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Abdo AI, Kopecki Z. Comparing Redox and Intracellular Signalling Responses to Cold Plasma in Wound Healing and Cancer. Curr Issues Mol Biol 2024; 46:4885-4923. [PMID: 38785562 PMCID: PMC11120013 DOI: 10.3390/cimb46050294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/10/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
Cold plasma (CP) is an ionised gas containing excited molecules and ions, radicals, and free electrons, and which emits electric fields and UV radiation. CP is potently antimicrobial, and can be applied safely to biological tissue, birthing the field of plasma medicine. Reactive oxygen and nitrogen species (RONS) produced by CP affect biological processes directly or indirectly via the modification of cellular lipids, proteins, DNA, and intracellular signalling pathways. CP can be applied at lower levels for oxidative eustress to activate cell proliferation, motility, migration, and antioxidant production in normal cells, mainly potentiated by the unfolded protein response, the nuclear factor-erythroid factor 2-related factor 2 (Nrf2)-activated antioxidant response element, and the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) pathway, which also activates nuclear factor-kappa B (NFκB). At higher CP exposures, inactivation, apoptosis, and autophagy of malignant cells can occur via the degradation of the PI3K/Akt and mitogen-activated protein kinase (MAPK)-dependent and -independent activation of the master tumour suppressor p53, leading to caspase-mediated cell death. These opposing responses validate a hormesis approach to plasma medicine. Clinical applications of CP are becoming increasingly realised in wound healing, while clinical effectiveness in tumours is currently coming to light. This review will outline advances in plasma medicine and compare the main redox and intracellular signalling responses to CP in wound healing and cancer.
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Affiliation(s)
- Adrian I. Abdo
- Richter Lab, Surgical Specialties, Adelaide Medical School, University of Adelaide, Adelaide, SA 5000, Australia
- Department of Surgery, The Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville, SA 5011, Australia
| | - Zlatko Kopecki
- Future Industries Institute, STEM Academic Unit, University of South Australia, Mawson Lakes, SA 5095, Australia
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Hasse S, Sommer MC, Guenther S, Schulze C, Bekeschus S, von Woedtke T. Exploring the Influence of Cold Plasma on Epidermal Melanogenesis In Situ and In Vitro. Int J Mol Sci 2024; 25:5186. [PMID: 38791225 PMCID: PMC11120903 DOI: 10.3390/ijms25105186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/30/2024] [Accepted: 05/05/2024] [Indexed: 05/26/2024] Open
Abstract
Epidermal melanin synthesis determines an individual's skin color. In humans, melanin is formed by melanocytes within the epidermis. The process of melanin synthesis strongly depends on a range of cellular factors, including the fine-tuned interplay with reactive oxygen species (ROS). In this context, a role of cold atmospheric plasma (CAP) on melanin synthesis was proposed due to its tunable ROS generation. Herein, the argon-driven plasma jet kINPen® MED was employed, and its impact on melanin synthesis was evaluated by comparison with known stimulants such as the phosphodiesterase inhibitor IBMX and UV radiation. Different available model systems were employed, and the melanin content of both cultured human melanocytes (in vitro) and full-thickness human skin biopsies (in situ) were analyzed. A histochemical method detected melanin in skin tissue. Cellular melanin was measured by NIR autofluorescence using flow cytometry, and a highly sensitive HPLC-MS method was applied, which enabled the differentiation of eu- and pheomelanin by their degradation products. The melanin content in full-thickness human skin biopsies increased after repeated CAP exposure, while there were only minor effects in cultured melanocytes compared to UV radiation and IBMX treatment. Based on these findings, CAP does not appear to be a useful option for treating skin pigmentation disorders. On the other hand, the risk of hyperpigmentation as an adverse effect of CAP application for wound healing or other dermatological diseases seems to be neglectable.
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Affiliation(s)
- Sybille Hasse
- Leibniz Institute for Plasma Science and Technology e.V. (INP), a Member of the Leibniz Health Technologies Research Alliance, Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany; (M.-C.S.); (S.B.); (T.v.W.)
| | - Marie-Christine Sommer
- Leibniz Institute for Plasma Science and Technology e.V. (INP), a Member of the Leibniz Health Technologies Research Alliance, Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany; (M.-C.S.); (S.B.); (T.v.W.)
| | - Sebastian Guenther
- Institute of Pharmacy, Department Pharmaceutical Biology, Greifswald University, Friedrich-Ludwig-Jahn-Str. 17, 17489 Greifswald, Germany; (S.G.); (C.S.)
| | - Christian Schulze
- Institute of Pharmacy, Department Pharmaceutical Biology, Greifswald University, Friedrich-Ludwig-Jahn-Str. 17, 17489 Greifswald, Germany; (S.G.); (C.S.)
| | - Sander Bekeschus
- Leibniz Institute for Plasma Science and Technology e.V. (INP), a Member of the Leibniz Health Technologies Research Alliance, Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany; (M.-C.S.); (S.B.); (T.v.W.)
| | - Thomas von Woedtke
- Leibniz Institute for Plasma Science and Technology e.V. (INP), a Member of the Leibniz Health Technologies Research Alliance, Felix-Hausdorff-Str. 2, 17489 Greifswald, Germany; (M.-C.S.); (S.B.); (T.v.W.)
