Orthopaedic implant infections are a significant burden on health care systems. They can be particularly difficult to treat due to the ability of bacteria to form biofilms on the implant surface as well as the rising occurrence of antimicrobial resistant bacterial species including Staphylococcus aureus. Current treatments include wound debridement and treatment with antibiotics, however in some cases this is not adequate, and the implant must be removed via revision surgery. Cold atmospheric plasma (CAP) and plasma functionalised liquids (PFLs) have antimicrobial properties which could be used as a treatment for orthopaedic implant infections. The aim of this research is to optimise a PFL treatment to treat methicillin resistant Staphylococcus aureus biofilms.
In this study PFLs generated by two in-house plasma arrangements are investigated, namely, a spark/glow ~25kHz frequency plasma jet and a microwave ~2.45 GHz frequency plasma jet. The chemistry of the liquids is compared using colorimetric and ion chromatographic methods. The efficacy of the liquids is assessed against planktonic S. aureus and S. aureus biofilms with maturities ranging from 24 hours to 72 hours. Our study shows PFLs generated from different plasma arrangements give distinct liquid chemistries as well as different efficacies for biofilm eradication. Notably, this study finds that PFLs are more effective against the planktonic form of S. aureus. Further, this study assesses the clinical efficacy and safety of the optimised PFLs against mature biofilms, singularly employed or in combination with direct CAP treatments.
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