Standard treatments for severe and infected burns commonly rely on silver, but due to silver-based cytotoxicity, patients are at risk of delayed wound healing and increased hypertrophic scarring (Qian et al., 2017, Barrett et al., 2022). Thus, there is a need for innovative burn treatments that manage infection risk and stimulate healing, ultimately minimising the risk of poor outcomes. Cold Atmospheric Plasma (CAP) has been shown to improve burn wound healing in many in vivo studies (Zinovev et al., 2018, Duchesne et al., 2019, Dang et al., 2021, Li et al., 2023, Abbasi et al., 2021), and in vitro stimulates keratinocyte and fibroblast proliferation and migration, improves bacterial killing efficiency of immune cells and modulates inflammatory signalling (Namini et al., 2019, Souza et al., 2020, Lee et al., 2023, Arndt et al., 2013, Bhartiya et al., 2021, Duchesne et al., 2018, Duchesne et al., 2021, Frescaline et al., 2020). Therefore, as a potential alternative to silver, CAP is of increasing interest.
Much of the present research has focussed on direct plasma treatments, delivering a range of therapeutic reactive oxygen and nitrogen species (RONS). However, direct plasma treatments can be challenging for clinical settings, as dosage from plasma devices can be unreliable, and the plasma delivery using plasma jets does not fit well with existing clinical pathways. To overcome this, a range of plasma-activated hydrogels are being developed to create a dressing with easy-to-deliver, consistent and quick-application doses of therapeutic reactive oxygen and nitrogen species (RONS) to be administered at the clinic. Indeed, our PVA-based plasma-activated hydrogels have reduced inflammatory markers in scald burn mouse models and show modest inhibitory effect against S.aureus in vitro. Optimisation of these dressings is ongoing, aiming to deliver a plasma-activated hydrogel which promotes healing and bacterial killing and integrates well into current clinical practice.