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Clinical Research
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A Multinational, Multicenter, Radomized, Double Blind, Placebo Controlled Trial to Evaluate the Efficacy of Cyclical Topical Wound Oxygen Therapy (TWO2) in the Treatment of Chronic Diabetic Foot Ulcers: The TWO2 Study
Clinical Research
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Topical oxygen therapy for diabetes-related foot ulcers: A systematic review and meta-analysis
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Guidance Documents

Oxygen is a vital component of basic and advanced wound healing. It plays a major part in intricate cellular processes involved with healing all types of wounds. Understanding the pathophysiology of a hypoxic situation at the tissue level is vital in establishing the types of wounds that will benefit from oxygen therapy. The options for comprehensive therapy are discussed in depth; indications such as venous leg ulcers and chronic venous insufficiency, as well as diabetic foot ulceration are also reviewed in this article. A summary of recent topical oxygen therapy evidence is presented, as well as the myths surrounding oxygen therapy. This guide is aimed at providing support for clinicians wishing to incorporate oxygen into their practice.
Guidance Documents

Oxygen therapy is a well evidenced modality of care in clinical wound practice. It can provide many benefits, such as a reduction in hospitalizations and amputations for diabetic foot ulceration patients. This article provides a practical top ten tips for the methods of optimization of oxygen therapy in your practice; taking into account factors for delivery of this modality such as activity, wound impacting factors; comfort, economic impact; geographic factors, capable participation level; compliance/ adherence, number of wounds and severity, and active infections, all of which will be discussed in this article to improve patient care delivery.
Guidance Documents

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Case Studies

Calciphylaxis, also known as calcific uremic arteriolopathy, is a rare disorder that presents with painful, necrotic, ischemic skin and tissue lesions resulting from reduced blood flow. Most often noted in patients with end-stage renal disease (ESRD) who are undergoing hemodialysis, it is highly lethal and poorly understood. While there is no recognized standard of care for treatment, sodium thiosulfate (STS) injections and hyperbaric oxygen therapy (HBOT) are often trialed in addition to standard evidence-based wound care.
Case Studies

Diabetes mellitus is a metabolic disorder associated with so many complications including diabetic foot syndrome. International Diabetes Federation (IDF) 2021 data reveals that globally 537 million people are suffering from disease & estimated to reach up to 783 million in 2045. In Indian subcontinent (SEA) about 90 million people in the year 2021 estimated to reach 152 million in the year 2045. [1] Diabetic foot syndrome characterized by infection; soft tissue damage & diabetic foot ulcer (DFU) due to diabetic peripheral neuropathy [2]. The prevalence of DFU in type 2 diabetes is 6.4% globally, with 6.38% in South India, and 14.30% in North India. DFU increases risk for lower extremity amputations [3] Many surgical and non-surgical treatments are available to tackle this problem including wound debridement, skin grafting, revascularization, frequent dressing of the wound site with offloading of foot and ultimately amputation in very severe cases to save the life of patient. Primary factor enhancing wound healing process, is oxygen. Hyperbaric oxygen therapy shown benefits in wound healing with adverse effect oxygen toxicity & barotrauma. Topical oxygen therapy (TOT) are safer alternative. It bypasses oxygen transport system & creating oxygen-rich wound bed environment & improved pH levels, helps to cure infection, enhance wound healing & rate of wound closure in chronic non-healing DFUs [4]