Current State and Future Perspectives of the Use of Cold Plasma in Patients with Complicated Wounds.

We report our experience in patients who were treated with cold plasma wound therapy from 2016 to 2020. Thirty-six patients with a median age of 71 years (23 males, 13 females) were registered in a prospective database. The median follow up was six months. In 15 patients, their wounds were associated with peripheral arterial disease, and they received peripheral interventional or open revascularisation prior to cold plasma therapy. Seven patients had a chronic venous insufficiency and 3 diabetic patients had chronic wounds caused by polyneuropathy. One patient suffered from chronic lymphoid disease. The cause of the wound could not be identified in the remaining patients. Wound treatment was conducted in an outpatient setting, if possible. Four patients were lost during follow-up. Surgical debridement of the wound before cold plasma therapy began was necessary in 14 cases. Each patient received 1 to 3 cold plasma treatments a week; 2 patients were treated for 1 year and the remaining patients were treated for 4 to 11 weeks. There were no major amputations in the long-term follow-up. In 25 patients, the progress of the wound stopped and in 11 patients the wounds were closed at the end of the therapy. In conclusion, our results support the use of cold plasma in complex wounds. Causal therapy is mandatory. Further studies are necessary to evaluate the impact of supplemental modern wound treatment with cold plasma therapy.

Increasing competence in compression therapy for venous leg ulcers through training and exercise measured by a newly developed score-Results of a randomised controlled intervention study.

Compression therapy with short-stretch bandages is the most common treating option for patients with venous leg ulcers in the decongestion phase in Germany. This randomised controlled intervention study examined whether a training is suitable to sustainably improve the skills of health care professionals. Altogether 55 nurses from hospitals and outpatient care participated. They were randomly assigned to case and control groups. Participants' abilities to properly apply a compression bandaging were assessed before and after a training session as well as after 1 and 3 months using a newly developed score (CCB score) based on six control parameters (CPs): padding, starting point, heel inclusion, heart direction, pressure at forefoot (A) and calf base (B1). After training, a significant increase in competence was observed, which only decreased non-significantly over the observation period: The average CCB score was 2.796 at V0, 4.89 at V1, 4.88 at V2, and 4.66 at V3. The CPs for pressure at A and B1 were met by a maximum of 42.6 and 43.6%, respectively, at all timepoints. The CP starting point was fulfilled by at least 61.7% after training, the CPs heart direction, heel and underpadding by at least 89.4, 96.4, and 97.9%, respectively. As a result of our study, it can be concluded that training improves the ability of users to apply compression bandagings, but one-off training does not appear to be suitable to improve the ability to apply compression bandagings with a therapy-relevant pressure. Therefor more training especially with pressure measuring devices would be necessary.