Christin Ulrich1, Franziska Kluschke1, Dr. Alexa Patzelt1, Dr. Staffan Vandersee1, Dr. Viktor A. Czaika1, Heike Richter1,
Dr. Adrienne Bob1, Dr. Johanna von Hutten1, Prof. Axel Kramer2,
Prof. Jürgen Lademann1, Dr. Bernhard Lange-Asschenfeldt1
Treatment of Purulent Wounds Immobilized Antisepticsinventionjournals
An experimental study of the wound healing abilities of immobilized forms of m and x lorgeksidinairamistinabigluconate on various bases in the treatment of purulent wounds. Results of the study showed the benefits of using a combination of m with m etronidazolomiramistinaized and immobilized on sodium carboxymethylcellulose and the preparation of chlorhexidine digluconate with m etiluratsilom immobilized on polymethylsiloxanepolyhydrates compared with ointment "Aevomekol."
Non Tuberculous Mycobacterium as a Causative Factor in Port Site Wound Infect...Crimsonpublisherssmoaj
Over the two decades there has been an increase in Non Tuberculous Mycobacterium (NTM) organisms in post laparoscopic port site skin and soft tissue infections. Presenting a patient who underwent eight successive surgical explorations of multiple skin and soft tissue sinuses and for aggressive necrosectomy and debridement of multiple sinuses caused by NTM organisms which ended up in abdominoplasty and meshplasty 2 months after the infection had been completely controlled. She finally had complete relief from the infection and had 6 months follow up from the last meshplasty surgery. The presentation and treatment of NTM skin and soft tissue infection are briefly outlined.
Rapid identification of dermatophyte species by 28S rDNA Polymerase Chain Rea...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Treatment of Purulent Wounds Immobilized Antisepticsinventionjournals
An experimental study of the wound healing abilities of immobilized forms of m and x lorgeksidinairamistinabigluconate on various bases in the treatment of purulent wounds. Results of the study showed the benefits of using a combination of m with m etronidazolomiramistinaized and immobilized on sodium carboxymethylcellulose and the preparation of chlorhexidine digluconate with m etiluratsilom immobilized on polymethylsiloxanepolyhydrates compared with ointment "Aevomekol."
Non Tuberculous Mycobacterium as a Causative Factor in Port Site Wound Infect...Crimsonpublisherssmoaj
Over the two decades there has been an increase in Non Tuberculous Mycobacterium (NTM) organisms in post laparoscopic port site skin and soft tissue infections. Presenting a patient who underwent eight successive surgical explorations of multiple skin and soft tissue sinuses and for aggressive necrosectomy and debridement of multiple sinuses caused by NTM organisms which ended up in abdominoplasty and meshplasty 2 months after the infection had been completely controlled. She finally had complete relief from the infection and had 6 months follow up from the last meshplasty surgery. The presentation and treatment of NTM skin and soft tissue infection are briefly outlined.
