Plattfaut Isabell, Besser Manuela, Severing Anna-Lena, Stürmer Ewa K, Opländer Christian
Department of Virology and Microbiology, Centre for Biomedical Education and Research (ZBAF), University Witten/Herdecke, Witten, Germany.
Clinic for General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany.
Int J Antimicrob Agents. 2021 May;57(5):106319. doi: 10.1016/j.ijantimicag.2021.106319. Epub 2021 Mar 11.
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.
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.
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.
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.
伤口愈合的一个主要问题是细菌污染，这常常导致生物膜形成和伤口感染，进而需要立即进行干预，如手术清创和彻底冲洗。用冷大气压等离子体（CAP）进行局部伤口消毒治疗可能是一种替代方法，且痛苦较小。
本研究使用三维金黄色葡萄球菌免疫活性生物膜系统hpBIOM以及标准的浮游菌测试，研究了作为CAP源的冷大气压氩等离子体射流（kINPen® MED）的抗菌效果。此外，使用角质形成细胞（HaCat）模型评估了皮肤细胞相容性。
在浮游条件下，CAP处理（0 - 240秒）后在CAP处理的培养基中孵育（15、120分钟）显示出轻微的杀菌效果，但对生物膜无效。然而，在相同条件下对角质形成细胞进行间接CAP处理导致代谢活性显著降低。短时间的CAP处理和暴露时间（30秒；15分钟）导致代谢活性略有增加；然而，更长时间的处理和/或暴露时间导致代谢活性明显降低，最高可达100%。添加过氧化氢酶可部分逆转这些效应，表明CAP产生的过氧化氢起主要作用。
这些结果表明，在潮湿环境或生物膜中，等离子体处理不能达到理想的消毒效果，也不能显著降低金黄色葡萄球菌的细菌负荷。因此，不建议将CAP处理作为伤口的单一抗菌治疗方法，但可用于辅助标准治疗。
