Investigating and Comparing the Effectiveness of Atmospheric Plasma Therapy with Vacuum Therapy (NPWT) compared to Vacuum Therapy (NPWT) Alone on Pressure Ulcer Patients: A Randomized, Controlled, Double-blind Clinical Trial Study

Introduction: A pressure ulcer is a type of injury that occurs when an area of the skin is subjected to constant pressure for a certain period of time. It decomposes the skin and the underlying tissue and causes tissue ischemia, interruption of nutrition and oxygen supply to the tissues, and ultimately tissue necrosis. Pressure ulcers are one of the most important and preventable problems and a defined indicator of the quality of care for health service providers. There are different methods for treating pressure ulcers. One of these methods is plasma therapy, which has antibacterial properties. It confirms the increase in epidermis formation, neovascularization, cell proliferation, and growth factor release. Vacuum therapy (NPWT) is another method that works based on the laws of physics, and by creating a uniform negative pressure on the surface of the wound, the dead space in the wound decreases and tissue perfusion increases, which provides tissue oxygen in addition to accelerating wound healing. It reduces the levels of bacteria in the wound. Considering the importance of early treatment of bedsores and taking into account the properties mentioned in plasma therapy and vacuum therapy, this study was conducted with the aim of investigating the effectiveness of plasma therapy together with vacuum therapy in comparison to vacuum therapy alone.Methods: In this study, ۱۵۰ patients with ۲nd, ۳rd, and ۴th degree pressure ulcers who were between the ages of ۱۸ and ۷۵ participated. After the initial screening and evaluation, the participants were randomly and blindly divided into two groups, A and B. The duration of the treatment is ۱۰ sessions, which were done twice a week. In both groups, patients underwent vacuum therapy in the first ۳ sessions, but in group A, plasma therapy was used during ۷ sessions after the treatment. Participants in group B during the next ۷ days and participants whose wound did not heal during the ten-day period used standard interventions, including dressings, to maintain wound moisture and, if necessary, clean the wound of infection. To evaluate the healing process of the wound in each visit session, after wound debridement, the healing rate of the wound was evaluated, the wound was photographed to record the healing process, and the wound was examined in terms of secretions, infection, and other desired factors.Results: In this study, ۱۵۰ patients with pressure ulcers in stages ۲ and ۳ were recruited. Patients were divided into