- Institute for Hygiene and Environmental Medicine, Greifswald University Medical Centre, Walther-Rathenau-Str. 48, 17489 Greifswald, Germany
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Barjasteh A, Kaushik N, Choi EH, Kaushik NK. Cold Atmospheric Pressure Plasma: A Growing Paradigm in Diabetic Wound Healing-Mechanism and Clinical Significance. Int J Mol Sci 2023; 24:16657. [PMID: 38068979 PMCID: PMC10706109 DOI: 10.3390/ijms242316657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
Diabetes is one of the most significant causes of death all over the world. This illness, due to abnormal blood glucose levels, leads to impaired wound healing and, as a result, foot ulcers. These ulcers cannot heal quickly in diabetic patients and may finally result in amputation. In recent years, different research has been conducted to heal diabetic foot ulcers: one of them is using cold atmospheric pressure plasma. Nowadays, cold atmospheric pressure plasma is highly regarded in medicine because of its positive effects and lack of side effects. These conditions have caused plasma to be considered a promising technology in medicine and especially diabetic wound healing because studies show that it can heal chronic wounds that are resistant to standard treatments. The positive effects of plasma are due to different reactive species, UV radiation, and electromagnetic fields. This work reviews ongoing cold atmospheric pressure plasma improvements in diabetic wound healing. It shows that plasma can be a promising tool in treating chronic wounds, including ones resulting from diabetes.
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Affiliation(s)
- Azadeh Barjasteh
- Department of Physics, Lorestan University, Khorramabad 68151-44316, Iran;
| | - Neha Kaushik
- Department of Biotechnology, College of Engineering, The University of Suwon, Hwaseong 18323, Republic of Korea;
| | - Eun Ha Choi
- Department of Electrical and Biological Physics/Plasma, Bioscience Research Center, Kwangwoon University, Seoul 01897, Republic of Korea;
| | - Nagendra Kumar Kaushik
- Department of Electrical and Biological Physics/Plasma, Bioscience Research Center, Kwangwoon University, Seoul 01897, Republic of Korea;
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Hämmerle G, Ascher S, Gebhardt L. Positive effects of cold atmospheric plasma on pH in wounds: a pilot study. J Wound Care 2023; 32:530-536. [PMID: 37682787 DOI: 10.12968/jowc.2023.32.9.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
OBJECTIVE Cold atmospheric plasma (CAP) is a promising new option for the treatment of hard-to-heal (chronic) wounds. The aim of this study was to observe the effect of CAP on wound pH, as a correlation between the pH of a wound and its healing tendency has been established in the literature. METHOD Patients with hard-to-heal wounds were treated with CAP in addition to standard treatment. Treatment was performed with the aid of a small, mobile plasma device, which was used for one minute at a time during dressing changes. The pH value, wound size, and other parameters, such as exudate and signs of infection, were recorded for each treatment. RESULTS A total of 10 patients took part in the study. During the observation period, there was a significant reduction in pH from a markedly alkaline pH of 9.6 to a neutral pH of 7. This was accompanied by a marked reduction in wound size by an average of 76% with seven applications of CAP within 28 days. The evaluation of tissue granulation, exudate and signs of infection showed a positive trend. CONCLUSION The number of patients in the present study is not sufficient to prove the relationship between the pH value of the wound and the treatment with CAP. However, there are clear indications that the positive effects of CAP on wound healing, which are recognised in several publications, are also due to its influence on wound pH value.
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Abu Rached N, Kley S, Storck M, Meyer T, Stücker M. Cold Plasma Therapy in Chronic Wounds-A Multicenter, Randomized Controlled Clinical Trial (Plasma on Chronic Wounds for Epidermal Regeneration Study): Preliminary Results. J Clin Med 2023; 12:5121. [PMID: 37568525 PMCID: PMC10419810 DOI: 10.3390/jcm12155121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/27/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
Chronic wounds (CWs) pose a significant health challenge in clinical practice. Standard wound therapy (SWT) is currently considered the gold standard. However, recent evidence suggests that cold plasma therapy (CPT) holds promise for improving CWs. In light of this, the POWER study was conducted as a multicenter, randomized clinical trial to investigate the effect of large-area plasma application compared with SWT in patients with chronic, non-healing arterial or venous wounds on the lower leg. To analyze the interim results, we employed a comprehensive range of statistical tests, including both parametric and non-parametric methods, as well as GLS model regression and an ordinal mixed model. Our findings clearly demonstrate that CPT therapy significantly accelerates wound closure compared with SWT. In fact, complete wound closure was exclusively observed in the CPT group during the intervention period. Additionally, the CPT group required significantly less antibiotic therapy (4%) compared with the SWT group (23%). Furthermore, CPT led to a significant reduction in wound pain and improved quality of life compared with SWT. In conclusion, the study highlights that the combination of CPT and SWT surpasses monotherapy with SWT alone.
