The management of challenging wounds in small animals can present significant clinical challenges in veterinary practice. They are often associated with delayed healing, persistent infection, pain, repeated veterinary visits, frequent bandage changes and increased treatment costs. In addition, complications such as wound dehiscence, tissue necrosis, excessive inflammation and self-trauma can further delay recovery and negatively impact patient welfare and owner satisfaction.

One technology attracting increasing interest in veterinary medicine as a drug free therapeutic option for wounds is cold atmospheric plasma, or CAP.

Cold atmospheric plasma is not the same as blood plasma

It is often described as “the fourth state of matter” after solid, liquid and gaseous states. When energy is applied to a gas, such as air, argon or helium, it can become ionised, producing plasma through electrical discharge. Cold atmospheric plasma is a partially ionised gas below 40 °C which is highly electrically conductive. The low temperature means it can be applied directly to living tissue without the heat damage associated with thermal plasma.

The various biological effects of CAP are based on the synergistic effects of the plasma components. Amongst other things, therapeutic cold plasma contains ions, electrons, reactive oxygen and nitrogen species (RONS), charged particles, UV radiation and electromagnetic fields.

In wound care, the therapeutic effects of CAP work in several ways

Firstly, CAP produces RONS which have antimicrobial activity and so help to reduce microbial burden. This includes antimicrobial activity against bacteria found in infected wounds. This is particularly important as challenging wounds are frequently associated with bacterial contamination, infection and biofilm formation, creating an environment that can hinder normal tissue repair and delay wound closure. By reducing microbial burden and supporting normal wound-healing processes, CAP may help create a more favourable environment for tissue repair. Cold atmospheric plasma also exerts inhibitory effects against a wide range of other micro-organisms such as fungi, yeast and viruses.

Secondly, CAP helps support tissue repair and regeneration by stimulating cellular signalling pathways involved in wound healing, promoting angiogenesis, modulating inflammation, and encouraging the activity of keratinocytes and fibroblasts.

Cold Atmospheric Plasma can be used for:

1. Wound Management on:

• Surgical wounds
• Traumatic injuries
• Pressure sores
• Infected wounds

2. Dermatological Conditions 

• Bacterial and fungal skin infections
• Hot spots (acute moist dermatitis)
• Otitis externa (ear infections)

PetCellpen is a handheld device that generates direct cold atmospheric plasma (CAP) for use in small-animal practice. It can be used in wound management, dermatology, neuromuscular and dental treatment protocols. The plasma is delivered directly to the skin or tissue via one of five interchangeable glass electrodes.

PetCellPen is designed for convenient clinical use, requiring no personal protective equipment for the animal or operator. In addition, treatment can be performed without shaving the area or applying gels beforehand.

In summary, the management of challenging wounds in veterinary practice can present significant clinical challenges. Cold atmospheric plasma is an emerging therapeutic option for many different types of wounds. As a drug-free therapeutic option, it can be incorporated into wound-management protocols as part of a multimodal approach to challenging wounds.

For more information on this innovative medical device go to PetCellpen or visit our PetCellpen Resouce Hub for product suport information, CPD and much more.

Written by Dr Sarah Woods BVSc BSc (Hons) PhD MRCVS, Veterinary Advisor, Forte Healthcare.