FAQs
What are the most frequently asked questions?
General
No, cold plasma therapy does not require conductive gel or any other additional consumables.
No, it is not necessary to use any special equipment or eye protection, it is completely safe, although it is best to avoid treating the patient’s eye area directly.
No, it is not necessary to shave, the cold plasma is just as effective without shaving. For large, densely furred areas, there is even a special comb-shaped electrode that facilitates the application of the therapy.
They usually tolerate cold plasma therapy very well. The noise hardly seems to bother them, unless the device is used directly in the ear canal area, in which case sedation is needed in most cases. The power can be regulated in a very specific way, so that patients can become completely accustomed to the therapy by starting at a lower frequency for the first minute and gradually increasing to the desired frequency.
We recommend that it should not be used directly in the eye area. Nor near the heart due to the interference it may cause with the heart rhythm. The jugular area should be avoided as it is an area with many important and delicate structures, so the risk of vascular and neurological interference should be minimized.
Up to 1 cm depth at the first level (reactive species and other components) and more than 1 cm at the second level (electromagnetic fields).
Yes, even on reptiles and birds.
Cold atmospheric plasma (CAP) is a technique that uses an electrical discharge to ionize air and create a mixture of reactive oxygen and nitrogen species with bactericidal and inflammation-modulating properties. It also generates other active components such as electrons and ions, ultraviolet radiation, visible light, thermal radiation and electromagnetic fields, which in addition to penetrating tissues to more than 1 cm are believed to be conducted by muscle fibres to even deeper layers.
Laser therapy, on the other hand, uses a laser light beam with a specific wavelength (usually in the range of 600-1000 nm) to stimulate ATP production in cells, which can increase the speed of wound healing and reduce pain. Laser therapy is usually applied indirectly, i.e. the laser is applied at some distance from the wound.
In short, while cold atmospheric plasma relies on the release of reactive species and other active components to promote healing, laser therapy uses a modified light to stimulate cellular metabolic activity. The other main difference is the way in which the energy is applied: CAP is applied directly, while laser therapy is applied indirectly , as in addition to an energy source it requires a resonance chamber and a conductive medium that varies depending on the intended use.
Isbary, G., et al. (2010). A first clinical study on cold atmospheric plasma for wound healing. Plasma Medicine, 1(1), 39-49.
Hamblin, M. R. (2016). Mechanisms of low-level laser therapy. Proc. SPIE 9730, Laser-Based Micro- and Nano-Technologies, 973004.
Both technologies are used in veterinary medicine to promote wound healing and to reduce pain, but have different mechanisms of action.
Cold atmospheric plasma (CAP) is a technique that uses an electrical discharge to ionize the air and create a mixture of reactive oxygen and nitrogen species, with bactericidal and inflammation-modulating properties up to 1 cm deep. It also generates other active components such as electrons and ions, ultraviolet radiation, visible light, thermal radiation and electromagnetic fields, which in addition to penetrating tissues more than 1 cm deep are believed to be conducted by muscle fibres to even deeper layers.
Photobiomodulation (PBM), on the other hand, is a technique that uses light with specific wavelengths (usually in the 600-1000 nm range) penetrating up to a maximum of 6 mm, to stimulate ATP production in cells, which can increase the speed of wound healing and reduce pain.
Isbary, G., et al. (2010). A first clinical study on cold atmospheric plasma for wound healing. Plasma Medicine, 1(1), 39-49.
Hamblin, M. R. (2016). Photobiomodulation: light therapy for the 21st century. Journal of Clinical and Aesthetic Dermatology, 9(6), 14–16
Bacteria have their genetic material unprotected because it is loose in the cytoplasm (prokaryotes), while animal and plant cells (eukaryotes) have a perfectly defined nucleus surrounded by a double nuclear membrane formed from the endoplasmic reticulum. This means that cold plasma affects bacteria and damaged cells much earlier than the patient’s cells. This is why we say that it has a very wide therapeutic window.
The complex process of wound regeneration requires a fine balance between the necessary naturally occurring oxidative stress and antioxidants. Thus, free radicals applied in the early wound process are beneficial, while their persistence in the tissue at later stages is not. The reactive species, especially of oxygen (ROS) and nitrogen (NOS) generated by the CAP, act immediately, inactivating micro-organisms and helping to eliminate already damaged cells, only while it is applied and without its effect being perpetuated over time. This disinfectant and debridement action, in addition to the other components of the cold plasma, which are maintained between sessions, are what contribute to the reactivation of the healing process. In chronic wounds with infection, secretion or a high component of cellular debris, an excess of free radicals is generated and maintained indefinitely in the tissue, which delays healing by negatively affecting fibroblasts, keratinocytes and the cellular matrix. Thus, a topical healing treatment with an anti-oxidative effect is not incompatible with the effect of cold plasma, but can be used at home, between PetCellpen sessions, if necessary, to optimize regeneration.