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Affiliation(s)
- Nessr Abu Rached
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany;
| | - Susanne Kley
- Scientific Institute for Health Economics and Health Research, Markt 9, 04109 Leipzig, Germany;
| | - Martin Storck
- Municipal Hospital Karlsruhe gGmbH, Moltkestraße 90, 76133 Karlsruhe, Germany;
| | - Thomas Meyer
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany;
| | - Markus Stücker
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany;
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Nitsch A, Qarqash S, Römer S, Schoon J, Ekkernkamp A, Niethard M, Reichert JC, Wassilew GI, Tzvetkov MV, Haralambiev L. Enhancing the Impact of Chemotherapy on Ewing Sarcoma Cells through Combination with Cold Physical Plasma. Int J Mol Sci 2023; 24:ijms24108669. [PMID: 37240019 DOI: 10.3390/ijms24108669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
Although Ewing's sarcoma (ES) is a rare, but very aggressive tumor disease affecting the musculoskeletal system, especially in children, it is very aggressive and difficult to treat. Although medical advances and the establishment of chemotherapy represent a turning point in the treatment of ES, resistance to chemotherapy, and its side effects, continue to be problems. New treatment methods such as the application of cold physical plasma (CPP) are considered potential supporting tools since CPP is an exogenous source of reactive oxygen and nitrogen species, which have similar mechanisms of action in the tumor cells as chemotherapy. This study aims to investigate the synergistic effects of CPP and commonly used cytostatic chemotherapeutics on ES cells. The chemotherapy drugs doxorubicin and vincristine, the most commonly used in the treatment of ES, were applied to two different ES cell lines (RD-ES and A673) and their IC20 and IC50 were determined. In addition, individual chemotherapeutics in combination with CPP were applied to the ES cells and the effects on cell growth, cell viability, and apoptosis processes were examined. A single CPP treatment resulted in the dose-dependent growth inhibition of ES cells. The combination of different cytostatics and CPP led to significant growth inhibition, a reduction in cell viability, and higher rates of apoptosis compared to cells not additionally exposed to CPP. The combination of CPP treatment and the application of cytostatic drugs to ES cells showed promising results, significantly enhancing the cytotoxic effects of chemotherapeutic agents. These preclinical in vitro data indicate that the use of CPP can enhance the efficacy of common cytostatic chemotherapeutics, and thus support the translation of CPP as an anti-tumor therapy in clinical routine.
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Affiliation(s)
- Andreas Nitsch
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Sara Qarqash
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Sarah Römer
- Department of General Pharmacology, Institute of Pharmacology, Center of Drug Absorption and Transport (C_DAT), University Medicine Greifswald, 17487 Greifswald, Germany
| | - Janosch Schoon
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Axel Ekkernkamp
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
- Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany
| | - Maya Niethard
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
- Sarcoma Centre, HELIOS-Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany
| | - Johannes C Reichert
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Georgi I Wassilew
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Mladen V Tzvetkov
- Department of General Pharmacology, Institute of Pharmacology, Center of Drug Absorption and Transport (C_DAT), University Medicine Greifswald, 17487 Greifswald, Germany
| | - Lyubomir Haralambiev
- Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
- Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany
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Gesundheitsökonomische Aspekte der Kaltplasmatherapie:
exemplarische Betrachtung der Versorgung chronischer Wunden mithilfe des
Plasmajet kINPen® MED. GESUNDHEITSÖKONOMIE & QUALITÄTSMANAGEMENT 2023. [DOI: 10.1055/a-2001-1879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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Sakulthai A, Sawangrat C, Pichpol D, Kongkapan J, Srikanchai T, Charoensook R, Sojithamporn P, Boonyawan D. Improving the efficiency of crossbred Pradu Hang Dam chicken production for meat consumption using cold plasma technology on eggs. Sci Rep 2023; 13:2836. [PMID: 36801899 PMCID: PMC9938122 DOI: 10.1038/s41598-023-29471-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 02/06/2023] [Indexed: 02/19/2023] Open
Abstract
The Pradu Hang Dam chicken, a Thai Native Chicken (TNCs) breed, plays an important role in many regions of Thailand because of its chewiness. However, there are some challenges with Thai Native Chicken, such as low production and slow growth rates. Therefore, this research investigates the efficiency of cold plasma technology in enhancing the production and growth rates of TNCs. First, this paper presents the embryonic development and hatch of fertile (HoF) values of treated fertilized eggs. Chicken performance indices, such as feed intake, average daily gain (ADG), feed conversion ratio (FCR), and serum growth hormone measurement, were calculated to assess chicken development. Furthermore, the potential of cost reduction was evaluated by calculating return over feed cost (ROFC). Finally, the quality aspects of chicken breast meat, including color, pH value, weight loss, cooking loss, shear force, and texture profile analysis, were investigated to evaluate cold plasma technology's impact on chicken meat. The results demonstrated that the production rate of male Pradu Hang Dam chickens (53.20%) was higher than females (46.80%). Moreover, cold plasma technology did not significantly affect chicken meat quality. According to the average return over feed cost calculation, the livestock industry could reduce feeding costs by approximately 17.42% in male chickens. Therefore, cold plasma technology is beneficial to the poultry industry to improve production and growth rates and reduce costs while being safe and environmentally friendly.
