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Cold Athmospheric Plasma Therapy (CAP)

New therapeutic principle for wound healing disorders and skin diseases

Cold Atmospheric Plasma: A promising therapeutic option in proctology?

A plasma is a state of matter that differs from solid, liquid and gaseous states. It is an ionized gas. Cold Atmospheric Plasma (CAP) is generated by passing a gas such as air, nitrogen or argon through an electric field. Unlike other plasma techniques, such as endoscopic hemostasis or ablation of abnormal tissue, CAP generation does not require a high temperature. This means that the plasma is not hot and therefore does not cause thermal damage to materials.

CAP is typically generated in a plasma generator consisting of a high-voltage electrode and a counter-electrode between which the gas is located. Since the CAP is generated at atmospheric pressure, it is also referred to as "atmospheric pressure plasma." The plasma generated consists of various particles, such as free electrons, ions, atoms, molecules, and radicals. These particles have different effects on materials and biological systems, leading to the diverse applications of CAP. In engineering, CAP has long been used for surface modification of plastics, metals and textiles, sterilization in the food and pharmaceutical industries, air purification and semiconductor manufacturing. 

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CAP is typically generated in a plasma generator consisting of a high-voltage electrode and a counter-electrode between which the gas is located. Since the CAP is generated at atmospheric pressure, it is also referred to as "atmospheric pressure plasma." The plasma generated consists of various particles, such as free electrons, ions, atoms, molecules, and radicals. These particles have different effects on materials and biological systems, leading to the diverse applications of CAP. In engineering, CAP has long been used for surface modification of plastics, metals and textiles, sterilization in the food and pharmaceutical industries, air purification and semiconductor manufacturing. 

Plasma applications in medicine

The use of Cold Atmospheric Plasma (CAP) in medicine has increased dramatically in recent years and several applications with proven efficacy have already been developed. Here are some examples:

  1. Wound Healing: CAP can be used to heal wounds faster by killing bacteria, promoting the formation of growth factors FGF-2 and VEGF-A, and promoting blood flow.

  2. Cancer therapy: CAP has shown that it can kill certain cancer cells without harming healthy cells.

  3. Skin diseases: CAP can be used to treat skin conditions such as psoriasis, atopic dermatitis and acne by reducing inflammation and inhibiting the growth of bacteria.

  4. Dentistry: CAP can be used to treat gingivitis and kill bacteria in the oral cavity.

  5. Sterilization: CAP can be used to sterilize medical instruments and surfaces by killing bacteria and viruses.

However, these applications are only a sampling of the potential uses of CAP in medicine, and there are many more potential uses currently being explored.

In proctology, the use of Cold Atmospheric Plasma (CAP) is expected to accelerate wound healing after surgery for hemorrhoids, fistulas and fissures, and sinus pilonidalis. It can also be used for conservative treatment of anal fissures without surgery. The efficacy with juvenile warts, herpes viruses and skin tumors gives hope that condylomata accuminata, which are very difficult to treat with conventional methods, can also be treated with CAP.

The great advantage of this therapy option is that it can be performed painlessly and without known side effects. It is therefore already explicitly recommended in the guideline Problem Wounds.

We would be pleased to inform you in a personal conversation whether Cold Atmospheric Plasma (CAP) is applicable and promising in your case.

Cold Atmospheric Plasma (CAP) Literature

Breuer, R. (2015): Cold plasma - A wonder substance? Bild der Wissenschaft,www.wissenschaft.de

German Society for Oral and Maxillofacial Surgery (DGMKG) S2k Guideline: Rational therapeutic use of cold physical plasma Version 1.0 of February 23, 2022

Hiller J. et al: Enhanced growth factor expression in chronic diabetic wounds treated by cold atmospheric plasma. Diabet Med. 2022 Jun;39(6):e14787. doi: 10.1111/dme.14787.

Kramer, A., Conway, B., Meissner, K., Scholz, F., Rauch, B., Moroder, A., Ehlers, A., Meixner, A., Heidecke, C., Partecke, L., Kietzmann, M., & Assadian, O. (2017). Cold atmospheric pressure plasma for treatment of chronic wounds: drug or medical device? Journal of Wound Care, 26(8), 470-475.

Stratmann, B., Costea, T., Nolte, C., Hiller, J., Schmidt, J., Reindel, J., Masur, K., Motz, W., Timm, J., Kerner, W., & Tschoepe, D. (2020). Effect of Cold Atmospheric Plasma Therapy vs Standard Therapy Placebo on Wound Healing in Patients With Diabetic Foot Ulcers. JAMA Network Open, 3(7),

Strohal, R., Dietrich, S., Mittlböck, M., & Hämmerle, G. (2022). Chronic wounds treated with cold atmospheric plasmajet versus best practice wound dressings: a multicenter, randomized, non-inferiority trial. Scientific Reports, 12(1).