“The panel endorses the adjunctive administration of TOT for hard-to-heal wounds.”

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“Consider the use of topical oxygen as an adjunct therapy to standard of care for wound healing.”

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IWGDF Wound Healing Guidelines 2023 - cover image

For advanced wound healing, it’s time to consider

NATROX® O₂ logo

Clinicians say it’s low-risk,
well-tolerated, and easy to use¹.1

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The NATROX® O₂ is a topical oxygen therapy device

Topical oxygen therapy has come of age and the evidence supporting its efficacy in healing chronic DFUs can no longer be disputed². 2

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Greater healing rate means hope for patients with chronic wounds.

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Is my patient suitable for NATROX® O₂?

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Discover more

Oxygen plays a vital role in wound healing

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  • promotes growth factor
    signalling transduction
  • collagen
    synthesis
  • cell proliferation &
    re-epithelialisation
  • angiogenesis and
    revascularisation
  • cell metabolism &
    energy production
  • antibacterial
    activities
Body outline covered in oxygen bubbles
x

Antibacterial Activities

Oxygen is essential during neutrophil or macrophage respiratory burst, producing reactive oxygen species (ROS) which are extremely important in microbial and debris clearance. 3

x

Cell metabolism & energy production

Nearly all cellular processes use energy in the form of adenosine triphosphate (ATP)

Low O2 x Glucose = 2 ATP
High O2 x Glucose = 36 ATP4

x

Angiogenesis and Revascularisation

Rate and quality of blood vessels affected by oxygen levels, supplemental oxygen accelerates blood vessel growth.5

x

Cell Proliferation &
Re-epithelialisation

Delivering low flow oxygen to a diabetic wound has been shown to increase the rate of wound closure, by as much as 69%. 6

x

Collagen synthesis

Collagen acts as the structural scaffold of the skin. Higher oxygen concentrations have been found to increase both the amount of collagen production and its tensile strength. 7

x

Promotes growth factor signalling transduction

Promotion of ROS essential for the signalling processes of growth factors and processes such as angiogenesis and extracellular matrix formation. 8 9

  • The presence of a wound increases the body’s need for oxygen by 20%. 10
  • Compromised healing occurs when oxygen demand is greater than the supply.

Supplementary oxygen
can improve wound healing

  • NATROX® O₂ generates and delivers continuous oxygen directly to the wound bed.
  • Evidence shows oxygen plays a vital role in enabling wound healing.

NATROX® O₂ is the best option for our patients because it is so discreet, doesn’t involve the patient attending multiple appointments and traveling for treatment. We decided NATROX® O₂ is our oxygen therapy of choice. 15

All hard to heal wounds are likely to benefit from Topical Oxygen Therapy. 16

Topical oxygen has been shown to increase the incidence of healing and decrease the time to heal. 17

cTOT may reduce the need for pharmacological analgesia. 24

Meta-analysis suggests that topical oxygen therapy significantly increased the likelihood of healing. 20

Consider Topical Oxygen as an adjunct therapy to standard of care for wound healing in people with diabetes-related foot ulcers where standard of care alone has failed. 21

cTOT may be a novel pain management device for hard-to-heal wounds. 24

Topical oxygen therapy improved healing of even advanced (Texas Grade III) DFUs, or wounds that had been open up for up to 88 weeks. 13

Browse our DFU resources

Continuous Topical Oxygen Therapy…leads to a higher rate of complete wound healing and a reduced wound area and time to healing. 18

A growing body of evidence supports the use of topical oxygen therapy (TOT) in the treatment of diabetic foot ulcers (DFUs). 22

cTOT may be new treatment modality for hard-to-heal leg ulcer pain. 24

Evidence shows topical oxygen can be an important tool to kickstart healing in chronic, hard-to-heal wounds. 19

Supplementary oxygen can help at any phase of wound healing

NATROX® O₂ offers the following benefits:

Icon depicting continuous oxygen delivery to wounds

Continuous oxygen therapy

Generates and delivers oxygen directly to wounds 24/7. Continuous flow ensures an oxygen-rich environment.

