Efficient Elimination of Microbial Infections in Wounds Using Plasma-Activated Water Hydrogel

Surgical site infections are among the most prevalent postoperative complications and remain a pressing global health challenge, exacerbated by the rise of antimicrobial resistance. Plasma-activated water (PAW) has recently gained attention as an innovative antimicrobial approach. However, earlier research indicated that its effectiveness relies on maintaining an acidic pH. To address this, we previously created a high-strength, neutral pH-buffered version (hs-PAbW) that is better suited for clinical use in humans. This neutral plasma activated water retained the potent antimicrobial activity. In this study, we engineered a hydrogel containing hs-PAbW at a bactericidal yet noncytotoxic dose (hs-PAbW-20) and assessed its efficacy in murine wound models. In BALB/c mice, hs-PAbW-20 gel significantly reduced Pseudomonas aeruginosa and Staphylococcus aureus burden, achieving results comparable to neosporin and soframycin treatments. This gel also accelerated wound closure by modulating genes crucial for wound repair. In diabetic C57BL/6 mouse model, hs-PAbW-20 gel decreased the burden of P. aeruginosa and promoted faster healing. Together, these findings highlight hs-PAbW-20 gel as a promising next-generation alternative to antibiotic-based wound therapies and represent one of the first comprehensive evaluations of a neutral-pH PAW formulated as a gel for surgical site infection management.