Active Free Radical Cold Atmosphere Plasma Promotes Healing of Diabetes Foot Ulcer: Mechanism and Challenge

Diabetic foot ulcers (DFUs) have become an important cause of disability and death in patients with diabetes. Traditional therapies are prone to problems such as recurrence and drug resistance, which result in unsatisfactory healing effects for DFUs. Although antibiotics are not the mainstay of treatment for DFUs, antibiotic resistance poses a critical clinical challenge for DFU patients who require long-term antibiotic therapy.

This review summarises the mechanism by which Cold Atmosphere Plasma (CAP) kills bacteria and activates healing ability through the production of reactive oxygen/nitrogen species (RONS). RONS, as the key active species of CAP, exert antibacterial effects in a series of bacterial, cellular, and animal experiments, promote cell migration and proliferation, stimulate angiogenesis, and exert anti-inflammatory effects. However, current high-quality clinical trials are still lacking, leaving substantial room for further clinical exploration of CAP in the treatment of DFUs. Finally, the challenges and prospects of CAP in treating diabetic foot ulcers are summarised.

As a comprehensive and innovative treatment method, the RONS produced by CAP offer a potential approach for treating DFUs and serve as a tool for promoting their healing. However, more clinical studies are needed for further verification.