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The effectiveness of different CAP devices for the treatment of hard-to-heal wounds is well documented by clinical case series and randomised controlled studies. The aim of this prospective, observational study was to investigate the bacterial load and composition in hard-to-heal wounds following CAP treatment, and the impact on long-term wound healing outcome. A total of 22 patients were included in the study. All wounds were exposed to the argon-driven CAP jet kINPen Med (neoplas med GmbH, Germany), in addition to standard phase-adapted wound care. A digital wound camera monitored wound area development over time, while swab tests monitored bacterial colonisation. The results showed that CAP application significantly reduced the bacterial burden almost immediately, although this reduction was not maintained. The analysis revealed a better healing tendency when wounds were colonised by Gram-positive bacteria as opposed to Gram-negative bacteria. Moreover, a higher susceptibility of Gram-negative bacteria to the CAP jet was detected. In conclusion, the bacterial composition of wounds might affect the healing outcome during CAP therapy.<\/jats:p>","DOI":"10.12968\/jowc.2023.0295","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T17:50:12Z","timestamp":1775152212000},"page":"332-341","source":"Crossref","is-referenced-by-count":0,"title":["Bacterial composition and healing tendency with cold atmospheric plasma treatment in diabetic wounds"],"prefix":"10.12968","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4762-7156","authenticated-orcid":false,"given":"Sybille","family":"Hasse","sequence":"first","affiliation":[{"name":"Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liane","family":"Kantz","sequence":"additional","affiliation":[{"name":"Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany"},{"name":"Diabetes Competence Center Karlsburg (KDK), Leibniz Institute for Plasma Science and Technology (INP), Karlsburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rn","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Clinic for Diabetes and Metabolic Diseases, outpatient foot clinic, Karlsburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas von","family":"Woedtke","sequence":"additional","affiliation":[{"name":"Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany"},{"name":"Greifswald University Medicine, Institute for Hygiene und Environmental Medicine, Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5130","reference":[{"key":"e_1_3_2_1_2","unstructured":"International Diabetes Federation. 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