Comparing two different plasma devices kINPen and Adtec SteriPlas regarding their molecular and cellular effects on wound healing

Background: Over the past years, plasma medicine has developed from an unknown and little accepted medical field into an integral part of medical research and subsequently of clinical treatment. The cellular mechanisms mediated by plasma treatment in wound healing are well investigated, and plasma sources specifically developed for treating wound healing disorders are already available. Nevertheless, the treatment results obtained with one plasma source cannot be simply transferred to another plasma device. The reason for this non-transferability is the biological effects caused by the 'cocktail' of reactive species, radiation (above all ultraviolet light), the electrical current flow from plasma to the body, the flow of working gas, and the heat transfer to the treated surface, depending on the plasma generation technology. Therefore, to avoid toxic, mutagenic, or otherwise damaging effects, the physical and biomedical performance parameters of each plasma device need to be comprehensively evaluated before the device can be used as a medicinal product. Objective: This article compared the most important molecular and cellular mechanisms investigated in vitro and in vivo in the context of wound healing. Methods: This study compared two plasma devices that are CE-certified medical devices class IIa, the kINPen (R) MED including the experimental predecessor devices kINPen09 and kINPen11 (summarized below under kINPen, plasma jet, neoplas and neoplas tools GmbH, Greifswald, Germany) and the MicroPlaSter/Adtec SteriPlas (plasma torch, Adtec Plasma Technology/Adtec Europe, Hiroshima, Japan/Hunslow, UK). Results: The kINPen and the MicroPlaSter are- both optically and technically. completely different plasma devices. The two devices are almost comparable with regard to their cellular effects such as collagen expression, induction of wound healing-relevant cytokines and growth factors, activation of immune cells and other protective mechanisms, as well as improved wound healing. The two devices differ with regard to their effect on cell proliferation and migration, probably due to different treatment times and modalities such as different mechanisms of action of the plasma devices, as well as sources of the cells. Conclusions: This comparative study showed that cold atmospheric plasma has several positive effects on wound healing and that kINPen and MicroPlaSter are two devices with substantial, comparable basic research.