SRS175 - Cold atmospheric plasma therapy for chronic venous and arterial ulcers: a prospective self-controlled clinical trial

Abstract Introduction Chronic venous and arterial ulcers are a major healthcare challenge due to delayed healing, recurrent infection, and high treatment costs. Cold Atmospheric Plasma (CAP) therapy has antimicrobial and regenerative effects and may serve as an adjunct to standard wound care (SWC). This study evaluated the efficacy and safety of CAP in a real-world outpatient setting. Methods Fourteen patients with 20 chronic lower-limb wounds of venous, arterial, or mixed aetiology were recruited across two UK wound care centres. The study included a 4-week SWC control phase, a 5-week CAP intervention phase (biweekly sessions using CPTcube®/CPTpatch®), and a 4-week follow-up. Wound area was measured weekly via digital imaging (Dermicus® validated with ImageJ). Bacterial bioburden was assessed with MolecuLight® fluorescence. Outcomes included wound area reduction, bacterial changes, and safety. Results Baseline wound area averaged 12.16 cm². Mean reductions were 8.3% during SWC, 13.1% during CAP, and 6.2% during follow-up, with two wounds fully healed. Responses varied: nine wounds improved more with SWC, three with CAP, five in both, and three worsened. CAP produced a significant decline in bacterial fluorescence (χ²(4) = 31.4, P < 0.001). No significant changes in pain were observed, and no adverse events occurred. Diabetes (P = 0.0198), hypertension (P = 0.0049), and lung disease (P = 0.0147) predicted poorer outcomes. Conclusions CAP was safe and significantly reduced bacterial load but showed variable effects on wound area. Patient factors strongly influenced outcomes, supporting the need for larger, stratified trials.