Biomedical accessibility of plasma-treated liquids in surgical procedures - the prevention of postoperative abdominal adhesions*

The prevention of postoperative abdominal adhesions is one of several indications for the intracorporeal use of plasma-treated liquids (PTL). Peritoneal adhesions as a result of tissue trauma during surgery are a major clinical problem, affecting around 93% of patients. Tissues and organs stick together due to abnormal wound healing, leading to pain, secondary infertility or even bowel obstructions. Biomedical accessibility of PTL in surgical procedures currently lacks the technical implementation of sterility, continuity, compaction and transportability.

We developed a compact DBD plasma-unit consisting of a top electrode (49 mm), a 3D-printed biocompatible fluidic layer, separated from the plasma discharge (2.5 mm gap, argon gas supply) by a semi-permeable PTFA membrane attached with a lid and a sealing ring enabling continuous liquid perfusion and PTL generation. The biologically reactive plasma species transpires via the electrical field to the ground electrode at the bottom of the platform.

We found a significant reduction in the adhesive properties of mesothelial cells using a talcum-based in-vitro adhesion model. Next, the results were expanded towards “in-vivo-like” patient-derived on-chip models. Biocompatibility of PTL was confirmed in a rabbit model. Furthermore, we found a dose-dependent antiproliferation and identified cell-type specific effects on cytoskeletal regulation, cell cycle control, apoptosis and various intracellular signaling pathways via protein analysis.