Background: Nitric oxide (NO) is known for decades to play a crucial role in many physiological
processes: this includes acting as an anti-microbial mediator/agent, vasodilator, inhibitor of
platelet aggregation, immune modulator, and tissue regeneration via regulation of epidermal cell migration,
collagen deposition and cytokine/chemokine microenvironment, making it a key player in wound
Methods: In order to demonstrate the therapeutic benefits as well as the safety of a NO wound irrigation
solution, a broad literature review summarizing efficacy and safety data was conducted.
Results: Beneficial effects on wound healing have been demonstrated in several non-clinical and clinical
studies. The combination of NO and wound rinsing seems to be a promising approach in terms of
improved wound healing of chronic wounds.
Conclusion: Based on the results, no safety concerns are expected for a daily 15 minutes use of a NOgenerating
rinsing solution system for wound irrigation of diabetic foot ulcers in adults.
Keywords: Nitric oxide, chronic wound, treatment, efficacy, toxicity, diabetic foot ulcer
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