Use of Non-Thermal Atmospheric Pressure Plasma Discharge for Coagulation

and Sterilization of Surface Wounds

Gregory Fridman1, Marie Peddinghaus3, Alexander Fridman2, Manjula Balasubramanian3,
Alexander Gutsol2, Gary Friedman4
1
School of Biomedical Engineering, Science, and Health Systems
2
Department of Mechanical Engineering and Mechanics, College of Engineering
3
Transfusion Services and Donor Center, College of Medicine
4
Department of Electrical and Computer Engineering, College of Engineering

Drexel Plasma Institute, Drexel University, Philadelphia, Pennsylvania, USA

Abstract
We demonstrate the ability of non-thermal plasma to promote blood coagulation and tissue sterilization in under
15 seconds of treatment. We demonstrate no gross (visible) or microscopic damage to tissue in as much as 5
minutes of plasma treatment. This procedure would be safe for patients since there are no exposed electrodes,
discharge is cold, and current is low. Initial experimental results obtained using cadaver organs and donor blood
support the fact that the DBD plasma can simultaneously sterilize skin and promote coagulation in bleeding
tissue. This technique will decrease wound healing time and virtually eliminate wound infections with skin flora.
Keywords: non-thermal plasma, tissue sterilization, blood coagulation, wound healing

1. Introduction
In the last decade, advances in electrical discharge plasma systems allowed for many new applications. Such
systems have been used for sterilization of surfaces, for biochemical surface functionalization, and for many
other new applications [6-13]. Specifically, thermal plasma discharges are applied in the field of blood
coagulation as a faster alternative to normal biochemical coagulation [7-9]. However, the use of thermal plasma
is limited for two reasons: (a) the extremely high temperatures (2,000 K up to 10,000 K) cause severe tissue
damage [7-9] (Fig. 1) and (b) the necessity of general anesthesia makes it inconvenient for wide-spread patient
use, apart from the hospital setting [8,9].
We have developed a Floating Electrode Dielectric
Barrier Discharge (DBD) plasma (Fig. 2) system that
promotes blood coagulation with simultaneous tissue
sterilization for treatment of surface wounds. This
treatment would be safe to patients because no exposed
electrodes are involved and high frequency current is kept
below a mili-ampere (see “Safety Considerations”
below). Our initial experiments have shown that such
plasma treatment hastens blood coagulation and causes Fig. 1. Tissue damage by thermal plasma:
simultaneous wound sterilization (probably via a tissue overheating, puncture and charring [7-9].
large concentration of chemically active species in
plasma [10-13] that are ions, radicals (O, OH, N)
and electronically-excited atoms and molecules
[1-6]). Fig. 3 and 6 display our prototype quartz-
coated treatment electrodes for wound surface
treatment by DBD plasma.
Fig. 2. Dielectric Barrier Discharge
 This plasma technology can find many applications in the medical field. Within the
hospital setting, this technology may prove useful in the operating room for patients
suffering from bleeding not amenable to other methods of coagulation. Because of the
potential for simultaneous sterilization, our device could also help prevent intra-
operative infections. Sterilization effects of non-thermal plasma are well-known [10-
13] and were confirmed, for example, in our research with NASA Jet Propulsion Lab
[14]. In the future, we intend to develop a significantly smaller version of our power
supply to create a portable, possibly battery-operated blood coagulator and wound
sterilizer (Fig. 4). In addition, due to its ability to promote coagulation, the non-
thermal plasma discharge device can be used for hemophiliac patients who have
clotting difficulties or those who are on anti-coagulants.
2. Experimental Setup
Fig. 3. Quartz-coated Schematics of our experimental setup of the varying and fixed (Fig. 4) frequency,
Treatment Electrode voltage, and power Floating Electrode DBD setups are presented. Power of both
systems is approximately 1 W/cm2 and the treatment surface varies from less than
2 2
1cm to 10cm depending on the attached electrode (Fig. 6). Utilizing the variable frequency, voltage, and power
setup we are able to tune the setup for treatment dose appropriate for a specific application. I.e. for tissue
sterilization we might want lower power with longer treatment time; while for blood coagulation we might want
high power with low treatment time to stop “gushers” – large flow of blood; or lower power to coagulate blood
in small cuts.

Fig. 4. Floating Electrode DBD schematic.

We started a fundamental study of mechanism of blood coagulation with the help of electrical discharge plasma.
Fig. 5 presents our setup for treatment of small blood volumes – 500µl. While not wasting too much blood per
test, this volume is a minimum required for standardized hematological tests we perform at the Drexel University
Hahnemann  Hospital hematology lab: PT (Prothrombin time), aPTT (activated partial thromboplastin time), and
STA-Thrombin® (Diagnostica Stago proprietary Thrombin formation time test). In this setup we are able to
precisely control the distance of Floating Electrode DBD to the treated blood sample for the purpose of
determining correct dose required for clot formation and to get reproducible results necessary for the
fundamental study.

 
Fig. 5. Blood treatment experimental setup schematic.
Schematic representations of the three treatment electrode types used for this research are shown in Fig. 6.
“Round” electrode is used for treatment of small areas and when distance between electrode and the treated
surface is closely monitored (±0.1mm). “Wand” electrode is used in hand-held operation where distance and
treated area are not precisely monitored. “Roller” is used for treatment of large flat areas.

