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Healthcare Professionals

Healthcare Professionals

Multimodality cyclical-pressure Topical Wound Oxygen (TWO2) therapy has been proven in multiple clinical studies to deliver faster, better quality, and more sustainable natural wound healing. TWO2 is an especially effective adjunctive treatment modality for chronic non-healing and acute complex wounds.

Recent high-quality randomized controlled trials (RCTs) and real-world evidence (RWE) studies have demonstrated that TWO2 therapy results in more durable healing and provides significant clinical, quality of life and cost saving benefits.

Most difficult to heal wounds have complicated etiologies resulting in an oxygen deficit in the wounded tissue. Furthermore, superior wound healing can only occur at oxygen levels greater than those delivered by a healthy blood supply.

TWO2 therapy has three component mechanisms


TWO2 provides the highest penetration of oxygen into the wounded tissue. The immediate availability of oxygen at a partial pressure of approximately 800 mmHg provides the greatest diffusion gradient into the tissue and supercharges cellular activity.

TWO2 propels stalled non-healing wounds that lack adequate oxygen, which prevents essential enzymic production responsible for cellular metabolism, collagen production and immune response to fight infection, into a robust healing pathway.

TWO2 kickstarts the stalled Inflammatory process – The higher level of oxygen provides fuel for ATP synthesis that stimulates the wound to progress out of the stalled Inflammatory state

TWO2 amplifies local immune response to fight infection

Upregulation of leukocyte function potentiates both neutrophil effectiveness and any concurrent antibiotic therapy being utilized to treat infected wounds. As bacterial metabolism accelerates, senescent bacteria become more susceptible to these defensive mechanisms. The increased oxygen levels also have a direct bactericidal effect on any anaerobic bacteria present.

TWO2 stimulates the proliferation of angiogenesis

An increase in the production of vascular endothelial growth factors (VEGF) results in prolific angiogenesis and new blood vessel growth. Additionally, there is a synergistic effect of oxygen on the reactive oxygen species (ROS) needed for transforming growth factor beta (TGFβ) and platelet-derived growth factor (PGF).

TWO2 promotes stronger collagen synthesis

Promotes the synthesis of superior quality triple-helix collagen for improved tensile strength, while healing the wound with ideal histology that results in little to no scarring, healthy desquamation, reducing the risk of callus formation, resulting in lower recurrence.


The non-contact cyclical compression provided is between 10 mb and 50 mb pressure that is equivalent to a level 3 conventional compression dressing (CCD). This helps to reduce both edema and the hydrostatic pressure in the lower leg that is a frequent component of lower extremity peripheral vascular disease. The higher positive pressure more effectively delivers oxygen deep into the wound bed, thereby encouraging granulation from the base. The cyclical nature of the pressure delivery eliminates concerns when treating ischemic wounds.

Non-contact cyclical compression:
  • Reduces edema
  • Decreases resistance to arterial flow
  • Improves oxygen diffusion and wound bed perfusion
  • Aids the passage of nutrients to wounded tissues
  • Accelerates the elimination of metabolites
  • Stimulates damaged end arteries to promote angiogenesis
  • Prevents the collapse of tunnels and fistulas, avoiding the formation of abscesses


A medical nebulizer delivers particulate humidity to the chamber to create an ideal moist wound healing environment.

TWO2 therapy may be performed with gas permeable dressings left in place.
The recommended* frequency and duration of therapy is:
  • Multi-Patch – 60 minute a day x 7 days a week
  • Extremity Chamber – 90 minute a day x 5 days a week

*Prescribers may determine alternative frequency or duration depending on an individual patient’s medical needs

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