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Cold Atmospheric Plasma As an Effective Method to Treat Diabetic Foot Ulcers: A Randomized Clinical Trial Publisher Pubmed



Mirpour S1 ; Fathollah S2 ; Mansouri P3 ; Larijani B4 ; Ghoranneviss M4 ; Mohajeri Tehrani M4 ; Amini MR5
Authors
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Authors Affiliations
  1. 1. Department of Applied physics, Eindhoven university of Technology, Eindhoven, Netherlands
  2. 2. Department of Applied physics, Amirkabir university of Technology, Tehran, Iran
  3. 3. Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: Scientific Reports Published:2020


Abstract

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. © 2020, The Author(s).