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Non-equilibrium Air Plasma for Wound Bleeding Control

机译：非平衡空气等离子控制伤口出血

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摘要

A low temperature non-equilibrium air plasma spray is tested as a blood coagulator. Emission spectroscopy of the plasma effluent indicates that it carries abundant reactive atomic oxygen (RAO), which can activate erythrocyte - platelet interactions to enhance blood coagulation for plug formation. Tests of the device for wound bleeding control were performed on pigs. Four types of wounds, straight cut and cross cut in the ham area, a hole in an ear saphenous vein, and a cut to an ear artery, were examined. The results showed that this plasma spray could effectively stop the bleeding and reduced the bleeding time considerably. Post-Operative observation of straight cut and cross cut wound healing was carried out. It was found that the plasma treatment had a positive impact on wound healing, in particular, of the cross cut wound; its healing time was shortened by a half. Bleeding, even from an external hemorrhage, may be life threatening if it is not treated swiftly [1]. Most cases occur under emergency situations. For example, Hemorrhage accounts for 30 to 40% of all fatalities, second only to central nervous system injury as a cause of death in the battlefields [2]. New methods and devices, which can effectively stop bleeding to save the life of an injured person, such as in accident and battlefield situations, are of considerable interest. The argon plasma coagulator (APC) is a high-frequency monopolar device used for non-contact thermal coagulation. This device is used in particular in endoscope surgery for bleeding control [3-5]. The heat carried by argon plasma, produced by a high-frequency discharge between the tip of a probe and the target tissue, cauterizes and desiccates blood. However, it is difficult to treat larger external wounds. On the other hand, reactive oxygen metabolites produced in non-equilibrium air plasma could also induce blood clotting effect. Oxidants can affect several key steps of platelet function to indirectly enhance platelet agglomeration through local increases in platelet-activating factor (PAF) [6]. Furthermore, oxidants promote de novo synthesis of tissue factor pro-coagulant activity [7]. Indeed, Kalghatgi et al. [8] showed that a blood sample could be clotted by direct contact of the sample to non-thermal atmospheric pressure plasma [9], produced by a dielectric barrier discharge (DBD). Therefore, new devices that can deliver copious low temperature plasma, which will not cause thermal damage on the tissue surrounding the wound, would be desirable. Chen et al. [ 10] and Kuo et al. [ 11 ] showed that a low temperature non-equilibrium air plasma [12] could clot anti-coagulated whole blood samples in less than 20 s, which is much less than 30 min for an untreated sample to reach complete coagulation. It was also found via emission spectroscopy that this plasma spray produces abundant reactive atomic oxygen (RAO) in its plasma effluent [13]. Activation of erythrocyte - platelet interactions by RAO to trigger blood coagulation was suggested as a plausible coagulation mechanism. However, those experimental results performed under well-controlled in-vitro conditions may not describe what occurs in the much more complicated in-vivo environment. In the present work, we use pigs as the animal model [14] to perform in-vivo tests of blood coagulation by non-equilibrium air plasma [12]. The effectiveness of this plasma spray to stop bleeding is studied. The results of these tests are presented and discussed. Post-operative observation of straight cut and cross cut wound healing has been conducted. The impact of plasma treatment on wound healing is reported.
机译：低温非平衡空气等离子体喷雾器已作为血液凝固剂进行了测试。血浆流出物的发射光谱表明，它带有丰富的反应性原子氧（RAO），可以激活红细胞-血小板相互作用，增强凝血功能，形成栓塞。在猪身上进行了伤口出血控制装置的测试。检查了四种类型的伤口，即火腿部位的直切口和横切口，耳大隐静脉的孔以及耳动脉的切口。结果表明，这种等离子喷雾可以有效地止血，并大大减少了出血时间。术后观察直切口和横切口伤口愈合情况。已经发现，等离子体处理对伤口愈合，尤其是横切伤口的愈合具有积极的影响。它的治愈时间缩短了一半。如果不及时治疗，甚至因外部出血而流血也可能危及生命[1]。大多数情况发生在紧急情况下。例如，出血占所有死亡人数的30％至40％，仅次于中枢神经系统伤害（在战场上是造成死亡的原因）[2]。可以有效地止血以挽救受伤人员生命的新方法和装置，例如在事故和战场情况下，备受关注。氩等离子体凝结器（APC）是用于非接触式热凝的高频单极设备。该设备尤其用于内窥镜手术中以控制出血[3-5]。探针尖端与目标组织之间的高频放电产生的氩等离子体所携带的热量会烧灼和干燥血液。但是，难以治疗较大的外部伤口。另一方面，在非平衡空气血浆中产生的活性氧代谢产物也可引起血液凝结作用。氧化剂会影响血小板功能的几个关键步骤，从而通过局部增加血小板活化因子（PAF）间接增强血小板聚集[6]。此外，氧化剂促进组织因子促凝血活性的从头合成[7]。实际上，Kalghatgi等人。 [8]显示血液样本可以通过电介质势垒放电（DBD）产生的非热大气压力血浆[9]直接接触而凝结。因此，将需要能够递送大量低温等离子体的新设备，其不会对伤口周围的组织造成热损伤。 Chen等。 [10]和Kuo等。 [11]显示，低温非平衡空气血浆[12]可以在不到20 s的时间内凝结抗凝全血样品，对于未经处理的样品，要达到完全凝结，要少于30分钟。通过发射光谱还发现，这种等离子体喷雾在其等离子体流出物中产生大量的反应性原子氧（RAO）[13]。 RAO激活红细胞-血小板相互作用以触发凝血被认为是可能的凝血机制。但是，在良好控制的体外条件下进行的实验结果可能无法描述在更为复杂的体内环境中发生的情况。在目前的工作中，我们使用猪作为动物模型[14]，通过非平衡空气血浆[12]进行体内凝血试验。研究了这种血浆喷雾剂止血的有效性。介绍并讨论了这些测试的结果。进行了直切口和横切口伤口愈合的术后观察。据报道等离子处理对伤口愈合的影响。

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  • 来源
  • 会议地点 Demanovska Dolina(SK)
  • 作者

    Spencer P. Kuo; Cheng-Yen Chen; Chuan-Shun Lin; Shu-Hsing Chiang;

  • 作者单位

    Department of Electrical and Computer Engineering, Polytechnic Institute of New York University, 6 MetroTech Center, Brooklyn, NY 11201, USA;

    Department of Electrical and Computer Engineering, Polytechnic Institute of New York University, 6 MetroTech Center, Brooklyn, NY 11201, USA;

    Department of Animal Science and Biotechnology, Tung Hai University, Taichung, Taiwan ROC;

    Department of Animal Science and Biotechnology, Tung Hai University, Taichung, Taiwan ROC;

  • 会议组织
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 生物工程学（生物技术）;
  • 关键词

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