Rapid identification of dermatophyte species by 28S rDNA Polymerase Chain Rea...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
EWMA 2013 - Ep500 - The Role of the Pharmacist as a Member of a Multidiscipli...EWMA
Aisling English (Final Year Pharmacy Undergraduate Student) 2 Dr Zena Moore (Supervisor)
1 School of Pharmacy, 2Faculty of Nursing & Midwifery , 1,2Royal College of Surgeons in Ireland, Dublin 2, Ireland
A. Bugalska-Żak
B. Bladowska
B. Wieczorek-Wójcik
M. Dykas
Ceynowa Hospital in Wejherowo, Poland
The Nursing Team for the Prevention and Treatment of Pressure Sores and Stomy Care
EWMA 2013 - Ep531 - Treatment of pressure ulcer in childhoodEWMA
Judit Vasas1, Angéla Meszes MD1, Gyula Tálosi MD2, Katalin Rácz MD2,
Lajos KeményMD1, Zsanett Csoma MD1
1Department of Dermatology and Allergology, University of Szeged, Hungary 2Department of Paediatrics, University of Szeged, Hungary
EWMA 2013 - Ep472 -USE OF A NEW HYDRO-DESLOUGHING DRESSING* IN EXUDING AND SL...EWMA
N. SMITH(1), C. BOUVIER(2)
(1) Laboratoires Urgo, Clinical Market Researcher, Sullington Road, Shepshed, Leicestershire, UK
(2) Laboratoires Urgo, Chenôve, France
EWMA 2013-Ep441-IN VITRO EVALUATION OF THE DEBRIDEMENT PERFORMANCE OF A NEW D...EWMA
C. Wiegand1, K. Reddersen1, M. Abel2, P. Ruth2, U.-Ch. Hipler1
1Department of Dermatology, University Medical Center Jena, Jena, Germany
2Lohmann & Rauscher GmbH & Co. KG, Rengsdorf, Germany
EWMA 2013 - Ep514 - INTERFACE PRESSURE AND STATIC STIFFNESS INDEX OF FOUR COM...EWMA
1A Andriessen PhD, 2IKY Wong, PhD, 3M Abel PhD
1Andriessen Consultants & UMC St. Radboud, The Netherlands. anneke.a@tiscali.nl
2Head of School, School of Nursing, Hong Kong Sanatorium & Hospital, HK
3Head of Medical & Regulatory Affairs, Lohman & Rauscher, Germany
EWMA 2013 - Ep518 - A NOVEL EGF-CONTAINING WOUND DRESSING FOR THE TREATMENT O...EWMAConference
Doerler Martin1), Eming Sabine2), Dissemond Joachim3), Stücker Markus1)
1) Department of Dermatology, Venereology and Allergology. Vein Centre of the Departments of Dermatology and Vascular Surgery, Ruhr-University Bochum, Bochum, GERMANY
2) Department of Dermatology, Venereology and Allergology, University of Cologne, Cologne, GERMANY
3) Department of Dermatology, Venereology and Allergology, University of Essen, Essen, GERMANY
EWMA 2013 - Ep500 - The Role of the Pharmacist as a Member of a Multidiscipli...EWMA
Aisling English (Final Year Pharmacy Undergraduate Student) 2 Dr Zena Moore (Supervisor)
1 School of Pharmacy, 2Faculty of Nursing & Midwifery , 1,2Royal College of Surgeons in Ireland, Dublin 2, Ireland
A. Bugalska-Żak
B. Bladowska
B. Wieczorek-Wójcik
M. Dykas
Ceynowa Hospital in Wejherowo, Poland
The Nursing Team for the Prevention and Treatment of Pressure Sores and Stomy Care
EWMA 2013 - Ep531 - Treatment of pressure ulcer in childhoodEWMA
Judit Vasas1, Angéla Meszes MD1, Gyula Tálosi MD2, Katalin Rácz MD2,
Lajos KeményMD1, Zsanett Csoma MD1
1Department of Dermatology and Allergology, University of Szeged, Hungary 2Department of Paediatrics, University of Szeged, Hungary
EWMA 2013 - Ep472 -USE OF A NEW HYDRO-DESLOUGHING DRESSING* IN EXUDING AND SL...EWMA
N. SMITH(1), C. BOUVIER(2)
(1) Laboratoires Urgo, Clinical Market Researcher, Sullington Road, Shepshed, Leicestershire, UK
(2) Laboratoires Urgo, Chenôve, France
EWMA 2013-Ep441-IN VITRO EVALUATION OF THE DEBRIDEMENT PERFORMANCE OF A NEW D...EWMA
C. Wiegand1, K. Reddersen1, M. Abel2, P. Ruth2, U.-Ch. Hipler1
1Department of Dermatology, University Medical Center Jena, Jena, Germany
2Lohmann & Rauscher GmbH & Co. KG, Rengsdorf, Germany
EWMA 2013 - Ep514 - INTERFACE PRESSURE AND STATIC STIFFNESS INDEX OF FOUR COM...EWMA
1A Andriessen PhD, 2IKY Wong, PhD, 3M Abel PhD
1Andriessen Consultants & UMC St. Radboud, The Netherlands. anneke.a@tiscali.nl
2Head of School, School of Nursing, Hong Kong Sanatorium & Hospital, HK
