Review of clinical applications of nitric oxide-containing air-plasma gas flow generated by Plason device

Abstract Background: Nitric oxide (NO) is a gaseous molecule produced by NO-synthases that regulates a wide range of physiological and pathophysiological processes. Endogenous NO signaling system plays an important role in all stages of wound healing. In 1998, a team from Bauman Moscow State Technical University and Sechenov First Moscow State Medical University (Sechenov University) developed the Plason device. Plason generates NO-containing air-plasma flow from atmospheric air and allows to apply required doses of NO to affected areas. It was shown, that exogenous NO penetrates through a wound surface, an intact skin, mucous membranes and a cornea, which leads to the wide range of applications. The experimental and clinical studies of 1992–2005 proved exogenous NO-therapy to be beneficial in patients with extensive purulent wounds, trophic ulcers, diabetic foot syndrome, purulent-inflammatory disease of soft tissues and scars. Methods: Up to now Plason is the only certified in Russia and Europe medical device generating NO from atmospheric air at high therapeutically significant concentrations (500-1200 ppm). It is used in Russia, Ukraine, Belarus and Slovakia. Other air-plasma devices, “Tianox” (Sarov, Russia) and “iNO pulse” (Bellerophon Inc., USA) generated low concentrations of NO (10-100 ppm) were found effective against severe acute respiratory syndrome and recently tested for treatment of COVID-19. The purpose of this review is to acquaint global medical community with the extensive experience of Russian clinicians in NO-therapy. It covers the NO-therapy studies in multiple medical fields published after 2006. Results and Conclusions: Application of the Plason device was beneficial in treatment of wounds, purulent, traumatic and scar lesions, joint diseases, including sports injuries, as well as in abdominal surgery, dentistry, ophthalmology, otolaryngology and other areas of medicine.