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冷大气等离子体在慢性糖尿病足溃疡治疗中的疗效:一例报告

Efficacy of Cold Atmospheric Plasma in Chronic Diabetic Foot Ulcer Management: A Case Report.

作者信息

Nakayama Bruna, Tapia Garcia Leandro, Serena Thomas

机构信息

Wound Care Research, SerenaGroup® Monroeville, Monroeville, PA, USA.

Wound Care Research, SerenaGroup® Research Foundation, Cambridge, MA, USA.

出版信息

Am J Case Rep. 2024 Dec 14;25:e945462. doi: 10.12659/AJCR.945462.

DOI:10.12659/AJCR.945462
PMID:39673112
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11654868/
Abstract

BACKGROUND Diabetes mellitus is a significant global health issue, affecting millions and costing billions annually in management. A major complication of diabetes is foot ulcers, which heal slowly due to nerve damage (neuropathy) and poor circulation. These ulcers have a high risk of infection and, if untreated, can lead to amputation. The rise of antibiotic-resistant bacteria further complicates treatment, making traditional methods like wound cleaning, dressings, and antibiotics less effective. Cold atmospheric plasma (CAP) therapy is a noninvasive, innovative treatment showing promise in addressing these wounds. CAP generates reactive oxygen and nitrogen species that stimulate cell growth, migration, and proliferation, which are critical for wound healing. It also kills bacteria, including antibiotic-resistant strains, preventing infection and promoting tissue regeneration. Additionally, CAP encourages release of growth factors and cytokines, helping tissue repair and reducing inflammation. Unlike traditional treatments, CAP targets harmful bacteria without harming healthy tissue, making it safer and more effective for treating non-healing wounds. This case highlights a 69-year-old man with a chronic diabetic foot ulcer, previously unresponsive to standard treatments, who experienced successful healing with CAP therapy. CASE REPORT A 69-year-old man with a chronic non-healing diabetic foot ulcer on the plantar surface of his left foot underwent multiple failed treatments over 60 weeks, including traditional wound care and advanced clinical trials, before being treated with CAP, leading to significant wound closure over the course of 15 weeks. CONCLUSIONS This report has highlighted the challenges of managing chronic diabetic foot ulcers and has shown that CAP can promote wound healing.

摘要

背景

糖尿病是一个重大的全球健康问题,影响着数百万人,每年在治疗方面花费数十亿美元。糖尿病的一个主要并发症是足部溃疡,由于神经损伤(神经病变)和血液循环不良,溃疡愈合缓慢。这些溃疡感染风险高,如果不治疗,可能导致截肢。抗生素耐药菌的增加使治疗更加复杂,使伤口清洁、敷料和抗生素等传统方法效果降低。冷大气等离子体(CAP)疗法是一种无创的创新治疗方法,在治疗这些伤口方面显示出前景。CAP产生活性氧和氮物质,刺激细胞生长、迁移和增殖,这些对伤口愈合至关重要。它还能杀死细菌,包括耐药菌株,预防感染并促进组织再生。此外,CAP促进生长因子和细胞因子的释放,有助于组织修复并减轻炎症。与传统治疗方法不同,CAP靶向有害细菌而不损害健康组织,使其在治疗不愈合伤口方面更安全、更有效。本病例突出了一名69岁患有慢性糖尿病足溃疡的男性,此前对标准治疗无反应,接受CAP治疗后成功愈合。病例报告:一名69岁男性,左脚足底有慢性不愈合糖尿病足溃疡,在接受CAP治疗前的60周内经历了多次治疗失败,包括传统伤口护理和高级临床试验,在15周的疗程中伤口明显闭合。结论:本报告突出了管理慢性糖尿病足溃疡的挑战,并表明CAP可以促进伤口愈合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e38/11654868/1573a79e8c7d/amjcaserep-25-e945462-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e38/11654868/3675e4ef79cc/amjcaserep-25-e945462-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e38/11654868/8da4155936e1/amjcaserep-25-e945462-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e38/11654868/481045b9818b/amjcaserep-25-e945462-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e38/11654868/1b5789fdaeb3/amjcaserep-25-e945462-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e38/11654868/d4f42386316b/amjcaserep-25-e945462-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e38/11654868/1573a79e8c7d/amjcaserep-25-e945462-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e38/11654868/3675e4ef79cc/amjcaserep-25-e945462-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e38/11654868/8da4155936e1/amjcaserep-25-e945462-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e38/11654868/481045b9818b/amjcaserep-25-e945462-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e38/11654868/1b5789fdaeb3/amjcaserep-25-e945462-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e38/11654868/d4f42386316b/amjcaserep-25-e945462-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e38/11654868/1573a79e8c7d/amjcaserep-25-e945462-g006.jpg

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本文引用的文献

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What's the true costs of wounds faced by different healthcare systems around the world?世界各地不同医疗体系面临的伤口的真实成本是多少?
Int Wound J. 2023 Dec;20(10):3935-3938. doi: 10.1111/iwj.14491. Epub 2023 Nov 14.
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The Effectiveness of Cold Atmospheric Plasma (CAP) on Bacterial Reduction in Dental Implants: A Systematic Review.冷等离体子体(CAP)对减少种植牙细菌的效果:系统评价。
Biomolecules. 2023 Oct 16;13(10):1528. doi: 10.3390/biom13101528.
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Type 1 and Type 2 Diabetes Mellitus: Commonalities, Differences and the Importance of Exercise and Nutrition.
1 型和 2 型糖尿病:共同之处、差异以及运动和营养的重要性。
Nutrients. 2023 Oct 7;15(19):4279. doi: 10.3390/nu15194279.
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Cold Plasma Therapy in Chronic Wounds-A Multicenter, Randomized Controlled Clinical Trial (Plasma on Chronic Wounds for Epidermal Regeneration Study): Preliminary Results.慢性伤口的冷等离子体疗法——一项多中心随机对照临床试验(用于表皮再生研究的慢性伤口等离子体研究):初步结果
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The Role of Cold Atmospheric Plasma in Wound Healing Processes in Critically Ill Patients.冷大气等离子体在危重症患者伤口愈合过程中的作用
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Point-of-care fluorescence imaging reveals extent of bacterial load in diabetic foot ulcers.即时荧光成像揭示糖尿病足溃疡的细菌负荷程度。
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Dynamic Role of Oxygen in Wound Healing: A Microbial, Immunological, and Biochemical Perspective.动态氧在伤口愈合中的作用:微生物学、免疫学和生物化学视角。
Arch Razi Inst. 2022 Apr 30;77(2):513-523. doi: 10.22092/ARI.2022.357230.2003. eCollection 2022 Apr.
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The Problem of Wound Healing in Diabetes-From Molecular Pathways to the Design of an Animal Model.糖尿病创面愈合问题——从分子途径到动物模型设计。
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