Hydrogen Peroxide Enhances the Therapeutic Efficacy of Plasma-Activated Gas for Infected Wound Treatment

Plasma-activated gas (PAG) offers advantages over direct plasma for wound treatment but suffers efficacy loss due to reactive species quenching by wound exudate proteins. To overcome this, we propose combining PAG with hydrogen peroxide (H₂O₂). In vitro sterilization experiments revealed that co-treatment with 1% H₂O₂ and PAG on Staphylococcus aureus (S. aureus) suspensions containing bovine serum albumin (BSA) achieved a bacterial reduction exceeding six orders of magnitude, enhancing generation of H₂O₂, NO₃⁻, and ONOO⁻. Animal experiments demonstrated that in infected wounds, PAG-H₂O₂ co-treatment significantly reduced bacterial load. Immunohistochemical and biochemical analyses showed this combination promoted healing by suppressing inflammation and inducing growth factors, without systemic toxicity. This novel approach markedly amplifies the therapeutic efficacy of PAG in treating infected wounds.