Cold Atmospheric Plasma for the Treatment of Superficial Driveline Infections in Patients with Left Ventricular Assist Devices

Purpose Despite all innovations in continuous flow left ventricular assist devices (cfLVAD) wound infections are still leading factors for morbidity and mortality in VAD patients. Over the last years, cold atmospheric plasma (CAP) has been safely and effectively used to treat superficial infections. Thus, in this study we present our results using CAP for the treatment of superficial driveline infections (SDI). Methods We describe a two center experience with 25 patients (21male, 4 female) and 32 treatments, who were implanted between 2012 and 2018 and developed a SDI in the follow up. 17 cases were treated inhospital, 9 in an outpatient clinic and 6 were treated in both. All wounds were treated with CAP (kinPen MED) starting from the day of diagnosis. Results The average number of CAP applications per case was 11.2 times (1-49), median duration of hospital stay due to SDI was 25 days (5-106). 19 cases were additional treated with antibiotics (59%). In 9 cases (28%) occurred an ascending driveline infection (ADI) requiring surgical revision. The 3 month event free survival was 23 cases (72 %). There were no adverse side effects of CAP therapy observed and there were no abnormalities of cfLVAD during CAP treatment. Conclusion In our study we demonstrate that CAP therapy could be effectively and safely applied in cfLVAD patients with SDI. Using CAP 72% of our cases with SDI were prevented from ADI. Future studies have to show if ambulant CAP therapy of superficial cfLVAD wound infections has the potential to prevent progression of infection or to avoid SDI infection at all as prophylactic therapy.