Originally published by our sister publication Infectious Disease Special Edition

A team of international scientists developed a new way to treat chronic wounds that could result in the use of fewer antibiotics (Adv Funct Mater 2024 Feb 12. https://doi.org/10.1002/adfm.202314345).

The treatment, plasma-activated hydrogel therapy (PAHT), involves boosting the plasma activation of hydrogel dressings with a unique mix of different chemical oxidants that decontaminated to improve healing of chronic wounds in the laboratory. The dressings were “highly effective” at controlling the growth of Escherichia coli and Pseudomonas aeruginosa, and “mildly effective” against Staphylococcus aureus. 

“Antibiotics and silver dressings are commonly used to treat chronic wounds, but both have drawbacks,” said Endre Szili, PhD, a physicist at the University of South Australia. “Growing resistance to antibiotics is a global challenge, and there are also major concerns over silver-induced toxicity. In Europe, silver dressings are being phased out for this reason.”

More than 540 million people worldwide are living with diabetes, of which 30% develop a foot ulcer during their lifetime. The cost of managing chronic wounds such as diabetic foot ulcers already exceeds $17 billion annually, and this cost is expected to climb in coming decades as obesity and lack of exercise lead to more cases.

Cold plasma ionized gas not only controls infection but also stimulates healing due to the potent chemical cocktail of oxidants, namely reactive oxygen and nitrogen species (RONS), it produces when it mixes and acti-vates the oxygen and nitrogen molecules in the ambient air, he explained. Dr. Szili and his colleagues showed plasma-activated hydrogel dressings with RONS makes the gel far more powerful, killing common bacteria.

“Despite recent encouraging results in the use of plasma-activated hydrogel therapy, we faced the challenge of loading hydrogels with sufficient concentrations of RONS required for clinical use. We have over-come this hurdle by employing a new electrochemical method that enhances the hydrogel activation,” he said.

In addition to killing common bacteria, the researchers said the plasma-activated hydrogels might also help trigger the body’s immune system, which can help fight infections.

“Chronic wound infections are a silent pandemic threatening to become a global healthcare crisis,” Dr Szili said. “It is imperative that we find alternative treatments to antibiotics and silver dressings because when these treatments don’t work, amputations often occur.”

In addition, the treatment is environmentally safe, he said, because it uses natural components in air and water to activate the ingredients, which degrade to nontoxic and biocompatible components.

The next step will involve clinical trials to optimize the electrochemical technology for human patients.

“Overall, this study shows that the new PAHT dressing offers a promising alternative to antibiotics and silver-based dressings for controlling infection and stimulating healing in wounds,” the researchers wrote.

A video explaining the treatment is available.