Schachl Johanna, Königshofer Markus, Stoiber Martin, Socha Martina, Grasl Christian, Abart Theodor, Michel-Behnke Ina, Wiedemann Dominik, Riebandt Julia, Zimpfer Daniel, Schlöglhofer Thomas
Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
Artif Organs. 2025 Feb;49(2):256-265. doi: 10.1111/aor.14869. Epub 2024 Sep 20.
Cold atmospheric plasma (CAP) therapy has been recognized as effective treatment option for reducing bacterial load in chronic wounds, such as adult ventricular assist device (VAD) driveline exit-site infections. Currently, there have been no reports on the safety and efficacy of CAP therapy for pediatric cannula infections and inflammations in paracorporeal pulsatile VADs.
The mechanical strength of Berlin Heart EXCOR cannulas were tested both before and after CAP treatment (SteriPlas, Adtec Healthcare Limited, UK) to prove material safety. A ring tensile test of 20 untreated and 20 CAP-treated (5 min) EXCOR cannulas (Ø12mm), assessed the force at the breaking point of the cannulas (F), at 25% (F) and 50% (F) of the maximum displacement. Additionally, the scanning electron microscope (SEM) micrographs for both groups examined any surface changes. Finally, the case of a 13-year-old male EXCOR patient with cannula infections, treated with CAP over 100 days, is presented.
The in vitro measurements revealed no statistically significant differences in mechanical strength between the control and CAP group for F (8.18 ± 0.36 N, vs. 8.02 ± 0.43 N, p = 0.21), F (16.87 ± 1.07 N vs. 16.38 ± 1.32 N, p = 0.21), and F (44.55 ± 3.24 N vs. 42.83 ± 4.32 N, p = 0.16). No surface structure alterations were identified in the SEM micrographs. The patient's cannula exit-sites showed a visible improvement in DESTINE wound staging, reduction in bacterial load and inflammatory parameters after CAP treatment without any side effects.
Overall, CAP therapy proved to be a safe and effective for treating EXCOR cannula exit-site wound healing disorders in one pediatric patient, but further studies should investigate this therapy in more detail.
冷大气等离子体（CAP）疗法已被公认为是减少慢性伤口细菌负荷的有效治疗选择，如成人心室辅助装置（VAD）驱动线出口部位感染。目前，尚无关于CAP疗法治疗小儿体外搏动性VAD插管感染和炎症的安全性和有效性的报道。
对柏林心脏EXCOR插管在CAP治疗（SteriPlas，英国Adtec Healthcare Limited公司）前后进行机械强度测试，以证明材料安全性。对20根未处理和20根经CAP处理（5分钟）的EXCOR插管（直径12mm）进行环形拉伸试验，评估插管在断裂点的力（F）、最大位移的25%（F）和50%（F）时的力。此外，对两组的扫描电子显微镜（SEM）显微照片进行检查，以观察任何表面变化。最后，介绍了一名13岁男性EXCOR患者插管感染，接受CAP治疗100多天的病例。
体外测量显示，对照组和CAP组在F（8.18±0.36N，vs.8.02±0.43N，p = 0.21）、F（16.87±1.07N vs.16.38±1.32N，p = 0.21）和F（44.55±3.24N vs.42.83±4.32N，p = 0.16）的机械强度上无统计学显著差异。SEM显微照片未发现表面结构改变。患者的插管出口部位在CAP治疗后，在DESTINE伤口分期上有明显改善，细菌负荷和炎症参数降低，且无任何副作用。
总体而言，CAP疗法被证明对一名小儿患者治疗EXCOR插管出口部位伤口愈合障碍是安全有效的，但进一步研究应更详细地调查这种疗法。
