AOTI's TWO2 topical wound oxygen therapy logo

Topical Wound Oxygen Therapy

A safe, non-invasive, adjunctive therapy that helps address the fundamental reasons chronic wounds fail to heal.

Now Available in Australia

TWO2 topical wound oxygen therapy logo with seated leg

Topical Wound Oxygen Therapy

A safe, non-invasive, adjunctive therapy that helps address the fundamental reasons chronic wounds fail to heal.

Now Available in Australia

Close Wounds Faster. Better.

Topical Wound Oxygen (TWO2) Therapy was designed by Advanced Oxygen Therapy Inc (AOTI) to provide more durable healing of unresponsive wounds.

It achieves this by delivering maximum penetration of oxygen into wounded tissue, which reverses wound tissue hypoxia. This creates an environment that stimulates the cellular mechanisms needed to form new blood vessels and grow strong patient tissue.

As oxygen pressure is cycled within a sealed environment, the limb receives non-contact compression, which reduces peripheral oedema and stimulates wound site perfusion. Added humidification helps to maintain an ideal moist wound healing environment.

Treatment can be performed in the comfort of one’s home without removing (gas-permeable) dressings. 90 minutes a session, as recommended by the treating clinician.

Save Limbs. Save Costs. Improve Quality of Life.

Backed by Randomised Controlled Trials and Retrospective Cohort Studies

A Randomised Control Trial (RCT) demonstrated that Topical Wound Oxygen (TWO2) therapy was 6 times more likely to heal a stubborn diabetic foot ulcer at 12 weeks compared to optimal standard-of-care, after adjusting for ulcer severity. Healed ulcers were 6 times less likely to recur at 12 months.1

A retrospective cohort study demonstrated that treating diabetic foot ulcers with TWO2 therapy is associated with significant reductions in hospitalisations (88%) and amputations (71%) in the real-world setting.2


  1. Robert G. Frykberg, Peter J. Franks, Michael Edmonds, Jonathan N. Brantley, Luc Téot, Thomas Wild, Matthew G. Garoufalis, Aliza M. Lee, Janette A. Thompson, Gérard Reach, Cyaandi R. Dove, Karim Lachgar, Dirk Grotemeyer, Sophie C. Renton, on behalf of the TWO2 Study Group; A Multinational, Multicenter, Randomized, Double-Blinded, Placebo-Controlled Trial to Evaluate the Efficacy of Cyclical Topical Wound Oxygen (TWO2) Therapy in the Treatment of Chronic Diabetic Foot Ulcers: The TWO2 Study. Diabetes Care. 1 March 2020; 43 (3): 616–624.
  2. Jessica Izhakoff Yellin, Julia A. Gaebler, Frank F. Zhou, Timothy Niecko, Olivia Novins, Amelia Ockert, Darcy Krzynowek, Matthew G. Garoufalis, Aliza M. Lee, and Robert G. Frykberg. Reduced Hospitalizations and Amputations in Patients with Diabetic Foot Ulcers Treated with Cyclical Pressurized Topical Wound Oxygen Therapy: Real-World Outcomes. Advances in Wound Care. 6 December 2021.

A Unique Multi-modal Approach

Oxygen two2 topical wound oxygen therapy


High pressure delivery results in greater tissue diffusion critical to restoring normal wound metabolism, resulting in more effective and durable healing.

Compression TWO2 topical wound oxygen therapy


Non-contact cyclical compression addresses edema and helps correct for the underlying peripheral vascular disease.

Humidification TWO2 Topical Wound Oxygen Therapy


Assures an ideal moist wound environment, promoting healthy granulation tissues for faster, more effective and durable healing.

The Benefits of TWO2 Therapy

80% Wound Closure Rate

Unprecedented closure rates in all wound stages

Significant Pain Reduction

Rapid reduction in wound related pain by over 75% within 3-4 weeks of commencing treatment.

Cost Savings

The ability to reduce healing times and complications can lead to significant cost savings.

Non Invasive Safe Therapy

Topical Wound Oxygen Therapy is easily applied and integrated into any Acute, Long Term and/or Chronic Wounds.

Before & After TWO2 Therapy

Foot Wounds

Foot TWO2 Topical Wound Oxygen Therapy treatment before

Foot TWO2 Topical Wound Oxygen Therapy treatment after

Leg Wounds

before TWO2 treatment leg

after TWO2 treatment leg

TWO2 Therapy System Components

TWO2 Topical Wound Oxygen Therapy controller


In-home Controller provides time therapy and cyclical pressure. Oxygen Concentrator is provided separately.

