds , 2008, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[16]  O. Kylián,et al.  Removal of Model Proteins Using Beams of Argon Ions, Oxygen Atoms and Molecules : Mimicking the Action of Low-Pressure Ar/O2 ICP Discharges , 2009 .

[17]  T. Brocklehurst,et al.  Atmospheric plasma inactivation of biofilm-forming bacteria for food safety control , 2005, IEEE Transactions on Plasma Science.

[18]  F. Gottrup,et al.  A new concept of a multidisciplinary wound healing center and a national expert function of wound healing. , 2001, Archives of surgery.

[19]  H. Manner.  Argon plasma coagulation therapy. , 2008, Current opinion in gastroenterology.

[20]  M. Laroussi,et al.  Spores Survivability After Exposure to Low-Temperature Plasmas , 2006, IEEE Transactions on Plasma Science.

[21]  A. Simpson,et al.  Elimination of transmissible spongiform encephalopathy infectivity and decontamination of surgical instruments by using radio-frequency gas-plasma treatment. , 2005, The Journal of general virology.

[22]  M Maarten Steinbuch,et al.  Plasma needle for in vivo medical treatment: recent developments and perspectives , 2006 .

[23]  M Moreau,et al.  Non-thermal plasma technologies: new tools for bio-decontamination. , 2008, Biotechnology advances.

[24]  S. Davis,et al.  LISFESYLES OF BACTERIA IN WOUNDS: PRESENCE OF BIOFILMS? , 2001 .

[25]  B. Saoudi,et al.  Bacterial spore inactivation by atmospheric-pressure plasmas in the presence or absence of UV photons as obtained with the same gas mixture , 2006 .

[26]  A. Falabella,et al.  Dermal fibroblasts from venous ulcers are unresponsive to the action of transforming growth factor-beta 1. , 1997, Journal of dermatological science.

[27]  R. Fitzpatrick,et al.  A pilot study on the use of a plasma skin regeneration device (Portrait® PSR3) in full facial rejuvenation procedures , 2007, Lasers in Medical Science.

[28]  Eva Stoffels,et al.  Superficial treatment of mammalian cells using plasma needle , 2003 .

[29]  Mounir Laroussi,et al.  Plasma interaction with microbes , 2003 .

[30]  I. Perry,et al.  Leg Ulcers: A Cross-Sectional Survey of Management Practices and Treatment Costs in Ireland , 2002 .

[31]  L. Deelman,et al.  Delayed Effects of Cold Atmospheric Plasma on Vascular Cells , 2008 .

[32]  E. Stoffels,et al.  Reattachment and Apoptosis After Plasma-Needle Treatment of Cultured Cells , 2006, IEEE Transactions on Plasma Science.

[33]  S. Priglinger,et al.  Pulsed electron avalanche knife: new technology for cataract surgery , 2007, British Journal of Ophthalmology.

[34]  M. Moody.  Metrotop: a topical antimicrobial agent for malodorous wounds. , 1998, British Journal of Nursing.

[35]  E. Stoffels,et al.  The effects of UV irradiation and gas plasma treatment on living mammalian cells and bacteria: a comparative approach , 2004, IEEE Transactions on Plasma Science.

[36]  R. Baxter,et al.  Quantitative analysis of residual protein contamination on reprocessed surgical instruments. , 2006, The Journal of hospital infection.

[37]  R. Diegelmann,et al.  Wound healing: an overview of acute, fibrotic and delayed healing. , 2004, Frontiers in bioscience : a journal and virtual library.

[38]  D. Greenhalgh,et al.  The role of apoptosis in wound healing. , 1998, The international journal of biochemistry & cell biology.

[39]  J. V. Vande Berg,et al.  Fibroblast senescence in pressure ulcers , 1998, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[40]  P. Murányi,et al.  Influence of relative gas humidity on the inactivation efficiency of a low temperature gas plasma , 2008, Journal of applied microbiology.

[41]  E. A. Nelson,et al.  Systematic review of antimicrobial treatments for diabetic foot ulcers , 2006, Diabetic medicine : a journal of the British Diabetic Association.

[42]  Richard L. Leask,et al.  Cell treatment and surface functionalization using a miniature atmospheric pressure glow discharge plasma torch , 2006 .

[43]  M. Harrison,et al.  Assessing venous ulcer population characteristics and practices in a home care community. , 2003, Ostomy/wound management.

[44]  Eva Stoffels,et al.  A plasma needle generates nitric oxide , 2006 .

