A new multidisciplinary paper involving vascular surgeons Anahita Dua (Massachusetts General Hospital, Boston, USA) and Naseer Ahmad (Manchester Vascular Centre, Manchester, UK) points to a “convergence” of evidence pointing to improved healing durability and substantial reductions in both hospitalisation and amputation in patients with diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) who undergo multimodality intermittent topical oxygen therapy.
By addressing hypoxia, oedema and impaired microcirculation simultaneously, the therapy offers a “mechanism-driven approach that translates into meaningful patient-centred outcomes”, the authors write.
The review, led by Matthew Garoufalis (Western University of Health Sciences, Pomona, USA) and published in the Journal of Clinical Medicine, looked variously at randomised controlled trials (RCTs), long-term venous ulcer studies, and real-world comparative effectiveness analyses that examined the therapy known as TWO2 therapy (AOTI).
RCT evidence from the multicentre, double-blind, sham-controlled TWO2 study demonstrated that durability of healing in DFUs was confirmed at one year, “with a significant 56% of ulcers in the therapeutic group remaining closed compared with just 27% in the sham group”, the authors point out.
A prospective controlled study of patients with chronic VLUs present for more than two years in TWO2 therapy was compared to conventional compression dressings, meanwhile, showed healing rates of 76% vs. 46% at 12 weeks; median time to closure of 57 vs. 107 days; and recurrence rates at 36 months of 6% vs. 47%.
The research group also highlighted a recent large cohort retrospective study that evaluated the effectiveness of TWO2 in chronic lower extremity wounds of varying aetiologies. Among a group of 3,126 patients, 64.8% achieved complete healing in 4.2 months, despite a mean pre-treatment wound age of seven months.
Dua, Ahmad and Garoufalis concluded that the findings “support the earlier and broader adoption of TWO2 therapy in the management of chronic lower extremity wounds”.