3Head of Medical & Regulatory Affairs, Lohman & Rauscher, Germany
EWMA 2013 - Ep518 - A NOVEL EGF-CONTAINING WOUND DRESSING FOR THE TREATMENT O...EWMAConference
Doerler Martin1), Eming Sabine2), Dissemond Joachim3), Stücker Markus1)
1) Department of Dermatology, Venereology and Allergology. Vein Centre of the Departments of Dermatology and Vascular Surgery, Ruhr-University Bochum, Bochum, GERMANY
2) Department of Dermatology, Venereology and Allergology, University of Cologne, Cologne, GERMANY
3) Department of Dermatology, Venereology and Allergology, University of Essen, Essen, GERMANY
Content Cytotoxicity Studies of Colorectal Carcinoma Cells Using Printed Impe...journalBEEI
Monitoring the effectiveness of drugs on cancer cells is crucial for chemotherapeutics studies. In-vitro cell-based biosensors can be used as an alternative for characteristic studies of cells’ response to drugs. Cell-based sensors provide real-time measurements and require smaller sample volumes compared to conventional T-flask measurement methods. This paper presents a biosensor that detects in real-time, impedance variations of human colon cancer, HCT-116 cells when treated with anti-cancer agent, 5-Fluorouracil (5-FU). Two different extracellular matrix (ECM); polyaniline and gelatin were tested and evaluated in terms of attachment quality. Polyaniline was found to provide the best attachment for HCT-116 cells and was used for cytotoxicity studies. Cytokinetic behavior indicated that 5-FU inhibited HCT-116 cells at IC50 of 6.8 µg/mL. Trypan blue exclusion method for testing cell viability was used to validate the impedance measurements, where the cancer cell concentrations were reduced to ~35% when treated with 2.5 µg/mL, and 50% when treated with 6.8 µg/mL. The results generated by the microfabricated impedance biosensor are comparable to the Trypan blue method since both gave similar cell growth trend. It can be concluded that the impedance biosensor has potential to be used as an alternative method in drug testing applications.
High Intensity of Continuous Ultrasound in the Skin Repair Process in Rats: R...inventionjournals
Healing is a complex process involving different steps. Any change in one of them interferes with the normal repair process causing functional, morphological and aesthetic problems in the scar. Therapeutic ultrasound is a widely used and studied resource for cutaneous repair. However, divergences and parameters cause further scientific investigations. The experimental research sought to verify the effects of the high intensity of the therapeutic ultrasound in the cutaneous healing process of rats in the different stages 3, 7 and 21 days. Methodology: 60 animals, male rats, young adults, were irradiated in one SHAM group and another group with 3MHz continuous and intensity 2.0W / cm² for 5 minutes, 24 h after surgery. Results: The high intensity of the TUS in the continuous mode promoted burns, necrosis and poor healing in the irradiated areas. Conclusion: The high intensity of continuous TUS irradiated for 5 minutes was not therapeutic in skin repair of rats
Extracorporeal shockwave therapy (ESWT) has analgesic and anti-inflammatory effects. With the evolu- tion and comprehension of its biological and physical mechanisms, the application of ESWT on other pathologies has also been studied, especially in musculoskeletal diseases. Recently, studies on animal models have shown its angiogenic capacity and a higher rate of local re-epithelization. These small stud- ies led to few trials using low-energy, radial ESWT to treat problematic chronic skin ulcers. Skin ulcers have diverse etiologies, ranging from pressure ulcers, burns, venous or arterial ulcers, and even diabetic ulcers. Their treatment is usually a challenge, due to the long-term treatment and high costs.
