Reactive Species and Redox Processes in Medical Gas Plasma-Promoted Wound Healing

The principal aim of this chapter is to provide a comprehensive overview of medical gas plasma technology for wound healing in animal models, veterinary medicine, and humans. Impaired or defective wound healing in skin injuries substantially burdens patients and the whole healthcare system. In recent years, the novel reactive oxygen and nitrogen species (ROS/RNS) based therapy using medical gas plasma technology has received significant attention among clinicians for targeting chronic wounds and numerous skin diseases. Gas plasma is a partially ionized gas operated at ambient pressure and body temperature. This chapter describes preclinical and clinical evidence and mechanisms mainly based on redox processes induced by gas-plasma-generated ROS/RNS. The chapter includes several assumptions, such as increased microbial inactivation, inflammation, immigration of skin cells, apoptosis of senescent cells, wound tissue oxygenation, and vascularization. We propose that several mechanisms in redox signaling act in concert, instead of any single factor playing a dominant role, in gas plasma-stimulated healing. Finally, we discuss current challenges, opportunities, and limitations of gas plasma technology, which may further support the clinical application of gas plasma as adjuvant therapy in wound care.