Icon depicting compatibility of NATROX® O₂ with other standard treatments

Easy to use

Compatible with most standard of care treatments.

Icon depicting how the ease of use and portability of NATROX® O₂ contribute to patient therapy compliance

Supports patient compliance

Ease of use and portability means minimal disruption to patients’ lifestyle, supporting compliance.

Icon depicting how NATROX® O₂ work with all active therapies the patient is using

Active therapy

Works together with existing therapies, across all patient groups and care settings.

Icon depicting the enhanced wound healing efficacy achieved with NATROX® O₂

Proven clinical efficacy

71% greater healing rates compared to standard of care alone.11 Numerous studies demonstrate the efficacy of healing using NATROX® O₂.

Icon depicting the short amount of time it takes to use NATROX® O₂ for wound care

Fast

Quick dressing changes and minimum debridement required, helps free up your time.

Icon depicting the hassle-free patient management of the NATROX® O₂ device for wound care

Hassle free

Easy for patients to self-manage. No out-of-hour service or support required.

Icon depicting that 9 out of 10 patients report being satisfied with NATROX® O₂, which enhances treatment compliance

Patient satisfaction

90% patient satisfaction scores12, improves compliance.

See the results for yourself

Assessing if NATROX® O₂ is right for your patient

Does my patient need NATROX® O2?

What to expect when using NATROX® O2?

How to increase
patient compliance

Risk factors
to consider

What are the patient benefits of using NATROX® O2?

Clinician assessing if NATROX® O₂ is right for her patient

Watch Our Video Series on How to Apply NATROX® O₂ Device for Wound Treatment

Preparing a wound for the application of the NATROX® O₂ device

Preparing the Wound
How to apply the NATROX® O₂ device for wound care therapy

General Application
How to apply the NATROX® O₂ device for treating diabetic foot ulcers (DFU)

Application for Diabetic Foot Ulcers (DFUs)
How to apply the NATROX® O₂ device for treating venous leg ulcers (VLU).

Application for Venous Leg Ulcers (VLUs) w/ Compression
How to apply the NATROX® O₂ device for treating pressure injuries

Application for Pressure Injuries (PI)
How to apply the NATROX® O₂ device for treating non-healing surgical wounds

Application for Non-Healing Surgical Wounds
How to apply the NATROX® O₂ device for treating non-healing surgical wounds.

Application with Complementary Products
The supplies and setup for the NATROX® O₂ system for chronic wounds

Setup & Supplies: Chronic Wounds
Introducing the NATROX® O₂ system for wound care

Intro to the NATROX® O₂ System
What to expect when using NATROX® O₂ wound therapy

What to Expect During NATROX® O₂ Therapy
Tips for clinicians who are treating patients' wounds with the NATROX® O₂ device

Tips & Tricks for Clinicians
See Full Video Series

Ready To See For Yourself?

Studies show patients with a chronic wound have a 71% greater chance of healing using NATROX® O₂ than with standard of care alone.11

Topical oxygen therapy can improve both patient outcomes and quality of life.14 See for yourself why NATROX® O₂ gets 90% patient satisfaction scores.12

Move forward with NATROX® O₂

Request additional information from your local team
The NATROX® O₂ is a topical oxygen therapy device

Clinical Evidence and Resources

Quick Guide to Continuous Topical Oxygen Therapy (cTOT)

April 26, 2024
Continuous Topical Oxygen Made Easy

March 22, 2024
M.O.I.S.T. Concept for the Local Therapy of Chronic Wounds: An International Update

April 26, 2024
Managing Wound Pain: International Perspectives on Assessments, Challenges and Treatment Options

April 11, 2024
Unlocking Wound Healing Potential: Insights on NATROX® O₂ Therapy with Dr. Windy Cole, DPM, CWSP

April 05, 2024
A model for diabetic foot ulcer clinical trials on advanced therapies

