HISTOLOGICAL EVIDENCE OF WOUND HEALING PROCESS IN CHRONIC WOUND TISSUE WITH MEDICAL PLASMA TREATMENT DURING PROLIFERATIVE PHASE
DOI:
https://doi.org/10.17501/3021677X.2023.1107%20Keywords:
chronic wounds, histology, proliferation phase, wound healingAbstract
Chronic wounds are defined as acute wounds that fail to heal within the expected time. The proliferative phase is one of four major phases in healing physiology that occurs on days 8 to 11, characterized by epithelial cell contraction leading to the edges merging and the wound size decreased. New treatments for chronic wounds have been developed, including medical plasma. Plasma is an ionized gas. Plasma generates RONS molecules, which can be effective in healing chronic wounds but histological view has not been reported. The aim of this study was to calculate the number of inflammatory cells, blood vessels, fibroblasts, the percentage of re-epithelialization, and the thickness of necrosis of chronic wound tissue in mice skin treated with plasma in the proliferation phase. The sample used tissue slides of mice skin with chronic wounds on the 11th day which had been treated with plasma daily. A total of 18 samples were divided into 4 groups. Control (K) chronic wound tissue without treatment, Contact Plasma (CP) chronic wound tissue with 5mm distance of plasma treatment, Contact-Noncontact Plasma (CP-NCP) chronic wound tissue with combination plasma treatment, days 0-6 distance of 5 mm and days 7-13 distance of 20 mm, Non-contact Plasma (NCP) chronic wound tissue with 20mm distance of plasma treatment. The results showed that the highest mean number of fibroblast cells, blood vessels, and percentage re-epithelialization were found in CP-NCP. The highest number of inflammatory cells was in K and the highest thickness of necrosis 70.5µm was found in CP. The final conclusion, the highest average number of fibroblast cells, blood vessels, and percentage of re-epithelialization was found in CP-NCP group indicated the CP-NCP group had the fastest healing process compared to the others. Thus, contact-non-contact plasma medical treatment has potential as a new treatment for chronic wounds.
Downloads
References
Alkawareek MY, Algwari QT, Gorman SP, Graham WG, O’Connell D, Gilmore BF. (2012). Application of atmospheric pressure nonthermal plasma for the in vitro eradication of bacterial biofilms. FEMS Immunology and Medical Microbiology. 65(2), pp. 381–384. doi: 10.1111/j.1574-695X.2012.00942.x.
Bekeschus S, Kolata J, Winterbourn C, Kramer A, Turner R, Weltmann KD. (2014). Hydrogen peroxide: A central player in physical plasma-induced oxidative stress in human blood cells. Free Radic Res. 48(5):542–9.
Bhattacharya, J., Dev, S. and Das, B. (2018). Nutrients for the Selective Growth of Specific Bacteria, Low Cost Wastewater Bioremediation Technology. Low Cost Wastewater Bioremediation Technology.
Clinton, A. and Carter, T. (2015). Chronic Wound Biofilms: Pathogenesis and Potential Therapies. Laboratory Medicine. 46(4). pp. 277–284. doi: 10.1309/lmbnswkui4jpn7so.
Darmawati S, Nasruddin N, Putri GSA, Iswara A, Kurniasiwi P, Wahyuningtyas ES, Nurani LH, Hayati DN, Ishijima T, Nakatani T, Sugama J. (2021). Accelerated healing of chronic wounds under a combinatorial therapeutic regimen based on cold atmospheric plasma jet using contact and noncontact styles. Plasma Medicine. 11(2):1–18. DOI: 10.1615/PlasmaMed.2021039083
Darmawati S, Rohmani A, Nurani LH, Prastiyanto ME, Dewi SS, Salsabila N. Wahyuningtyas ES, Murdiya F, Sikumbang IM, Rohmah RN, Fatimah YA, Widiyanto A, Ishijima T, Sugama J, Nakatani T, Nasruddin N. (2019). When plasma jet is effective for chronic wound bacteria inactivation, is it also effective for wound healing?. Clin Plasma Med. 2019;14:100085 https://doi.org/10.1016/j.cpme.2019.100085
Engkasan, J. P. (2018). Chronic Wounds, Braddoms Rehabilitation Care: A Clinical Handbook. Elsevier Inc. doi: 10.1016/B978-0-323-47904-2.00024-6.
Fridman G, Friedman G, Gutsol A, Shekhter AB, Vasilets VN, Fridman A. (2013). Applied Plasma Medicine. Plasma Process Polym. 5:503–33.