The device is cleaned with a disinfectant wipe before and after each treatment. Disinfection of the electrodes and the device with wipes was considered sufficient in the context of the EC approval of the device as a medical device.
During operation, the glass electrode sterilizes itself through the cold plasma emitted. The electrodes should not be placed in an autoclave.
The average lifetime is 5 years. The PetCellpen and EquCellpen devices have been tested for prolonged use for 8 hours a day and after three years they still deliver the same performance. The device is guaranteed for 2 years and functional checks and repairs can be carried out at the factory in Switzerland. There is also the option of having this done outside Switzerland at partner technical companies in the EU.
Yes, in fact to a certain extent, the presence of water molecules in the tissue to be treated facilitates the formation of reactive species, however, in abscesses or lesions with a lot of secretion you should try to eliminate as much excess liquid as possible. For example, by flushing with saline solution and removing excess moisture. There is no problem if a chemical is used prior to the use of the device.
No, there are none.
Yes, above all to maintain hydration, but like everything else it will depend on the type of wound. An acute moist dermatitis that needs oxygenation is not the same as a wound with exposed bone that is healing by second intention.
APPLICATIONS
The first protocols were extrapolated from human medicine and we have been gaining experience over a period of 5 years. Everything is explained in detail in the Therapeutic Guide. In addition to the general rules of application based on measurements of the biological effect of INP and the clinical experience of experts, there is a list of selected indications and treatment recommendations. The electrode is then selected according to the pathology. The duration of therapy is based on the size of the area to be treated and the size of the electrode, but also on the appearance of the wound. If you have any questions, a veterinary technician is always available to answer them at LIVISTO.
Depigmented areas are no more sensitive to cold plasma than pigmented areas and as far as we know, pigmentation is not affected. However, scars and keloids can be remodelled and reduced by increasing microcirculation and improving cellular architecture.
Demodex spp. and lice. No experience with Sarcoptes spp. infestation.
The effect of cold plasma therapy is dose- and time-dependent. At low doses it promotes cell regeneration and wound healing, at high doses it inhibits cell regeneration and can even lead to cytotoxicity. This means that to simply treat a non-healing wound, we remain within the therapeutic window. On the other hand, if we wanted to treat warts or small skin tumours, we would be looking for cytotoxicity or apoptosis. The PetCellpen could be successful only with very small tumours, as it is designed for a high level of therapeutic safety.
Yes, juvenile cat cellulitis is a multifactorial disease, we can treat the infectious and inflammatory parts and thus successfully treat the cellulitis. Feline acne can also be treated. Eosinophilic plaques can be treated by two approaches. On the one hand, to reduce secondary infections and, on the other hand, to inhibit cell proliferation. Cytotoxic doses should be used for this purpose and treated for a sufficiently long time.
Case: Robin, Amiris (pgs. 10 y 29).
To disinfect tissues after intraoral surgery or to stimulate rapid healing, e.g. after gingival excision in epulis, hyperplasia, dental extractions. As stomatitis is a multifactorial condition, it can recur after cold plasma treatment if the cause has not been remedied. In addition, as CAP has antiviral activity, it can also help in immune-mediated stomatitis such as eosinophilic stomatitis and to treat calicivirus and herpesvirus ulcerations in cats.
Case: Amy (pg. 15)
It depends on the animal. Treatments in the lip or eyelid area are very well tolerated without sedation, of course depending on the temperament of the animal. To help with habituation, a low frequency is selected first and gradually increased over the first 2 minutes. Light sedation is always helpful and of course treatment inside the ear canal or intraoral use will need sedation or general anaesthesia.
At the moment it is not recommended for use in the eye. There are ophthalmological studies in human medicine, but we are not yet at that stage in veterinary medicine. Experts are currently trying to determine the doses and protocols that would make this indication possible.
It will not cure these compressions, but cold plasma therapy reduces the oedema around a pinched nerve root and can modulate the inflammation caused by the compression, thereby also reducing pain. The cause (e.g. a herniated disc) cannot be cured directly with cold plasma therapy, but due to the improved blood circulation we can expect a faster degradation of the protruding material. Added to this is the pain-inhibiting effect due to the muscle relaxing effect and the desensitizing effect on the afferent nerve pathways, which can quickly improve the overall picture.
Yes, it works very well. Cold plasma treatment helps to dry the tissue and therefore helps seromas and haematomas to heal more quickly, as microcirculation is stimulated.
Yes, this is a common application of cold plasma therapy in practice.
Cases: Age, Logan, Beans (pgs. 1, 2 y 13)
It has no negative effect on sutures, and it is even advisable to use it on fresh wounds to promote wound healing and to disinfect the wound as well, to avoid the formation of biofilms. There is also no contraindication to using it on staples or on metal implants.