ABSTRACT- Two hundred fifty samples were collected from Khartoum teaching hospital (KTH) by swabs from units'
surfaces including walls, seats, tables, floor, medical devices, doors and windows. Air samples were also investigated by
using settle plate method. The samples were cultured on blood agar for primary isolation. Identification of MRSA was
carried out according to standard method. Resistance to methicillin and vancomycin was done for each isolate. The disc
diffusion method and In-Use test were used to evaluate the effectiveness of the four disinfectants (Clorox (sodium
hypochlorite) + Water, Phenol + liquid soap + Chloroxylenol "Dettol", Formalin + Water, and Dettol (Chloroxylenol
solution) + Liquid soap + Water) against MRSA. Data were analyzed by the statistical analysis program Statistical Package
for the Social Science (SPSS) using One-Way Analysis of Variance (ANOVA) and Least Significant Difference
(L.S.D) test.
The results revealed that the prevalence of MRSA was 66 (25%). Among these 11(16%) were vancomycin resistant.
Moreover, the study on the role of disinfectants in controlling infection showed that two of these disinfectants (Formalin +
Water, Dettol (Chloroxylenol solution) + Liquid soap + Water) were significantly effective on MRSA (P<0.05),>0.05) on the same organisms.
It is concluded that the prevalence of MRSA in KTH was high and the rate of Vancomycin resistant S. aureus (VRSA) is
increasing. The disinfectants used routinely in KTH were not equal in their efficiency and there was failure in the actions
of two of them.
Key words: MRSA, Hospital, Disinfectants, Infection Control, Sudan.
EWMA 2013 - Ep564 - DEVELOPING A TIME CONCEPT TREATMENT IN A POST-TRAUMATIC W...EWMAConference
L. BALTÀ DOMÍNGUEZ, M. BERENGUER PÉREZ, F-J. CORPAS ALCALÁ and C. SANTIAGO FERNÁNDEZ(1)
P. WILKEN(2)
(1) SAP Muntanya. Institut Català de la Salut, Barcelona, Spain
(2) URGO GmbH, Sulzbach, Germany
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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Protonitazene (hydrochloride) CAS: 119276-01-6
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
EWMA - Ep447 - Effects of tissue-tolerable plasma on chronic wound treatment compared to a modern conventional liquid antiseptic
1. Effects of tissue-tolerable plasma on chronic
wound treatment compared to a modern
conventional liquid antiseptic
1 Charité – Universitätsmedizin Berlin, Department of Dermatology, Allergology and Venerology
(Berlin, GERMANY)
2 University of Greifswald, University Medicine, Institute of Hygiene and Environmental Medicine
(Greifswald, GERMANY)
Department of Dermatology Charité
University Medicine Berlin
Christin Ulrich1, Franziska Kluschke1, Dr. Alexa Patzelt1, Dr. Staffan Vandersee1, Dr. Viktor A. Czaika1, Heike Richter1,
Dr. Adrienne Bob1, Dr. Johanna von Hutten1, Prof. Axel Kramer2,
Prof. Jürgen Lademann1, Dr. Bernhard Lange-Asschenfeldt1
2. Abstract
Aim: Recently, it was reported that tissue-tolerable plasma (TTP) is highly efficient in the reduction of the
bacterial load of the skin surface. These studies were until now mostly performed in vitro using either cell
culture assays or experimental assays with tissue harvested from animals in vitro and on intact human skin
as well. We aimed to compare the effects on bacterial colonization of the wounds and the rate of wound
healing in patients of our department.
Methods: Sixteen patients suffering from chronic leg ulcers were treated with either tissue-tolerable plasma
or octenidine dihydrochloride as a control 3 times a week over a time period of 2 weeks. The effects on
bacterial colonization of the wounds and the rate of wound healing were investigated by assessing the
wound´s bacterial load as well as the change of the wound´s surface-area and depth.
