Health Technology Wales Guidance Advises Routine Adoption of NATROX® O₂

NHS Wales advised to adopt continuous topical oxygen therapy (cTOT) for the treatment of chronic, non-healing diabetic foot ulcers

[13 December 2022 – Cambridge, UK] – NATROX® Wound Care, a leading provider of advanced wound care technology for the treatment of chronic wounds, is pleased to announce Health Technology Wales (HTW) has published Guidance advising the routine adoption of NATROX® O₂ for the treatment of chronic, non-healing and complex diabetic foot ulcers (DFUs).

“The status of [the] guidance is that NHS Wales should adopt this guidance or justify why it has not been followed.” ⁹

Following HTW’s prior Topic Exploration Report and Evidence Appraisal Report which analyse the merits of continuous Topical Oxygen Therapy (cTOT), this latest publication focuses on the clinical and health-economic outcomes of using cTOT when treating DFUs. It concludes that routine adoption of cTOT, in addition to standard of care, increases complete wound healing and reduces wound area and time to healing compared to standard of care alone – and all with cost savings.

“We’re thrilled to see Health Technology Wales advising the routine adoption of cTOT,” said Craig Kennedy, CEO of NATROX® Wound Care. “NATROX® O₂ is a game changer. It’s heartening that a well-respected, independent body has come to this same conclusion.”

The Guidance comes on the heels of NATROX® O₂ being added as an approved supplier to the UK’s NHS Supply Chain and NHS Shared Business Services. Adding the therapy marked the first time cTOT was listed as a category within these frameworks – a move further validating the therapy as an effective, needed treatment.

What is NATROX® O2
NATROX® O₂ is an innovative, easy-to-use device that uses oxygen to stimulate healing.  The small, wearable device delivers low-flow oxygen directly to the wound 24/7. Clinicians can use it during any phase of wound healing, and it is compatible with any standard secondary dressing. Studies show patients with a chronic wound have a 71% greater chance of healing and experience a 73% greater reduction in wound size using NATROX®O₂.¹

How oxygen helps heal chronic wounds
A substantial body of evidence shows the vital role oxygen plays in enabling wound healing.2,3,4,5,6 Patients may experience stalled healing and develop a chronic wound due to low oxygen levels in the tissue called “local hypoxia.” Treating this remains a challenge for clinicians because it can result in compromised healing or non-healing wounds which remain open. However, studies show delivering low-flow oxygen to a diabetic wound can increase the rate of wound closure, by as much as 69%.⁷ 

The burden of diabetes
Chronic wounds, which include DFUs, pose a significant problem both on patient quality of life and costs to healthcare systems worldwide.⁸ DFUs are the single largest reason for hospital admissions in people with diabetes.⁹ Diabetes leads to 4 million deaths per year¹⁰, and, sadly, this disease is on the rise. Between 2019 and 2045 the estimated number of adults with diabetes worldwide will increase by 51% to as many as 700 million people.¹⁰

“We have the opportunity right now to reshape the future. We’ve all seen the statistics on diabetes—and frankly, they’re depressing. What motivates our team is seeing the positive impact NATROX® O₂ makes on wound care patients every day. Being included in this Guidance is another step towards shaping a future we can all feel inspired by,” said Kennedy.


  1. 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.
  2. 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.
  3. Boulton, A., Armstrong, D.G., Löndahl, M., et al., 2022. New Evidence-Based Therapies for Complex Diabetic Foot Wounds. ADA Clinical Compendia, 2 pp.1–23. Available at: <> [Accessed 1 July 2022].
  4. 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.
  5. 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.
  6. Lee, A., 2022. Optimizing oxygen therapy in your clinical wound practice. Wound Masterclass, 1, pp.61-4. [online] Available at: <> [Accessed 15 July 2022].
  7. Asmis, R., Qiao, M., Zhao, Q., 2010. Low-flow oxygenation of full-excisional skin wounds on diabetic mice improves wound healing by accelerating wound closure and re-epithelialization. Int Wound J, 7 pp.349-57.
  8. Gottrup, F. 2020. Portable, practical and effective: clinical benefits of NATROX® topical oxygen therapy. Journal of Wound Care May 2020, 29(5):53.
  9. Health Technology Wales, 2022. Health Technology Wales (HTW) Guidance 043 (Sep 2022). (online) Available at: Accessed: 02 Dec 2022
  10. IDF Diabetes Atlas, 2019. Available at: [Accessed 1 June 2021].

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About Health Technology Wales
Health Technology Wales (HTW) is an independent, national body seeking to improve the quality of healthcare in Wales. They aim to facilitate the identification, appraisal, and adoption of innovative health and social care technologies that offer the most promise to deliver improved health, well-being and value for the people of Wales. Learn more at:

About Inotec AMD Ltd.

NATROX® Wound Care is an Inotec AMD brand. The specialist wound care company based in Cambridge, England was formed specifically to introduce new technologies to healthcare professionals worldwide to promote faster and better healing for patients. The company’s flagship product, NATROX® O₂, is positioned to become integral to global wound care treatment regimes in the coming years. To learn more, visit: