Cold Atmospheric Plasma Therapy for Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis of Randomised...

Area of Science:

• Wound Healing
• Regenerative Medicine
• Plasma Medicine

Background:

• Diabetic foot ulcers (DFUs) are a severe complication of diabetes, often leading to amputation and increased mortality.
• Cold atmospheric plasma (CAP) is an emerging therapy with potential antimicrobial and tissue regeneration properties.

Purpose of the Study:

• To systematically review and meta-analyze randomized controlled trials (RCTs) on the efficacy and safety of adjunctive cold atmospheric plasma (CAP) therapy for diabetic foot ulcers (DFUs).

Main Methods:

• A systematic review and meta-analysis of RCTs comparing CAP plus standard care versus standard care alone for DFUs.
• Included studies focused on adult patients with DFUs, adhering to PRISMA 2020 guidelines.
• Primary outcome was final fractional wound area; secondary outcomes included ≥50% wound-size reduction, bacterial load, and adverse events.

Main Results:

• Adjunctive CAP significantly reduced the final fractional wound area (MD -0.29, p=0.002) and increased the proportion of ulcers achieving ≥50% reduction by week 3 (RR 2.39, p<0.001).
• Bacterial load decreased in both groups, with no sustained significant difference between CAP and standard care.
• No serious treatment-related adverse events were reported during the study period.

Conclusions:

• Adjunctive cold atmospheric plasma therapy demonstrates potential for improving early healing outcomes in diabetic foot ulcers.
• CAP exhibits a favorable short-term safety profile for DFUs.
• Further large-scale, long-term RCTs are needed to evaluate complete wound closure, recurrence rates, and optimal CAP treatment parameters.