Results: It could be shown, that wounds treated with either TTP or octenidine dihydrochloride showed
comparable healing rates and similar reduction of microbes, underlining its low cytotoxicity as suggested by
previous in vivo studies.
Conclusions: Our study could demonstrate, that TTP is a new and innovative antiseptic approach for the
treatment of chronic leg ulcers with an antiseptic efficiency compared to one of the most efficient and
biocompatible liquid antiseptic.
3. Background
In the age of multi-resistant microbes and the increasing lack of efficient antibiotics, chemical antisepsis plays
a major role in the prevention of infections. It is thus a crucial part of modern wound management. The ideal
antiseptic substance would hereby efficiently eliminate microbes without impairing the process of tissue repair.
In order to promote the healing process of acute and chronic wounds, the wound bed needs to be prepared
according to modern rules after thorough wound assessment. Modern wound bed preparation translates into
treatment algorithms entailing cleansing, debridement, antisepsis, elimination of wound healing inhibiting
factors as well as stimulation of healing factors and the concept of moist wound healing [1]. The efficacy and
safety of chemical antiseptics contributing to tissue repair has, in this respect, been proven in numerous
studies [2, 3]
Physical antiseptic treatments may present an interesting alternative to chemical antiseptics, since they exert
their antimicrobial effects independently of chemical and biological mechanisms responsible for the resistance
in microbes.
Tissue tolerable plasma (TTP) represents a novel therapeutic method with promising capabilities in the field of
dermatological interventions, in particular disinfection but also wound antisepsis and regeneration. The energy-
transfer by plasma into living tissue is not easily educible, as a variety of features such as the medium´s actual
molecule-stream, the ions, electrons and free radicals involved, as well as the emission of ultraviolet, visible
and infrared light contribute to its increasingly well characterized effects[4].
Our goal was to investigate whether TTP can be safely used for wound antisepsis.
4. Background – what is plasma?
In order to treat living tissue, thermal damage needs to be avoided. Low temperature
plasma (tissue-tolerable plasma) is now available to minimize potential damage to the
skin. The Plasma Jet Pen ( plasma jet kinpen 09), developed by the Leibniz Institute
for Plasma Science and Technology, Greifswald, Germany, in cooperation with
Neoplas GmbH, Greifswald, Germany, is generating a low-temperature plasma. A
detailed description of the plasma jet is given by Hubner et al. [5]. The plasma jet
consists of a base station including the power supply and the control unit, together with
a handpiece containing the gas flow and the electrical discharge system. The
discharge system was operated with argon, applied in the pulsed mode, with the
pulses being generated at a frequency of 1.82 MHz. The plasma stream had a length
of approximately 10 mm. The plasma-tissue interaction zone was approximately 1 mm
in diameter. The plasma stream had a length of approximately 10 mm; the plasma-
tissue interaction zone was approximately 1 mm in diameter.
Plasma is partially ionized gas
(4th state of aggregation)
solid liquid gas plasma
There are plenty of mainly hot plasma sources
surrounding us!
Source of figures: Leibniz-Institut für Plasmaforschung und Technologie e.V., Greifswald, Germany
5. Methods
Patient groups
Patients suffering from chronic leg ulcers were recruited from the Department of Dermatology, Venereology and Allergology,
Charité Universitätsmedizin, Berlin, Germany. None of the patients showed clinical signs of wound infections and patients
undergoing antibiotic treatment were excluded from the study. Patients included in the study (n= 16; 6 male and 10 female
patients) suffered from chronic leg ulcers (n= 11; Widmer stage III), ulcus cruris arteriosum (n=1), ulcus cruris mixtum (n= 4).
Median ulcer persistence was 12 months (minimal duration 4 weeks and longest 15 years). Median age was 75 years (33 to
90). Wound extent ranged from 1 to 36 cm2 and 4 mm in depth. The wounds were graded by the extent of exudation (none,
mild and moderate). Wound dressings were chosen according to the extent of exudation. The study was approved by the
Ethical Committee of Charité, Universitätsmedizin, Berlin, Germany, before start of the experiments (EA1/010/10).
