title: The repetitive use of non-thermal dielectric barrier discharge plasma boosts cutaneous microcirculatory effects.
abstract: Non-thermal atmospheric plasma has proven its benefits in sterilization, cauterization and even in cancer reduction. Furthermore, physical plasma generated by dielectric barrier discharge (DBD) promotes wound healing in vivo and angiogenesis in vitro. Moreover, cutaneous blood flow and oxygen saturation can be improved in human skin. These effects are mostly explained by reactive oxygen species (ROS), but electric fields, currents and ultraviolet radiation may also have an impact on cells in the treated area. Usually, single session application is used. The aim of this study was to evaluate the effects of the repetitive use of cold atmospheric plasma (rCAP) on cutaneous microcirculation.
  
  
  
  The repetitive use of non-thermal atmospheric plasma boosts cutaneous microcirculation effects.
  
  
  
  Microcirculatory data was assessed at a defined skin area of the radial forearm of 20 healthy volunteers (17 males, 3 females; mean age 39.1±14.8years; BMI 26.4±4.6kg/m(2)). Microcirculatory measurements were performed under standardized conditions using a combined laser Doppler and photospectrometry system. After baseline measurement, CAP was applied by a DBD plasma device for 90s and cutaneous microcirculation was assessed for 10min. Afterwards, a second session of CAP application was performed and microcirculation was measured for another 10min. Then, the third application was made and another 20min of microcirculatory parameters were assessed.
  
  
  
  Tissue oxygen saturation and postcapillary venous filling pressure significantly increased after the first application and returned to baseline values within 10min after treatment. After the second and third applications, both parameters increased significantly vs. baseline until the end of the 40-minute measuring period. Cutaneous blood flow was significantly enhanced for 1min after the first application, with no significant differences found during the remainder of the observation period. The second application improved and prolonged the effect significantly until 7min and the third application until 13min.
  
  
  
  These data indicate that the repetitive use of non-thermal atmospheric plasma boosts and prolongs cutaneous microcirculation and might therefore be a potential tool to promote wound healing.
authors.affiliation: Department of Plastic and Hand Surgery and Burn Care Unit, University Hospital of Schleswig-Holstein, Campus Lübeck, University of Lübeck, Lübeck, Germany. Electronic address: tobias.kisch@gmx.de.
authors.forename: Tobias
authors.initials: T
authors.lastname: Kisch
authors.affiliation: Department of Plastic and Hand Surgery and Burn Care Unit, University Hospital of Schleswig-Holstein, Campus Lübeck, University of Lübeck, Lübeck, Germany.
authors.forename: Sophie
authors.initials: S
authors.lastname: Schleusser
authors.affiliation: Application Center for Plasma and Photonic APP, Fraunhofer Institute for Surface Engineering and Thin Films IST, Göttingen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Helmke
authors.affiliation: Department of Plastic and Hand Surgery and Burn Care Unit, University Hospital of Schleswig-Holstein, Campus Lübeck, University of Lübeck, Lübeck, Germany.
authors.forename: Karl Ludwig
authors.initials: KL
authors.lastname: Mauss
authors.affiliation: Department of Plastic and Hand Surgery and Burn Care Unit, University Hospital of Schleswig-Holstein, Campus Lübeck, University of Lübeck, Lübeck, Germany.
authors.forename: Eike Tilman
authors.initials: ET
authors.lastname: Wenzel
authors.affiliation: Department of Plastic and Hand Surgery and Burn Care Unit, University Hospital of Schleswig-Holstein, Campus Lübeck, University of Lübeck, Lübeck, Germany.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Hasemann
authors.affiliation: Department of Plastic and Hand Surgery and Burn Care Unit, University Hospital of Schleswig-Holstein, Campus Lübeck, University of Lübeck, Lübeck, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Mailaender
authors.affiliation: Department of Plastic and Hand Surgery and Burn Care Unit, University Hospital of Schleswig-Holstein, Campus Lübeck, University of Lübeck, Lübeck, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Kraemer
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D005260:Female; D005542:Forearm; D064368:Healthy Volunteers; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation / Q000187:drug effects*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D058626:Plasma Gases / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply*; D013057:Spectrum Analysis; D013997:Time Factors; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D058626:Plasma Gases; D010100:Oxygen
keywords: Cutaneous microcirculation; Human skin; Laser Doppler; Photospectrometry; Repetitive cold atmospheric plasma; rCAP