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Affiliation(s)
- Apichaya Sakulthai
- Department of Agro-Industry Technology Management, Panyapiwat Institute of Management, Nonthaburi, 11120 Thailand
| | - Choncharoen Sawangrat
- Department of Industrial Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai, 50200, Thailand. .,Agriculture and Bio Plasma Technology Center (ABPlas), Thai-Korean Research Collaboration Center (TKRCC), Science and Technology Park, Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Duangporn Pichpol
- grid.7132.70000 0000 9039 7662Department of Veterinary Biosciences and Veterinary Public Health, Chiang Mai University, Chiang Mai, 50200 Thailand
| | - Jutamart Kongkapan
- Department of Agro-Industry Technology Management, Panyapiwat Institute of Management, Nonthaburi, 11120 Thailand
| | - Tiranun Srikanchai
- Department of Agro-Industry Technology Management, Panyapiwat Institute of Management, Nonthaburi, 11120 Thailand
| | - Rangsun Charoensook
- grid.412029.c0000 0000 9211 2704Department of Agricultural Sciences, Faculty of Agriculture Natural Resources and Environment, Naresuan University, Phisanulok, 65000 Thailand
| | - Phanumas Sojithamporn
- grid.7132.70000 0000 9039 7662Department of Industrial Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai, 50200 Thailand ,grid.7132.70000 0000 9039 7662Agriculture and Bio Plasma Technology Center (ABPlas), Thai-Korean Research Collaboration Center (TKRCC), Science and Technology Park, Chiang Mai University, Chiang Mai, 50200 Thailand
| | - Dheerawan Boonyawan
- grid.7132.70000 0000 9039 7662Department of Physics and Materials Science, Chiang Mai University, Chiang Mai, 50200 Thailand
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Werra UEM, Dorweiler B. Kaltplasmatherapie in der Wundbehandlung – Was wissen wir? GEFÄSSCHIRURGIE 2022. [DOI: 10.1007/s00772-022-00960-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Efficacy of Cold Atmospheric Plasma Therapy on Chronic Wounds: An Updated Systematic Review and Meta-Analysis of RCTs. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:5798857. [PMID: 36262869 PMCID: PMC9576403 DOI: 10.1155/2022/5798857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/26/2022] [Indexed: 11/22/2022]
Abstract
Objective A previous meta-analysis has revealed that cold atmospheric plasma (CAP) might not be clinically beneficial to chronic wounds. However, several new randomized controlled trials (RCTs) reported that CAP was an effective treatment option for accelerating wound healing in chronic wounds. The purpose of this review is to incorporate these new results and evaluate the efficacy of CAP in chronic wounds. Methods The major databases, including PubMed, Embase, Cochrane Library, and Web of Science, were searched for articles related to CAP treatment in chronic wounds until March 21, 2022. The literature retrieval and evaluation were carried out by two independent researchers. Result A total of 13 randomized clinical trials published between 2010 and 2022 were finally included. CAP therapy showed to be more effective in reducing the area of wounds (mean difference (MD): -1.74, 95%; confidence interval (CI): [-3.14, -0.33], p = 0.02), compared with non-CAP treatments. The immediate reduction of the bacterial load was higher in the CAP group than in the control group. (MD: -0.37, 95%; CI: [-0.7, -0.05], p = 0.02). Conclusion No significant changes were found in long-term antibacterial efficacy and pain perception between the two groups. However, more RCTs of excellent methodological quality are required to confirm technical details of the source of AP and the appropriate duration of the treatment with plasma.
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