Treatment Arms
Patients were assigned to either treatment arm A (tissue tolerable plasma, TTP) or arm B (antiseptic). The plasma treatment
of the wounds was thoroughly performed in order to avoid islands of untreated wound areas because of the small beam exiting
the plasma pen (1.5mm diameter). For this reason mainly smaller ulcers were assigned to the study group A. Roughly 1 cm2 of
wound surface was treated for 1 min, including a 1 cm wide margin of the skin adjacent to the wound edge.
Patients included in arm B were treated with an antiseptic containing 0.1% octenidine dihydrochloride (ODC) and 2% 2-
phenoxyethanol as active ingredients (Octenisept®, Schuelke & Mayr GmbH, Norderstedt, Germany). ODC was applied in the
same manner as in the operating room for antiseptic treatment of the skin, an amount of 0.2 ml/cm2 proved sufficient to ensure
complete coverage of the wound surface. After 2 min, when the solution had completely evaporated and (like in arm A after
treatment) the bacterial colonization of the treated wound surface was investigated. Patients of both study groups were
treated 3 times a week over a time period of 2 weeks.
Wound assessment
Assessment of the wound surface and volume
The wound surface was traced on a transparency (day 1) before the start of the experiments and at the end (day 14) and the
depths of the wound were measured using the following formula:2/3π x lenght/2 x width/2 x depth
Assessment of the bacterial load
After initial debridement, nitrocellulose filters (diameter: 50 mm, pore size 0.45 µm) were gently pressed onto the wound bed
and after 30 seconds subjected to further incubation and analysis. After each treatment the procedure was repeated. Filters
were then placed on Columbia blood agar plates for 30 seconds, which afterwards were incubated for 18 h at 37 ºC. After 18 h
the colony-forming units (CFU)/cm2 were assessed. CFUs were subjected to further microbiological analysis in order to
identify the exact species of bacteria. Staphylococcus (S.) aureus and Pseudomonas (P.) aeruginosa were cultured on CASO-
agar plates and identified using the 3%-hydrogenperoxide-test, and commercial test kits. These bacterial nitrocellulose-swabs
were taken at each day of examination from day 1 to the end of the study on day 14. Between the days of antiseptic treatment,
the wound dressings were changed using the none-touch technique in order to avoid contamination.
6. Results
Antiseptic efficacy
The total colony forming units/cm2 (cfu/cm2) after the incubation
of the bacteria on the surface of the agar plates were counted
prior to the antiseptic treatment with either TTP or octenidine.
Wounds of the TTP-treated study group were more colonized
(117.6 cfu/cm2) compared to the octenidine-treated group (43.7
cfu/cm2) before the antiseptic treatment (Fig. a). In order to
evaluate the acute antiseptic properties of TTP and octenidine
the bacterial colonization at the first two visits before and after
each antiseptic treatment was determined and the median
calculated. Both antiseptic treatment options lead to a significant
reduction of the total bacterial count within their study group (Fig.
a). Fig. b shows the total reduction of the bacterial count after the
treatment with either TTP or octenidine. In the TTP-treated
wounds a slight but significantly higher total reduction of the
bacteria (-48.1 cfu/cm2) was observed compared to the
octenidine-treated wounds (-17.1 cfu/cm2). However, the relative
microbial reduction compared to the initial colonization was
slightly less in the TTP-treated group (47%) compared to the
octenidine-treated group (64%) (Fig. c).
