Review and analysis of healing durability in lower extremity wounds treated with intermittent cyclically pressurised topical wound oxygen.

This review explores a treatment called intermittent cyclically pressurised topical wound oxygen (CPTWO) and whether it helps lower-extremity wounds—like diabetic foot ulcers and venous leg ulcers—stay healed rather than reopening. The authors note that these wounds often recur after closing because the underlying conditions (such as diabetes or vein problems) persist, so 'durable healing' (sustained closure with fewer recurrences and complications) is a more meaningful goal. They synthesised clinical and mechanistic evidence on CPTWO, a device that delivers oxygen directly to the wound surface in repeating pressure cycles while applying compression. In a double-blind randomised trial cited in the review, adding CPTWO doubled the proportion of ulcers closed at 12 months (56% versus 27%) and tripled closure at 12 weeks (41.7% versus 13.5%), with an adjusted odds ratio of 6.00. The authors also describe how topical oxygen may support infection control, new blood vessel growth, and stronger collagen cross-linking, while cyclical compression reduces swelling and inflammation, potentially improving tissue quality. The review is limited by being a synthesis of existing evidence rather than a large new trial, and the abstract is truncated, so not all findings are visible here. Still, the results suggest CPTWO may be a valuable addition for hard-to-heal lower-limb wounds in diverse patient groups.