Welcome to the 5′-TOP-3′ Blog - Insights into Physical Plasma Medicine

Dear readers,

a very warm welcome to the brand-new blog of 5′-TOP-3′.

This platform is dedicated to news, developments, and scientific perspectives from a still relatively young, yet highly dynamic field of research and innovation: physical plasma medicine.

Our goal is to create a space where knowledge is shared, ideas are discussed, and a growing interdisciplinary community can stay informed about one of the most exciting frontiers in modern medicine and technology.

Who is this blog for?

This blog is intentionally designed for a broad and diverse audience.

We address practitioners from human medicine, dentistry, and veterinary medicine, as well as students in medical and biomedical disciplines. At the same time, we welcome researchers, engineers, and developers working on physical plasma technologies, companies involved in medical device innovation, and curious readers without specialized background knowledge who are simply interested in emerging therapeutic approaches.

Physical plasma medicine is, by its very nature, an interdisciplinary field. It sits at the intersection of physics, biology, engineering, and clinical medicine. This diversity is one of its greatest strengths, but it also makes communication across disciplines particularly important.

Although the scientific community working in this field continues to grow steadily, it is still relatively small in comparison to more established areas of research. What is remarkable, however, is the strong international role played by Germany and the broader DACH (Germany, Austria, Switzerland) region. Many foundational studies, technological innovations, and early clinical applications originate from this part of the world.

To enhance the international visibility of this field and to facilitate exchange within the global community, all blog articles will be published in English. This allows research, discussions, and perspectives from the German-speaking scientific landscape to be more easily shared and recognized worldwide.

A recurring question: What do we actually call "physical plasma medicine"?

To kick things off, we want to address a topic that has accompanied physical plasma medicine for many years and continues to spark discussion: terminology.

Anyone who has explored the scientific literature in this field will quickly notice something striking. There is not just one term for physical plasmas used in medicine, but a whole range of them.

You may come across expressions such as:

Non-invasive physical plasma, cold plasma, cold physical plasma, cold atmospheric plasma, cold atmospheric physical plasma, cold atmospheric pressure plasma, cold atmospheric physical pressure plasma, tissue tolerable plasma, tissue tolerable physical plasma, non-thermal plasma, non-thermal physical plasma, non-thermal atmospheric plasma.

And this list is likely not even exhaustive.

At first glance, this might seem like a harmless linguistic curiosity. In reality, however, this diversity of terminology creates real challenges. It complicates literature searches, makes it harder to compare studies, and can be particularly confusing for newcomers trying to gain an overview of the field.

One of the most commonly used abbreviations is CAP, standing for cold atmospheric plasma. From a physics perspective, this term makes sense. From a medical point of view, however, it raises several important questions.

Why the term “cold” can be misleading in medicine

In physics, the word “cold” has a very specific meaning. It refers to the fact that the heavy particles in the physical plasma, such as ions and neutral gas molecules, remain at relatively low temperatures, while the electrons can have much higher energies.

In medicine, however, the term “cold” is interpreted very differently.

Clinicians typically associate “cold” with temperatures close to freezing. Therapeutic procedures that deliberately use low temperatures are known as cryotherapies, where tissue is intentionally frozen to destroy diseased cells.

The temperatures encountered in medical physical plasma applications are entirely different. They are typically around 40 °C, which is close to or slightly above normal body temperature.

From a medical perspective, this is clearly not “cold.” Using the term “cold physical plasma” can therefore be misleading. It may suggest conditions that are not actually present in clinical use. Moreover, it implicitly raises the question of whether there is such a thing as “hot plasma” used therapeutically.

High-temperature physical plasmas do exist in physics, of course, but they do not play a role in medical therapy. For clinicians, the descriptor “cold” provides little practical value.

The problem with “atmospheric”

The second part of the term CAP, namely “atmospheric,” can also lead to misunderstandings.

In plasma physics, this term indicates that the physical plasma is generated at atmospheric pressure, meaning under normal environmental conditions rather than in a vacuum or at very low pressures. Technologically, this is indeed significant, as many traditional physical plasma applications require reduced pressure environments.

In medicine, however, treatment at atmospheric pressure is simply the default condition. Only a few specialized fields, such as diving medicine, operate under significantly different pressure conditions. For most medical users, this information is therefore not particularly relevant.

In addition, the term “atmospheric” may be interpreted as meaning that the physical plasma is generated directly from ambient air. While this is true for some devices, many physical plasma systems use carrier gases such as argon, helium, pure oxygen, or defined gas mixtures. In these cases, the physical plasma is not strictly “atmospheric” in origin, even though it is generated at atmospheric pressure.

