Takes Two to Save Two Diabetic Feet

 

Healing Diabetic Foot Ulcers with Oxygen: Understanding TWO2 Therapy

Diabetic foot ulcers (DFUs) are a painful and frustrating complication of diabetes, often resistant to healing and at risk of infection, gangrene, and even amputation. While traditional wound care — dressings, debridement, offloading, and antibiotics — remains the cornerstone of management, some stubborn wounds need something more. This is where TWO2 therapy comes into the picture.

What is TWO2 Therapy?

TWO2 stands for Topical Wound Oxygen therapy — an advanced wound-healing approach that delivers pressurized oxygen directly to the wound site. Unlike hyperbaric oxygen therapy (HBOT), which involves placing the entire body in a chamber, TWO2 targets only the wound itself using a specially designed, portable system.

Think of it as giving your wound a concentrated dose of oxygen — exactly where it’s needed the most.

 

How Does It Work?

Oxygen is critical for tissue repair, immune defense, and the formation of new blood vessels. But many chronic wounds, especially in diabetic patients, suffer from poor blood flow and oxygen deficiency.

TWO2 therapy works through a sealed, pressurized chamber that wraps around the affected limb (usually the foot or leg). Inside, it delivers:

• 100% pure oxygen
• In cyclic pressure pulses, improving oxygen absorption and circulation

This combination accelerates healing in several ways:

• Promotes angiogenesis (new blood vessel growth)
• Boosts collagen synthesis and skin repair
• Enhances white blood cell activity to fight infection
• Reduces local swelling and inflammation

 

Why Is It Beneficial for Diabetic Foot Ulcers?

Patients with diabetes often have multiple challenges — neuropathy, reduced blood flow, and impaired immune response. These make ulcers harder to heal.

Clinical studies show that TWO2 therapy:

• Increases wound healing rates significantly
• Is especially effective in non-healing ulcers that haven't responded to standard care
• Can reduce the need for amputation when used in time

A 2020 study published in Diabetes Care showed that TWO2-treated patients were twice as likely to achieve complete wound closure compared to those receiving only standard care.

 

Who Can Use TWO2?

TWO2 therapy is most suitable for:

• Chronic diabetic foot ulcers
• Venous leg ulcers
• Pressure ulcers or non-healing surgical wounds
• Patients with adequate arterial supply, but local hypoxia

It's generally used 5-7 times per week, for sessions lasting 60–90 minutes, and can often be administered at home under guidance.

 

Is It Safe?

Yes — TWO2 is non-invasive, painless, and well-tolerated. Most patients report no discomfort during the sessions. However, it should not be used in:

• Wounds with untreated infections
• Necrotic tissue without proper debridement
• Patients with severe peripheral arterial disease (unless revascularized)

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TWO2 vs. Hyperbaric Oxygen: What's the Difference?

Feature	TWO2 Therapy	Hyperbaric Oxygen Therapy (HBOT)
Application Site	Directly to the wound	Whole-body chamber
Portability	Home or clinic use	Hospital-based
Oxygen Delivery	Topical, cyclically pressurized	Systemic, at high pressure
Risk of Systemic Side Effects	Minimal	Possible (e.g., ear barotrauma)
Cost & Convenience	More accessible	More resource-intensive

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Final Thoughts

TWO2 therapy is a promising, patient-friendly advancement in the management of chronic diabetic foot ulcers. By delivering life-giving oxygen right where it's needed, it offers new hope to patients battling stubborn wounds.

If you or a loved one is dealing with a non-healing diabetic foot ulcer, consult your wound care specialist or plastic surgeon to see if TWO2 therapy could be part of your healing plan.

 

Want to know if TWO2 therapy is available in your area or if you're a suitable candidate? Reach out to your plastic surgeon today.

 Dr Ashish Gupta

Director, Dept. Of Plastic, Microvascular and Cosmetic Surgery 

Deep Hospital, Ludhiana