Fig. 6. Treatment electrodes. Top: 3D models; bottom: schematic representations;

left to right: “round”, “wand”, “roller”.
During treatment, tissue samples are placed directly on a grounded stainless steel plate. Blood samples are
dispensed into 0.1 or 0.5 ml grounded stainless steel, aluminum, brass, or titanium containers (Fig. 5). For blood
treatment we found titanium to be the best material where control blood sample coagulates the slowest.
3. Safety considerations
Safety of Floating Electrode DBD plasma electrode for humans needs to be considered for application in wound
healing. Here we consider a simplified electric scheme to estimate conditions required for electrical safety. Once
human approaches Floating Electrode, plasma ignites and at that point we can consider DBD plasma as capacitor
and resistor in series and human as a resistor and
capacitor in series (Fig. 7).
Total plasma resistance can then be estimated as a sum of
capacitive and active resistances:
Σ i
Rp = + Rp
C pω
2
⎛ 1 ⎞
+ ( Rp )
2
R pΣ = ⎜ ⎟
⎜C ω⎟
⎝ p ⎠
Where R pΣ is total plasma resistance, C p is plasma
Fig. 7. Plasma/human interface principal schematic.
capacitance, R p is plasma active resistance, and ω is the
signal frequency. Similarly, total resistance of a human can be estimated as:
2
⎛ 1 ⎞
⎟ + ( Rh )
Σ
R = ⎜
2

⎝ Chω ⎠
h

Where RhΣ is total resistance of a human, Ch is human capacitance, and Rh is active resistance of a human. For
the Floating Electrode DBD plasma device to be safe, total plasma resistance needs to be greater than total
resistance of a human:
2
⎛ 1 ⎞
2
⎛ 1 ⎞
⎟⎟ + ( R p ) >> ⎜ ⎟ + ( Rh )
2 2
⎜⎜
⎝ C pω ⎠ ⎝ Chω ⎠
Active resistance of a human is ~1 MOhm [15-17]
and human capacitance is ~50 pF (though it ranges
from 20 pF to 90 pF, depending on the surface
human is standing on, thickness of his/her soles,
and distance to nearest grounded object) [15,17].
For our frequency range, Floating Electrode DBD
plasma active resistance can be estimated to 5 to 10
MOhm and its capacitance to ~50pF [18,19]. Thus
at the operating frequency of 12 kHz we see that Fig. 8. Floating Electrode DBD: safe to touch.
total resistance of a human (1.9 MOhm) is far
smaller than total plasma resistance (5.3 MOhm), assuming Ch =50 pF, Rh =1 MOhm, C p =50 pF, R p =5
MOhm. Even in the case where human total resistance will increase for some reason, total current passing
through the human will be very low because of a massive total resistance of the system. From this estimation we
can conclude that even in the worst case where resistance of a human is approaching that of plasma, the overall
system will still be completely safe from the electrical standpoint (Fig. 8).
4. Results
In our tests we have successfully accomplished the following:
• Designed and built a Dielectric Barrier Discharge (DBD) system capable of delivering 1 W/cm2 of plasma
power at operating frequencies of 10-30 KHz. While the system employs a power supply delivering voltage of
up to 10 KV, it is perfectly safe as the high frequency plasma current is limited to below a milli-ampere.
• Developed treatment electrodes (Fig. 3-6) for treatment of blood and tissue samples.
• Performed blood coagulation tests on blood from cadaver organs (Fig. 9). The results consistently show faster
coagulation when exposed to DBD plasma: for example, blood treated for 15 seconds completely coagulates in
2 minutes while untreated sample coagulates in 13 minutes.
• Performed blood coagulation tests on cadaver organs with subsequent gross and microscopic evaluation of
tissue to test for damage. Our analysis demonstrates blood clotting within 15 seconds without gross or
microscopic evidence of tissue damage (Fig. 10,11).
• Performed skin sterilization tests on cadaver skin with subsequent microbiologic culture. The results
demonstrate complete sterilization of skin flora after 6 seconds of treatment by the plasma.
• Examined skin histology to find existence and/or extent of microscopic damage. No tissue damage was found
after as much as 5 minutes of plasma treatment (Fig. 11).

Fig. 10. 1-minute plasma treatment shows no visible tissue

Fig. 9. Plasma-assisted blood coagulation with 15-second
damage. Left: before treatment; right: after treatment.
treatment (left) and 1-minute treatment (right);
control drop on the bottom, treated drop on top.

Fig. 11. Skin histology (left to right): control, 1 minute, and 5 minute treatment times show no detectable tissue damage.
5. Conclusion
This device can find many applications in the medical field, ranging from replacing high-power, high-
temperature thermal plasma coagulators in the operating rooms to personal portable wound sterilizing and
healing instruments. The scope of the presented research included only initial studies of plasma influence on
blood coagulation and simultaneous tissue sterilization. However, these studies are essential in providing us with
knowledge and expertise on the underlying processes.
At the present, we are actively working on developing a kinetic model of DBD plasma influence on Blood
plasma coagulation cascade as well as DBD plasma role in the tissue sterilization process. We have interesting
modeling results (that agree with experimental evidence) involving DBD plasma influence on Calcium ion
concentration and in turn on blood coagulation cascade. These results will be presented at the ISPC-17
conference.
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