March 21, 2024
International Consensus: Use of Topical Oxygen Therapy in Wound Healing – JoWC Sep 2023

November 03, 2023
NATROX® O₂ Topical Oxygen Therapy: Master Evidence Summary & Clinical Insights

February 16, 2024
Consensus on the Clinical Efficacy and Guidelines of Continuous Topical Oxygen Therapy for Wounds – JoWC LATAM Oct 2023

November 02, 2023
New Expert Guidelines from IWGDF Highlight the Growing International Recognition of Topical Oxygen Therapy (TOT) for Diabetic Foot Ulcers

May 16, 2023
Clinician Information Leaflet

May 06, 2020
Podcast: Pain and the Journey of the Chronic Wound Patient

November 07, 2023
Supporting the Patient Journey – Podiatry Management Nov 2023

November 07, 2023
Holistic Approach to a Wound Care Patient

November 01, 2023
The Efficacy of Continuous Topical Oxygen Therapy in the Treatment of Challenging Diabetic Foot Ulcers; A Case Series

November 01, 2023
Accelerated Healing with NATROX® O₂: Managing Late Radiation Tissue Injury Following Mohs Surgery

January 09, 2024
Supporting the Patient Journey: The Use of Topical Oxygen Therapy in Chronic Wound Pain Management

October 10, 2023
Case Series Examining the Efficacy of cTOT in Treatment of DFUs

May 23, 2023
Barriers Eliminated: An Advanced Digital Wound Platform Combined with Continuous Topical Oxyen Therapy Improves Access, Saves Time, and Decreases Wound Size in Complex Diabetic Patients

April 26, 2023
New Expert Opinion in Support of Topical Oxygen Therapy (TOT)

November 21, 2022
Delphi Consensus on Guidelines for the Use of Topical Oxygen

November 07, 2022
A new algorithm for the management of diabetic foot ulcer: recommendations from Central and Eastern Europe

April 25, 2023
Topical Oxygen Therapy relieves pain from hard-to-heal leg ulcers and improves healing: a case series

May 06, 2022
New study shows substantial pain relief with NATROX® O₂

May 11, 2022
How wound care clinicians can optimize clinical outcomes and resources

October 10, 2022
Health Technology Wales Guidance Advises Routine Adoption of NATROX® O₂

December 13, 2022
NATROX® O₂ Masterclass Guide

August 23, 2022
New Evidence in Support of Topical Oxygen Therapy (TOT)

July 06, 2022
TOT in the Treatment of DFUs: Randomised controlled clinical trial (RCT)

February 18, 2022
3 exciting results give you clinical confidence to recommend NATROX® O₂

July 06, 2021
Painful non-healing mixed leg ulcer

May 04, 2021
Dr. Lee presents: Continuous TOT – Improving Healing in Diabetic Foot

November 18, 2021
See all resources
Expand Reference List
References

[1] Kaufman, H., 2020. Portable, practical and effective: clinical benefits of Natrox topical oxygen therapy. Journal of Wound Care, 29(5):S31.

[2] Andrew J.M. Boulton, et al, 2022. New Evidence-Based Therapies for Complex Diabetic Foot Wounds. ADA Clinical Compendia 22 February 2022; 2022 (2): 1–23. Available at: https://bit.ly/3OVEidn Accessed 1 July 2022.

[3] Babior, BM (1978). Oxygen – dependent microbial killing by phagocytes. New England Journal of Medicine, 298:659-68.

[4] Lordish, H., et. al (2000). Molecular cell biology, 4th edition, New York: Freeman.

[5] Knighton, D., et al (1981). Regulation of wound healing and angiogenesis — effect of oxygen gradients and inspired oxygen concentrations. Surgery. 90:262-70.

[6] Asmis, R., et. al (2010). Low-flow oxygenation of full-excisional skin wounds on diabetic mice improves wound healing by accelerating wound closure and re-epithelialization. International Wound Journal, 7:249-57.