[45]  D. Armstrong,et al.  Standard, appropriate, and advanced care and medical-legal considerations: Part one-diabetic foot ulcerations , 2003 .

[46]  Anne Berger,et al.  Surgical site infection – a European perspective of incidence and economic burden , 2004, International wound journal.

[47]  V. Shukla,et al.  A prospective, descriptive study to identify the microbiological profile of chronic wounds in outpatients. , 2009, Ostomy/wound management.

[48]  Xi-Wei Hu,et al.  An 11 cm long atmospheric pressure cold plasma plume for applications of plasma medicine , 2008 .

[49]  N. Abramzon,et al.  Biofilm Destruction by RF High-Pressure Cold Plasma Jet , 2006, IEEE Transactions on Plasma Science.

[50]  H. Uhm,et al.  Sterilization effect of atmospheric plasma on Escherichia coli and Bacillus subtilis endospores , 2009, Letters in applied microbiology.

[51]  T. Tennenbaum,et al.  Novel Insights into Wound Healing Sequence of Events , 2007, Toxicologic pathology.

[52]  E. Stoffels,et al.  Plasma treatment of mammalian vascular cells: a quantitative description , 2005, IEEE Transactions on Plasma Science.

[53]  Bin Liu,et al.  Killing of S. mutans Bacteria Using a Plasma Needle at Atmospheric Pressure , 2006, IEEE Transactions on Plasma Science.

[54]  R. Demling.  Burns: what are the pharmacological treatment options? , 2008, Expert opinion on pharmacotherapy.

[55]  Gyoo Cheon Kim,et al.  Tooth bleaching with nonthermal atmospheric pressure plasma. , 2009, Journal of endodontics.

[56]  A. Barbul,et al.  Role of nitric oxide in wound repair. , 2002, American journal of surgery.

[57]  Christos Christodoulatos,et al.  Environmental and biological applications of microplasmas , 2005 .

[58]  Michael G. Kong,et al.  Protein destruction by atmospheric pressure glow discharges , 2007 .

[59]  R. Todhunter,et al.  In vitro analysis of nonthermal plasma as a disinfecting agent. , 2006, American journal of veterinary research.

[60]  Zhenxiang Chen,et al.  Sterilization and plasma processing of room temperature surfaces with a one atmosphere uniform glow discharge plasma (OAUGDP) , 2000 .

[61]  R. Bone,et al.  T-cell reactivity and its predictive role in immunosuppression after burns. , 1999, Critical care medicine.

[62]  B. Shenton,et al.  The influence of surgical operations on components of the human immune system , 1985, The British journal of surgery.

[63]  J. Hansbrough,et al.  Altered helper and suppressor lymphocyte populations in surgical patients. A measure of postoperative immunosuppression. , 1984, American journal of surgery.

[64]  D. Church,et al.  Burn Wound Infections , 2006, Clinical Microbiology Reviews.

[65]  M. Mommaas,et al.  Lipid and ultrastructural characterization of reconstructed skin models. , 2000, International journal of pharmaceutics.

[66]  Gregory Fridman,et al.  Applied Plasma Medicine , 2008 .

[67]  M. Cowman,et al.  Scanning Electron and Atomic Force Microscopy to Study Plasma Torch Effects on B. cereus Spores , 2006, IEEE Transactions on Plasma Science.

[68]  A. Barbul,et al.  General principles of wound healing. , 1997, The Surgical clinics of North America.

[69]  Daniel Palanker,et al.  On mechanisms of interaction in electrosurgery , 2008 .

[70]  N. Mukaida,et al.  Essential involvement of IL‐6 in the skin wound‐healing process as evidenced by delayed wound healing in IL‐6‐deficient mice , 2003, Journal of leukocyte biology.

[71]  Michel Moisan,et al.  Using the flowing afterglow of a plasma to inactivate Bacillus subtilis spores: Influence of the operating conditions , 2000 .

[72]  Benjamin A Lipsky,et al.  Clinical management of diabetic foot infection: diagnostics, therapeutics and the future , 2007, Expert review of anti-infective therapy.

[73]  L. Nardo,et al.  Laparoscopic treatment of pelvic pain associated with minimal and mild endometriosis with use of the Helica Thermal Coagulator. , 2005, Fertility and Sterility.

[74]  G. Shama,et al.  Cold atmospheric plasma disinfection of cut fruit surfaces contaminated with migrating microorganisms. , 2008, Journal of food protection.

[75]  A. Barbul,et al.  Nitric Oxide and Wound Healing , 2004, World Journal of Surgery.