7. Results Changes of the bacterial colonization before and after the antiseptic treatment
The overall bacterial counts over the study period of 14 days were not significantly changing in
both study groups compared to the initial colonization (Fig. a). The bacterial counts in the
octenidine group were slighltly but not significantly increasing from 43.7 cfu/cm2 at visit 1 to 51.3
cfu/cm2 at visit 6 while the bacterial count in the TTP-treated group was slightly increasing from
98.0 cfu/cm2 at visit 1 to 127.8 cfu/cm2 at visit 6 (Fig. b). This translates to a total decrease of -
14.9 cfu/cm2 in the octenidine-treated group and an increase of 14.83 cfu/cm2 in the TTP-
treated group over the study period of 14 days (Fig. b). In relation to the original bacterial count
35% decrease within the octenidine-treated group and an increase of 12% in the TTP-treated
group was observed (Fig. c).
General composition of bacterial wound colonization
Within both treatment arms, the two largest groups of bacteria colonizing the wounds were
identified as S. aureus (41.2%) and P. aeruginosa (17.6%). 60% of the TTP-treated wounds
compared to 40% of the OCD-treated wounds were colonized by S. aureus. While no P.
aeruginosa colonization was found within the TTP-treated wounds, 30% of the octenidine-
treated wounds were colonized.
Relation of exudation and bacterial colonization
The average of all wounds included in the study were graded mild exudating (mean: 1.2) with a
comparable degree in both groups. Exudation in the TTP-treated wounds was reduced by 30%
and remained unchanged in the other group.
Moderate exudating wounds were slightly more colonized (2.2 cfu/cm2) than mild or non-
exudating wounds (1.85 cfu/cm2). Moreover, moderate exudating wounds were more commonly
colonized by S. aureus and P. aeruginosa (80%) than with mild exudating wounds or wounds
with no signs of exudation (50%).
Relation of wound depths/sizes and bacterial colonization
Deeper wounds (3-4 mm depth) compared to more superficial wounds (0-3 mm) showed a
more diverse bacterial colonization spectrum (1.69 different colonies in superficial wounds
compared to 2.29 different colonies in deep wounds). The depths of the TTP-treated and
octenidine-treated wounds (0.21 and 0.20 respectively) were similar in our experiments.
However, the diversity of colonization was also related to the original wound area. Wounds
sized < 8.6 cm2 showed an average of 1.67 different bacterial species compared to wounds >
8.6 cm2 showing an average of 2.6 different bacteria species.
Since the wounds in the octenidine-treated group (13.1 cm2) were bigger than the TTP-treated
group (7.1 cm2) more different bacteria species were found in the octenidine-treated wounds
(2.6) compared to the TTP-treated group (1.67).
8. Results
Changes of the wound volumes under
antiseptic treatment
The initial wound volume in the TTP-
treated group dropped from 0.69 cm3 to
0.30 cm3 (median) while the wound
volume of the octenidine-treated group
dropped from 2.7 cm3 to 1.6 cm3
(median) (Fig. a). The initial volume of
the TTP-treated wounds was
significantly smaller than in the
octenidine-treated group at the
beginning of the study as already
pointed out in the method section (Fig.
3a). The wound area volume was
decreasing over the study period of 2
weeks by 0.39 cm3 (median) in the
TTP-treated group and by 0.89 cm3
(median) in the octenidine-treated
group (Fig. b). These measurements
translate to a relative wound volume
change of 56 % (median) in the TTP-
treated and 19% (median) in the
octenidine-treated group (Fig. c).
9. Conclusion
TTP-Treatment shows similar capacities in terms of wound disinfection to established
chemical antiseptic formulations. It is well tolerated when used on chronic wounds.
It does not impair wound regeneration, although in this study we observed a bias
untowards smaller wounds in the TTP-treated arm, which must be considered to heal
faster.
TTP-treatment and octenidine-treatment of chronic wounds lead to a significant reduction
of the bacterial load. Due to the low cytotoxicity TTP-treatment might present an
alternative treatment option for antisepsis. Extended investigations on a larger study
population are needed in order to identify the wound conditions that benefit most of this
innovative treatment. Especially the role of TTP in the elimination of multiresistant
bacteria will have to be studied in vivo.
10. References
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