Treatment of chronic venous leg ulcers with a hand-held DBD plasma generator

Abstract

In cold plasma medicine, anti-inflammatory, anti-itch, antimicrobic, ultraviolet, and other therapeutic modalities are combined within one treatment. Two types of cold plasma can be discerned: direct (dielectric barrier discharge [DBD]) and indirect plasma. DBD generates a low-temperature plasma under atmospheric pressure. The PlasmaDerm VU-2010 device is a noninvasive active medical intervention that does not come into direct contact with skin. For our medical application, a nonequilibrium, weakly ionized, physical DBD plasma is generated by the application of high voltages across small gaps; the electrode is covered by a dielectric. The skin itself acts as the second electrode. Chronic leg ulcers are a major problem among the elderly. The prevalence corresponds to 2-4% of the population. Eighty percent of chronic leg ulcers are caused by varicosis. In general, 3 phases of wound healing (cleaning of the wound ground, granulation, and epithelialization) can be discerned as disturbed in chronic venous leg ulcers. Wound debridement, modern wound dressings, and compression hosiery comprise methods of standard care. Despite these measures, leg ulcers often persist. Additional plasma treatment may have the potential to facilitate wound healing by disinfection, stimulation of tissue regeneration and microcirculation, and acidification of the wound environment. We are currently conducting an ongoing clinical trial with the PlasmaDerm VU-2010 device to assess the safety, applicability, and efficacy of plasma treatment for chronic venous leg ulcers. So far, no adverse effects of plasma treatment have been reported, pointing toward a positive outcome of our study.