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Chronic wounds affect many patients, with no downward trend in recent decades. This is a significant economic and social issue, and this condition has an impact on functional disabilities and quality of life, especially among the elderly. Diagnosis is essentially clinical, and there are many causes, but 90% of leg ulcers, for example, are primarily vascular in origin. There are wounds of traumatic, post-operative, and vascular origin, as well as pressure sores. The main purpose of invasive tests is to objectively determine the cause (arterial damage) or to check for underlying osteitis. Chronic wounds are usually infected or colonized by bacteria from the skin and digestive flora. There is no indication for antibiotic therapy in the treatment of wounds. Nursing staff play an important role in therapeutic management, which must be carried out in harmony with other healthcare professionals, such as general practitioners and specialists. This management has two main goals: to accelerate the epidermalization of chronic wounds, or even their healing, and to limit local and general complications, the recurrence of which remains the most difficult to control. There are many types of healing dressings available, adapted to each type of ulceration: fibrinous, necrotic, superinfected, etc.
Nevertheless, innovative solutions can accelerate healing, thereby reducing hospital stays, disabilities associated with chronic wounds, and complications such as skin-related septicemia. Research efforts may focus on the use of growth factors, for example, for old or stubborn forms of the disease, despite proper medical treatment, or on any other innovative technique.
The properties of cold plasma appear to be suitable for the treatment of chronic wounds, as has been demonstrated in cell models, animal models, and with argon plasma in several countries around the world on an experimental basis in humans.
The GREMI in Orléans has acquired internationally recognized expertise in the technique of cold helium plasma. The combination of this applied research laboratory and the Infectious Diseases Department of the Orléans University Hospital has led to the development of relationships that have resulted in the proposal to conduct this study, based in its first phase on the evaluation of the medical device's tolerance.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Plasma treatment with exposure 1 min/10 cm² + conventional treatment | Experimental |
| |
| Plasma treatment with exposure 3 min/10 cm² + conventional treatment | Experimental |
| |
| Treatment using dressings impregnated with ions induced by exposure to plasma | Experimental |
| |
| Conventional treatment with hydrocolloid dressing or adapted dressing, local care | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| cold plasma treatment with helium 1min/10cm2 | Device | The plasma will be applied using the multi-jet probe by an investigating physician over the entire surface of the ulceration during the defined exposure times (1min/10 cm2), after which the nurse will apply the standard dressing appropriate for the characteristics of the ulceration. The sessions will be repeated daily for 8 days. |
| Measure | Description | Time Frame |
|---|---|---|
| Level of local inflammation | Everyday for 8 days |
| Measure | Description | Time Frame |
|---|---|---|
| Change in the size of the ulcer | Measurement of the wound area using MolecuLight for daily photographies and computer analysis of the images | Day 0, Day 2, Day 4, Day 6 and Day 7 |
| Change in the extent of tissue loss |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Thierry PRAZUCK, PH | Contact | +332 38 51 43 61 | thierry.prazuck@chu-orleans.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier Universitaire d'Orléans, France | Recruiting | Orléans | 45000 | France |
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|
| cold plasma treatment with helium 3min/10cm2 | Device | The plasma will be applied using the multi-jet probe by an investigating physician over the entire surface of the ulceration during the defined exposure times (3min/10 cm2), after which the nurse will apply the standard dressing appropriate for the characteristics of the ulceration. |
|
| dressings impregnated with ions induced by exposure to plasma | Device | The plasma will be applied using the multi-jet probe by an investigating physician over the dressing, after which the nurse will apply the dressing on the ulceration. |
|
Measuring wound volume with the MolecuLight
| Day 0, Day 2, Day 4, Day 6 and Day 7 |
| semi-quantitative change in total bacterial load | semi-quantitative change in total bacterial load between Day 0 and Day 7 on bacterial samples taken from the base of the ulcer | Day 0 and day 7 |
| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
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