[7] Stephens, F., et. al (1971). Effects of changes in inspired oxygen and carbon dioxide tensions on wound tensile strength. Annals Surgery, 173:515.

[8] Sundaresan, M. et.al (1996). Regulation of reactive oxygen species generation in fibroblasts by Rac1. Biomechanical Journal, 318:379-82.

[9] Sen, CK (2003). The general case for redox control wound repair. Wound Repair Regeneration, 11:431-8.

[10] Jonsson K. Jenson JA., Goodsen WH, et. al (1991). Tissue oxygenation, anemia, and perfusion in relation to wound healing in surgical patients. Annals of Surgery, 214 (5):605-613.

[11] Serena TE, Bullock NM, Cole W et al. Topical oxygen therapy in the treatment of diabetic foot ulcers: a multicentre, open, randomised controlled trial. J Wound Care 2021; 30: Suppl.5 S7-14.

[12] Jones, N.C., G; Ivins, N.M.; Harding, K.G et al. (2017) The role of topical oxygen therapy in the treatment of diabetic foot ulceration. Poster in Wounds UK Harrogate, UK.

[13] Lee, A., 2022. Optimizing oxygen therapy in your clinical wound practice. Wound Masterclass Vol 1, June 2022. [online] Available at: https://woundmasterclass.com/ [Accessed 15 July 2022].

[14] Gottrup, F. 2020. Portable, practical and effective: clinical benefits of NATROX® topical oxygen therapy. Journal of Wound Care May 2020, 29(5):53.

[15] Samanatha Tate. Head of Podiatry, Westmead Hospital, Australia. BSc (Hons) Podiatry, Accredited Lymphoedema Practitioner, Grad Cert. Clinical Lead. Dec 2023.

[16] Bem, R., Chadwick, P., Cvjetko, I., et al, 2023. A new algorithm for the management of diabetic foot ulcers: recommendations from Central and Eastern Europe. Journal of Wound Care, 32(S), p.264-70. Available at: https://bit.ly/nwc-tot-algorithm-JWCMay23

[17] Lavery, L. A. et al. WHS (Wound Healing Society) guidelines update: Diabetic foot ulcer treatment guidelines. Wound Repair and Regeneration (2023) doi:10.1111/wrr.13133.

[18] Health Technology Wales, 2022. Health Technology Wales (HTW) Guidance 043 (Sep 2022). (online) Available at: https://bit.ly/nwc_HTWSepGuidance

[19] Kaufman, H., Gurevich, M., Tamir, E., et al., 2021. Topical oxygen therapy used to improve wound healing in a large retrospective study of wounds of mixed aetiology. Wounds International, 12(2) pp.62-8.

[20] Carter, M.J., Frykberg, R.G., Oropallo, A., et al., 2022. Efficacy of Topical Wound Oxygen Therapy in Healing Chronic Diabetic Foot Ulcers: Systematic Review and Meta-Analysis. Adv Wound Care, doi: 10.1089/wound.2022.0041.

[21] Chen et al, 2023. IWGDF DFU Wound Healing Interventions Guideline (2023 update). Available at: https://bit/ly/nwc-iwgdf-guidelines2023

[22] Serena T.E., Andersen, C., Cole, W., et al., 2022. Guidelines for the use of topical oxygen therapy in the treatment of hard-to-heal wounds based on a Delphi consensus. J Wound Care, 31(Sup3) pp.S20-S24. doi: 10.12968/jowc.2022.31.Sup3.S20. PMID: 35199564.

[23] Lee, A., 2022. Optimizing oxygen therapy in your clinical wound practice. Wound Masterclass, 1, pp.61-4. [online] Available at: <https://woundmasterclass.com> [Accessed 15 July 2022].

[24] Jebril, W., Nowak, M., Palin, L., et al., 2022. Topical oxygen treatment relieves pain from hard-to-heal leg ulcers and improves healing: a case series. J Wound Care, 31(1) pp.4-11