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Platelets are key in cold physical plasma-facilitated blood coagulation in mice
2017, Bekeschus, Sander, Brüggemeier, Janik, Hackbarth, Christine, Woedtke, Thomas von, Partecke, Lars-Ivo, van der Linde, Julia
Purpose: Surgical interventions inevitably lead to destruction of blood vessels. This is especially dangerous in anticoagulated patients. Electrocauterization is a frequently used technique to seal incised tissue. However, leading to a superficial layer of necrotic tissue, the treated area evolves a high vulnerability to contact, making it prone to detachment. As a result, dangerous postoperative bleeding may occur. Cold physical plasma was previously suggested as a pro-coagulant treatment method. It mainly acts by expelling a delicate mixture of oxidants. We therefore tested the suitability of an atmospheric pressure plasma jet (kINPen MED) as a new medical device for sufficient blood coagulation in a murine model of liver incision. Methods: Plasma treatment of murine blood ex vivo induced sufficient coagula. This effect did not affect any tested parameter of plasmatic coagulation cascade, suggesting the mechanism to be related to cellular coagulation. Indeed, isolated platelets were significantly activated following exposure to plasma, although this effect was less pronounced in whole blood. To analyze the biological effect of plasma-on blood coagulation in vivo, mice were anticoagulated (clopidogrel inhibiting cellular and rivaroxaban inhibiting plasmatic hemostasis) or received vehicle only. Afterwards, a partial resection of the left lateral liver lobe was performed. The quantification of the blood loss after liver incision followed by treatment with kINPen MED plasma or electrocauterization revealed a similar and significant hemostatic performance in native and rivaroxaban but not clopidogrel-treated animals compared to argon gas-treated controls. In contrast to electrocauterization, kINPen MED plasma treatment did not cause necrotic cell layers. Conclusion: Our results propose a prime importance of platelets in cold physical plasma-mediated hemostasis and suggest a clinical benefit of kINPen MED plasma treatment as coagulation device in liver surgery.
First insights on plasma orthodontics - Application of cold atmospheric pressure plasma to enhance the bond strength of orthodontic brackets
2016, Metelmann, Philine H., Quooß, Alexandra, Woedtke, Thomas von, Krey, Karl-Friedrich
Objective: The development of an ideal adhesive system has long been subject of research. Recent studies show that treatment with cold atmospheric pressure plasma (CAP) positively affects the bonding properties of enamel. Conditioning with CAP could therefore improve the mechanical and physical properties of bracket adhesives, e.g. Glass ionomer cement (GIC). Material and methods: Laser-structured brackets (Dentaurum, Ispringen) were bonded onto 60 bovine mandibular incisors using different orthodontic adhesives. For 20 specimens FujiOrthoLC (GC America Corp, Alsip, USA) was used according to manufacturer's instructions. Another 20 specimens received a 60 s CAP-treatment (kINPen med, Neoplas tool, Greifswald, Germany) before bracket bonding, of which 10 were re-moistened before applying FujiOrthoLC and 10 remained dry. Onto 20 specimens, brackets were bonded with the Composite Transbond XT (3M/Unitek, St. Paul, USA) following manufacturer's instructions. The shear bond strength of brackets on the teeth was determined with the universal testing machine Zwick BZ050/TH3A (Zwick, Ulm, Germany). Results: Brackets bonded with FujiOrthoLC in standard method, showed average shear bond strength of 5.58±0.46 MPa. Specimens treated with plasma showed clinically unacceptable adhesion values (re-moistened group: 2.79±0.38 MPa, dry group: 1.01±0.2 MPa). Bonding onto dried out teeth also led to spontaneous bracket losses (4 of 10 specimens). The composite group (Transbond XT) showed clinically acceptable adhesion values (7.9±1.03 MPa). Conclusions: Despite promising potential, surface conditioning with CAP could not improve the adhesive properties of GIC. By contrast, a decrease in shear bond strength was noticed after CAP treatment. Further investigations have to show whether it is possible to increase the retention values of other orthodontic adhesives by CAP application and thus take advantage of positive characteristics and reduce side effects.