Cold Atmospheric Plasma for Promoting Healing and Anti-Infection of Chronic Wounds: a Meta-Analysis.

Background: Cold atmospheric plasma (CAP) has shown good clinical efficacy in treating chronic wounds, but its superiority over conventional treatment is still under debate. This meta-analysis systematically analyzed the clinical efficacy of CAP compared to control therapy.

Methods: Relevant literature was obtained online according to PRISMA guidelines. Randomized controlled trials (RCTs) were selected based on reduced bacterial load and wound size or area in chronic wounds as observation outcomes. The data were pooled and analyzed using REVMAN 5.2.

Results: Twelve studies were included in the meta-analysis, comprising two on wound bacterial load, four on wound size or area, and six on both wound bacterial load and size. For the reduction in wound size or area, CAP showed a significant superior effect compared to the control group. Out of the five RCTs that evaluated wound size, CAP showed a higher number of wounds reduced (CAP vs. control: OR = 1.75; 95% CI = 1.11 - 2.77; p = 0.02). The percentage of relative reduced wound area was evaluated by five RCTs (CAP vs. control: MD = 43.24%; 95% CI = 24.95% - 61.54%; p < 0.00001). For reduced bacterial load, CAP also showed significantly better efficacy than control, as evaluated in eight RCTs (CAP vs. control: OR = 2.06; 95% CI = 1.16 - 3.68; p = 0.01).

Conclusions: A total of 448 patients with chronic wounds were included in all 12 meta-analysis studies, indicating that CAP has better clinical efficacy in treating chronic wounds. These findings provide a valuable reference for the clinical application of CAP.