Microplasma Treatment versus Negative Pressure Therapy for Promoting Wound Healing in Diabetic Mice
Pei-Lin Shao1, Jiunn-Der Liao2,3, Shun-Cheng Wu4
1Department of Nursing, Asia University, Taichung 41354, Taiwan.
Abstract:
The delayed healing response of diabetic wounds is a major challenge for treatment. Negative pressure wound therapy (NPWT) has been widely used to treat chronic wounds. However, it usually requires a long treatment time and results in directional growth of wound healing skin tissue. We investigated whether nonthermal microplasma (MP) treatment can promote the healing of skin wounds in diabetic mice. Splint excision wounds were created on diabetic mice, and various wound healing parameters were compared among MP treatment, NPWT, and control groups. Quantitative analysis of the re-epithelialization percentage by detecting Ki67 and DSG1 expression in the extending epidermal tongue (EET) of the wound area and the epidermal proliferation index (EPI) was subsequently performed. Both treatments promoted wound healing by enhancing wound closure kinetics and wound bed blood flow; this was confirmed through histological analysis and optical coherence tomography. Both treatments also increased Ki67 and DSG1 expression in the EET of the wound area and the EPI to enhance re-epithelialization. Increased Smad2/3/4 mRNA expression was observed in the epidermis layer of wounds, particularly after MP treatment. The results suggest that the Smad-dependent transforming growth factor β signaling contributes to the enhancement of re-epithelialization after MP treatment with an appropriate exposure time. Overall, a short-term MP treatment (applied for 30 s twice a day) demonstrated comparable or better efficacy to conventional NPWT (applied for 4 h once a day) in promoting wound healing in diabetic mice. Thus, MP treatment exhibits promise for treating diabetic wounds clinically.
Insights
Nonthermal microplasma (MP) treatment effectively promotes diabetic wound healing, showing comparable or superior results to negative pressure wound therapy (NPWT). This novel approach enhances re-epithelialization and wound closure kinetics in diabetic mice.
Area of Science:
- Biomedical Engineering
- Wound Healing Research
- Plasma Medicine
Background:
- Diabetic wounds exhibit delayed healing, posing a significant clinical challenge.
- Negative pressure wound therapy (NPWT) is a common treatment but requires prolonged application and can lead to directional tissue growth.
- Nonthermal microplasma (MP) is explored as a potential alternative for promoting wound repair.
Purpose of the Study:
- To investigate the efficacy of nonthermal microplasma (MP) treatment in promoting the healing of skin wounds in diabetic mice.
- To compare the effects of MP treatment with conventional NPWT and a control group on key wound healing parameters.
Main Methods:
- Splint excision wounds were created on diabetic mice.
- Wound healing parameters were assessed, including wound closure, blood flow (histology, OCT), re-epithelialization (Ki67, DSG1 expression), and epidermal proliferation index (EPI).
- Gene expression analysis focused on Smad2/3/4 mRNA in the epidermal layer.
Main Results:
- Both MP treatment and NPWT enhanced wound closure kinetics and wound bed blood flow.
- MP treatment and NPWT increased Ki67 and DSG1 expression and EPI, promoting re-epithelialization.
- MP treatment significantly increased Smad2/3/4 mRNA expression, suggesting TGF-β pathway involvement.
- Short-term MP treatment (30s twice daily) showed comparable or better efficacy than NPWT (4h once daily).
Conclusions:
- Nonthermal microplasma treatment is a promising therapeutic option for accelerating diabetic wound healing.
- MP treatment enhances re-epithelialization via Smad-dependent TGF-β signaling.
- MP offers a potentially more efficient and effective alternative to NPWT for diabetic wound management.