“Plasma” means something else in medicine

Another important issue concerns the term “plasma” itself.

In medicine, the word “plasma” is almost automatically associated with blood plasma, the liquid component of blood that contains proteins, hormones, and electrolytes. Biologists may also think of the cytoplasm within cells.

To avoid confusion, it is therefore helpful to explicitly refer to physical plasma.

In physics, "plasma" describes an ionized state of matter. It is often referred to, somewhat simplistically, as the fourth state of matter, alongside solids, liquids, and gases.

This clarification is not just theoretical. In practice, it makes a real difference. During presentations and discussions, it is not uncommon to see initial confusion when the term “plasma” is introduced. Many listeners instinctively think of blood.

Over time, it becomes almost second nature to clarify immediately that we are talking about physical plasma, not biological liquids.

Other terms can also cause confusion

Beyond CAP, several other expressions used in the literature can be problematic.

Take, for example, the term “tissue tolerable plasma”.

The intention behind this phrase is to emphasize that the treatment is biologically well tolerated. However, in certain contexts, particularly in oncology, this wording can be misleading. In cancer therapy, the goal is often to damage or eliminate diseased tissue, such as tumor cells.

Another example is the term “gas plasma.” From a physical point of view, this is somewhat imprecise. Matter is either in a gaseous state or in a plasma state, where a significant fraction of particles is ionized and collective electromagnetic interactions occur.

Why terminology should reflect the medical context

As physical plasma applications continue to develop in medicine, it may be beneficial to adapt terminology more closely to the needs and perspectives of medical users.

This does not mean oversimplifying or ignoring the underlying physics. Modern medicine has long relied on highly complex physical technologies. Imaging modalities such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT), as well as advanced radiation therapy systems, are based on sophisticated physical principles.

However, for clinical practice, what ultimately matters is that users can apply the technology safely and interpret its effects correctly. A complete understanding of every technical detail of device engineering is not always necessary.

Clear, intuitive terminology can significantly facilitate this process.

A possible step forward: Non-Invasive Physical Plasma

Against this background, the term “non-invasive physical plasma” (NIPP) represents an interesting alternative. This designation has emerged from discussions within the scientific community and offers several advantages.

First, it explicitly refers to physical plasma, thereby avoiding confusion with blood plasma.

Second, it highlights a medically relevant characteristic: non-invasiveness. In medicine, a procedure is considered non-invasive if it does not penetrate the body or cause significant structural damage to tissue.

In many cases, plasma applications meet these criteria. Their biological effects are primarily mediated by reactive oxygen species (ROS), which can influence cellular signaling pathways.

Importantly, these effects are achieved without substantial energy transfer to the tissue. Unlike laser or electrosurgical procedures, physical plasma treatments typically do not cause significant thermal destruction.

Side effects and tissue effects

Available studies and clinical experience suggest that severe side effects associated with physical plasma applications are rare.

In the case of physical plasma jets, where a continuous gas flow is directed at the tissue, mild drying of the treated area may occasionally occur. Temporary redness has also been reported. These effects are generally mild and reversible.

In contrast to ablative techniques, no significant volume of tissue is removed. Instead, plasma induces biological responses at the cellular level, including antimicrobial effects and modulation of cellular signaling pathways.

Why minimal tissue damage can be beneficial

A key principle in medicine is that minimizing unintended damage to surrounding tissue often leads to better healing outcomes.

This concept is well established across many fields. A good example is surgery. Modern minimally invasive procedures, often referred to as keyhole techniques, use very small access points. Compared to large surgical incisions, they typically result in faster recovery, less pain, and fewer complications.

Reduced tissue damage also helps preserve the function of the affected area. Scar tissue, for instance, can impair normal physiological processes. In the gastrointestinal tract, for example, scarring may reduce or even disrupt nutrient absorption.

Physical plasma applications follow a similar logic. Instead of mechanically removing tissue or destroying it through high temperatures, they aim to influence biological processes in a targeted manner while preserving overall tissue structure.

Looking ahead

At first glance, discussions about terminology may seem like purely academic exercises.

In reality, language plays a crucial role in shaping scientific fields. Clear and consistent terminology facilitates communication, supports research, and ultimately enables clinical implementation.

In the upcoming posts on this blog, we will explore various aspects of physical plasma medicine in more detail. Topics will include fundamental scientific principles, technological developments, clinical applications, and future perspectives.

This field is still young, highly interdisciplinary, and full of open questions.

And that is precisely why it is worth talking about.

Thank you for being here.

Welcome to 5′-TOP-3′.