TWO2 Topical Wound Oxygen Therapy Extremity-Chamber

Extremity Chamber

Medium and large single-use extremity chamber.

TWO2 In-Home Setup Training Video

Frequently Asked Questions

Product Usage

Will my patients be able to use the Therapy themselves; I am concerned about ease of use and compliance?

Yes, most patients do not need assistance to use TWO2 therapy. TWO2 therapy has a few simple set up steps. Before first use, the patient will be instructed on how to set up and use the TWO2 therapy. Additionally, easy instructions are provided on the screen of the TWO2 Controller to guide the patient step-by-step.

What is the time commitment required for the TWO2 therapy for the Extremity Chamber?

Each Extremity Chamber session is for 90 minutes, as recommended by the treating clinician. Patients often complete their session while enjoying other activities such as reading, watching television, or the like.

How long will my patients be on Therapy?

The duration of the Therapy depends on the severity and complexity of the wound.

Is it painful?

TWO2 therapy is not painful.

When is the best time of day to perform Therapy?

TWO2 therapy can be performed at any time. It is best to perform TWO2 therapy when the Patient can comfortably sit or lay down for the duration of the treatment.

When should I consider using TWO2 therapy?

TWO2 therapy can be used on acute and chronic wounds where it is determined to be clinically necessary or beneficial.

Wound Types and Management

On what types of wounds can TWO2 therapy be used?

TWO2 therapy is cleared for use for treating chronic and acute wounds.

Do I need to treat the wound bed in any special manner before using the TWO2 therapy?

Using TWO2 therapy does not change what you do as part of standard of care for wound bed preparation, which includes debridement of devitalized and necrotic tissue, moisture and infection management.

Are there any contra-indications for TWO2 therapy?

TWO2 should not be used in the presence of acute thrombophlebitis, or Deep Vein Thrombosis.

I often see patients that have wounds that are infected; can I still use the TWO2 therapy?

Yes, TWO2 therapy can be used in the presence of infection. The infection should be concomitantly managed as instructed by the treating prescriber.

Can I use the TWO2 therapy with a wound with osteomyelitis (OM)?

Yes, TWO2 therapy can be used in combination with appropriate osteomyelitis treatments as instructed by the treating prescriber .

Are there any dressing that are particularly recommended for use with the TWO2 therapy?

Any gas permeable as instructed by the treating prescriber.

Can I use TWO2 therapy concurrently with Negative Pressure Wound Therapy (NPWT)?

The therapies are not compatible for use at the same time but may be used sequentially.

Can Patients use TWO2 therapy where there is poor arterial circulation?

TWO2 therapy can be used with Patients who have poor circulation. The compression used in TWO2 therapy is cyclical and is not held constant, so therefore does not reduce distal perfusion.

Does the Patient need to remove dressings before treatment?

Gas permeable dressings are compatible with TWO2 therapy and may be left in place.

Is TWO2 therapy only used at home?

TWO2 therapy may be used in any healthcare setting, including; hospitals, outpatient, as well as, Skilled Nursing Facilities and nursing homes, etc.


What makes TWO2 therapy different from full body Hyperbaric Oxygen Therapy (HBOT)?

HBOT is the systemic delivery of oxygen though the body by blood vessels that need to be intact for oxygen to reach and help close to the wound. TWO2 therapy is a multimodality that delivers oxygen directly to the wound site and does not rely on good blood circulation. TWO2 therapy provides a higher pressure topical oxygen delivery (pO2 ≈ 800 mmHg) which results in superior tissue oxygenation. This effective delivery of oxygen is combined with cyclical non-contact compression and humidification. TWO2 therapy is convenient for use in settings easily accessible for the patient, is less expensive, and does not have the practical limitations and a number of relative contraindications associated with HBOT.

Is this a new therapy?

Over 20,000 patients have been treated with TWO2 therapy. Two million TWO2 treatments have been applied by the patients at home.

What clinical evidence do you have to support the use of TWO2 therapy? Has TWO2 therapy been tested on humans?

TWO2 therapy is supported by a large number of studies. Research results from studies in humans have been published in leading Scientific journals, such as Diabetes Care, Advances in Wound Care, Ostomy and Wound Management (OWM), Vascular and Endovascular Surgery, and International Wound Journal.

Where can I get additional information?

Feel free to connect with us via any of the contact methods on our Contact page, which include telephone, email and a contact form.

AOTI publishes some informative videos on Youtube.