Cold Atmospheric Plasma Treatment of Infected Skin Tissue: Evaluation of Sterility, Viability, and Integrity

Sterilization of equipment and tissues is a common clinical practice: there are different chemical, mechanical, and electromagnetic aseptic techniques for inactivating microorganisms. In particular, skin tissue banks are investigating new methods to efficiently decolonize skin tissues, while preserving their structural features. In recent years, cold atmospheric plasma (CAP) has demonstrated bactericidal, virucidal, and fungicidal properties, due to the generation of reactive species and charged particles. For this reason, the aim of this paper is to demonstrate that the implementation of a dielectric barrier discharge (DBD) treatment in air can effectively decontaminate skin tissue from Staphylococcus aureus, retaining cell viability and skin integrity. Fresh skin samples, taken from multitissue donors, were contaminated with Staphylococcus aureus and treated with a DBD source, to verify the level of bacterial decontamination induced by plasma. Cell viability and structural properties of skin tissue were investigated using MTT assay and hematoxylin-eosin staining, respectively. Our results show that CAP can sterilize skin tissue with a bacterial load up to 103 CFU/cm2; moreover, it does not affect cell viability, and no loss of skin structural properties was observed. Thus, CAP treatment could be considered an innovative method for decolonization of human skin, without inducing any microscopic tissue damage, while keeping good cell viability.