Identifying the Therapeutic Application of Cold Atmospheric Plasma in Chronic Wound Healing: A Scoping Review

Abstract

Background: Cold atmospheric plasma (CAP) is a plasma that is generated through the application of electric or electromagnetic fields to a gas operates at a low temperature and is produced under atmospheric pressure, making it suitable for medical applications. It has demonstrated beneficial effects in various medical fields, including oncology, dentistry, and dermatology. Chronic wounds are a type of wounds that are difficult to heal, which can negatively impact individual quality of life, different treatment modalities are used to treat chronic wounds. However, due to the complexity of chronic wounds new therapies are required to address these complexities. CAP therapy has shown promising results in promoting wound healing. This review aims to assess these existing data on the application of CAP therapy in chronic wound healing. Objective: Explore the mechanisms by which Cold Atmospheric Plasma (CAP) therapy promotes chronic wound healing, assess its effectiveness across various chronic wound types, and identify the optimal treatment duration to balance both efficacy and safety in chronic wound care. Methods: A scoping review was conducted of English language articles published from 2019 onward that focus on the application of cold plasma therapy in chronic wound healing. A comprehensive literature search was performed across four databases—PubMed, Embase, Google Scholar, and ClinicalTrials.gov. Both clinical and pre-clinical studies were included. Articles were assessed for inclusion, and data were extracted from those deemed relevant. A thematic analysis was then conducted to identify recurring themes within the data. Results: Following the initial broad screening of relevant articles, 36 studies were selected for detailed analysis. The thematic analysis revealed six key themes, including patient characteristics, treatment outcome, patients-reported outcome, CAP therapy protocol, mechanisms of wound healing, and correlations each theme offers an insight into the use of cold plasma therapy for chronic wound healing. The data indicates that cold plasma therapy lacks follow-up studies, a lack of standardization in the application of cold plasma therapy for chronic wound healing, and an underrepresentation of various types of chronic wounds in the research. Conclusion: This review highlights the promising potential of cold plasma therapy (CAP) for chronic wound healing while identifying critical research gaps. Future research should address these gaps to better gauge the full therapeutic potential of CAP therapy in healing chronic wounds.