Antibacterial and Antifungal Activity of a Cold Atmospheric Nitrogen Plasma Device in Porcine Burn and Excisional Wound Models: A Consolidated Pilot Evaluation

Cold atmospheric plasma (CAP) has emerged as a novel antimicrobial therapy for wound management; however, in vivo evidence for nitrogen-based CAP across distinct wound types remains limited. This consolidated pilot study evaluated the antimicrobial efficacy of a nitrogen CAP device using two specific pathogen-free (SPF) minipig models: partial-thickness burns (n = 2, 20 wounds) and full-thickness excisional wounds (n = 1, 10 wounds). Wounds were assigned to the vehicle control or plasma treatment (six sessions over 14 days). Microbial bioburden was quantified on tryptic soy agar (TSA) and Sabouraud dextrose agar (SDA). At day 14, animal-level analysis showed TSA reductions of 67.8–73.4% (pooled Cohen’s d = 2.10; presented as a descriptive pilot effect-size estimate) and SDA reductions of 58.4–68.5%. Wound-level linear mixed-effects model sensitivity analysis suggested reductions on both TSA and SDA, with a non-significant treatment × wound type interaction. Exploratory histopathology showed a trend toward accelerated epithelialization, with no device-related adverse events. These findings provide preliminary in vivo evidence that nitrogen-based CAP reduced cultivable bacterial and fungal burden in both wound types and support the design of adequately powered confirmatory studies.