Ghavaminejad, A., Park, C. H. and Kim, C. S. (2016). In Situ Synthesis of Antimicrobial Silver Nanoparticles within Antifouling Zwitterionic Hydrogels by Catecholic Redox Chemistry for Wound Healing Application. Biomacromolecules. 17(3). pp. 1213–1223. doi: 10.1021/acs.biomac.6b00039.
Gupta A, Kumar P. (2015). Assessment of the histological state of the healing wound. Plast Aesthetic Res. 2(5):239.
Haertel B, von Woedtke T, Weltmann KD, Lindequist U. (2014). Non-thermal atmospheric-pressure plasma possible application in wound healing. Biomolecules and Therapeutics. 22(6). pp. 477–490. doi: 10.4062/biomolther.2014.105.
Huda, N., Febriyanti, E. and Laura, D. De. (2018). Edukasi Berbasis Nutrisi dan Budaya pada Penderita Luka Kronis. Jurnal Pendidikan Keperawatan Indonesia. 4(1). p. 1. doi: 10.17509/jpki.v4i1.12307.
Jamal M, Tasneem U, Hussain T, Andleeb S. (2015). Bacterial Biofilm: Its Composition, Formation and Role in Human Infections. Res Rev J Microbiol Biotechnol. 4(3):1–14.
Khristian, E., Inderiati, D., (2017). Sitohistoteknologi. Cetakan Pertama, Kementrian Kesehatan Republik Indonesia
Lloyd G, Friedman G, Jafri S, Schultz G, Fridman A, Harding K. (2010). Gas plasma: Medical uses and developments in wound care. Plasma Process Polym. 7(3–4):194–211.
McCarty, S. M., Percival, S. L. (2013). Proteases and Delayed Wound Healing. Advances in Wound Care. 2(8). pp. 438–447. doi: 10.1089/wound.2012.0370.
Nasruddin N, Nakajima Y, Mukai K, Komatsu E, Rahayu HSE, Nur M, Ishijima T, Enomoto H, Uesugi Y, Sugama J, Nakatani T. (2015). A simple technique to improve contractile effect of cold plasma jet on acute mouse wound by dropping water. Plasma Proc Polym. 12:1128–38. pp. 1128–1138. doi: 10.1002/ppap.201400236.
Nasruddin, Nakajima Y, Mukai K, Setyowati H, Rahayu E, Sugama J. (2014). Cold plasma on full-thickness cutaneous wound accelerates healing through promoting inflammation, re-epithelialization and wound contraction. Clin Plasma Med. 2(1):28–35.
Oztruk, A., Firrat, C., Parlakpinar, H., BayKarabulut, A., Krimlioglu, H., Gurlek, A. (2017). Beneficial Effects of Aminoguanidine on Skin Flap Survival in Diabetic Rats, Hindawi Publishing Corporation Experimental Diabetes Research. Volume 90, Article ID 721256
Putri, GSA., Ali A. (2022). Gambaran Histologi Fase Remodelling Jaringan Luka Kronik Kulit Mencit Setelah Pemberian Perlakuan Plasma Jet. Jlabmed. 6(1): 1-6
Serra R, Grande R, Butrico L, Rossi A, Settimio UF, Caroleo B, Amato B, Gallelli L, de Franciscis S. (2015). Chronic wound infections: the role of Pseudomonas aeruginosa and Staphylococcus aureus. Expert Rev Anti Infect Ther. 13(5):605-13. doi: 10.1586/14787210.2015.1023291.
Thana P, Wijaikhum A, Poramapijitwat P, Kuensaen C, Meerak J, Ngamjarurojana A, Boonyawan D. (2019). A compact pulse-modulation cold air plasma jet for the inactivation of chronic wound bacteria: Development and characterization. Heliyon. 5(9):e02455. doi: 10.1016/j.heliyon.2019.e02455.
Wang PH, Huang BS, Horng HC, Yeh CC, Chen YJ. (2018). Wound healing. J Chinese Med Assoc. 81(2):94–101
Youssef, K., Ullah, A., Rezai, P., Hasan, A., & Amirfazli, A. (2023). Recent advances in biosensors for real time monitoring of pH, temperature, and oxygen in chronic wounds. Materials Today Bio, 22, 100764. https://doi.org/10.1016/j.mtbio.2023.100764
Zhihao Li, S. Zhang, F. Zuber, S. Altenried, A. Jaklenec, R. Langer, Q. Ren. (2023). Topical application of Lactobacilli successfully eradicates Pseudomonas aeruginosa biofilms and promotes wound healing in chronic wounds, Microbes and Infection, https://doi.org/10.1016/j.micinf.2023.105176.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 GSA Putri, R Padanunan
This work is licensed under a Creative Commons Attribution 4.0 International License.
