Intraoperative Application of Cold Atmospheric Plasma Reduces Inguinal Wound Healing Disorders-A Pilot Study

Background: Inguinal wound healing disorders have been a relevant problem in the surgical treatment of peripheral arterial occlusive disease (PAD) for decades with reported rates of up to 30%. Despite the otherwise diverse innovations in vascular surgery, there are hardly any improvements in this area, on the contrary, comorbidities such as obesity, as relevant risk factors, continue to increase. The application of cold atmospheric plasma (CAP) has in turn shown promise in approaches for the treatment of chronic wounds, we therefore evaluated the potential reduction in inguinal wound healing disorders through the intraoperative application of CAP. Methods: We carried out a pilot study including 50 patients with a high risk for inguinal wound healing disorders that underwent a peripheral arterial reconstruction with inguinal access. Alternately, these patients were treated once intraoperatively with CAP (n = 25) or served as the control group (n = 25). The wound condition was then evaluated for the next fourteen days, with a follow up of three months. Results: The two groups showed no differences regarding risk factors such as smoking, obesity, PAD stage or surgery-related aspects like incision length or duration of surgery. No differences were found regarding wound-related readmission. However, the patients who had been treated intraoperatively with CAP showed a significant reduction in the need for surgical revisions due to inguinal wound healing disorders (8% vs. 32%, p = 0.034). Conclusions: This pilot study shows that the intraoperative use of CAP could be a promising approach to reduce major inguinal wound healing disorders.