Topical exposure of nitric oxide gas to wounds such as chronic non-healing
wounds may be beneficial in promoting healing of the wound and in
preparing the wound bed for further treatment and recovery. Nitric oxide
gas may be used, for example, to reduce the microbial infection and
burden on these wounds, manage exudate secretion by reducing
inflammation, upregulate expression of endogenous collagenase to locally
debride the wound, and regulate the formation of collagen. High
concentration of nitric oxide ranging from about 160 to 400 ppm may be
used without inducing toxicity in the healthy cells around a wound site.
Additionally, exposure to the high concentration for a first treatment
period reduces the microbial burden and inflammation at the wound site
and increase collagenase expression to debride necrotic tissue at the
wound site. After a first treatment period with high concentration of
nitric oxide, a second treatment period at a lower concentration of
nitric oxide preferably ranging from about 5-20 ppm may to provided to
restore the balance of nitric oxide and induce collagen expression to aid
in the closure of the wound.