Rural health
Rural clinics and the teams who support them.
WOUND THERAPY · AOTI
AOTI Topical Wound Oxygen (TWO2) Therapy
We help care teams serving rural areas and the Plain Communities reach AOTI’s Topical Wound Oxygen (TWO2) therapy.
WHO WE ARE
Hard-to-heal wounds, closer to home.
Supply Chain Butler, Inc. is based in Franklin, TN, and led by David Gamble II, Founder and CEO.
WHAT IT IS
What TWO2 is and who recognizes it.
- Oxygen. TWO2 delivers topical oxygen to the wound.[1]
- Compression. AOTI says TWO2 applies non-contact cyclical compression, which reduces edema and mobilizes blood and lymphatic fluids, enhancing oxygen diffusion.[1]
- Humidification. AOTI says TWO2 also supplies a fine particulate mist that helps create the ideal level of humidity for effective wound healing.[1]
- At home or on location. AOTI says a member of its care team comes to the patient’s home or location to show how to use TWO2 therapy.[1]
- Recognition. The ADA Standards of Care name topical oxygen therapy as an add-on option for diabetic foot ulcers that have not healed with standard care.[3]
- Clinical leadership. Dr. Matthew Garoufalis, DPM, is AOTI’s Chief Medical Officer.[2]
HARD-TO-HEAL WOUNDS
Start with this.
View on YouTube (opens in a new tab)
TWO2 Mechanism of Action, by AOTI: how the three parts of TWO2 work together.
More videos
Topical Wound Oxygen Multimodality Therapy for Chronic Wounds - Dr. Robert Frykberg
A Brief Review of the published RCT and RWE for Cyclical-Pressure Topical Wound Oxygen (TWO2) Therapy
Q and A: Practical Topical Oxygen Therapy
Interview with Matthew Garoufalis - Podiatrist from the United States of America
See the full Hard-to-Heal Wounds playlist on YouTube (opens in a new tab)
WHAT THE EVIDENCE SAYS
The published evidence on topical wound oxygen
These are peer-reviewed studies and guidelines anyone can look up. Each card links to the record on PubMed or the journal.
The TWO2 Study: a multinational, double-blinded, placebo-controlled trial of cyclical Topical Wound Oxygen (TWO2) for chronic diabetic foot ulcers.
Finding: At 12 weeks, at the trial’s first planned analysis, 41.7% of ulcers closed with TWO2 compared with 13.5% with a sham device, both alongside optimal standard care.
Topical Oxygen Therapy for Diabetic Foot Ulcers: Updated Evidence From Randomised Trials.
Finding: Pooling three trials, topical oxygen alongside standard care increased complete closure at 12 weeks (RR 1.53, 95% CI 1.14–2.05). The authors note the evidence base is still small.
Efficacy of Topical Wound Oxygen Therapy in Healing Chronic Diabetic Foot Ulcers.
Finding: Across four trials, topical oxygen improved complete healing (RR 1.59, 95% CI 1.07–2.37). The authors rated the evidence as moderate.
More studies (3)
Guidelines on interventions to enhance healing of foot ulcers in people with diabetes.
Finding: Gives a conditional recommendation, based on low-certainty evidence, for topical oxygen therapy where best standard of care has not healed the wound alone.
Reduced Hospitalizations and Amputations in Patients with Diabetic Foot Ulcers Treated with Cyclical Pressurized Topical Wound Oxygen Therapy.
Finding: In matched groups of 140 patients, 7.1% of TWO2 patients were hospitalized compared with 40.0% without TWO2, and 8.6% compared with 31.4% had amputations. This was a retrospective study.
A synergistic multimodality treatment approach to address the key drivers of wound chronicity.
Finding: Explains how combining oxygen delivery with cyclical compression addresses hypoxia, edema and inflammation in chronic wounds.
Study funding and authors are listed in each paper. The 2022 real-world study was sponsored by AOTI, the 2026 mechanism review includes an AOTI co-author, and AOTI’s Chief Medical Officer, Dr. Matthew Garoufalis, co-authored the 2020 trial and the 2022 study. The 2026 Wound Repair and Regeneration review and the IWGDF guideline list no AOTI-affiliated authors. One author of the 2023 meta-analysis, an investigator in the 2020 trial, reports AOTI research support and consulting. See each paper’s disclosures.
Clinicians decide on treatment. Supply Chain Butler, Inc. is a Master Distributor for AOTI under its Master Distributor Agreement with AOTI.
WHO WE HELP
Care teams where life happens.
The Plain Communities
Plain-language guidance and one direct contact.
Senior living and home health
Teams caring for people with hard-to-heal wounds where they live.
QUESTIONS
Frequently asked questions
What is TWO2 therapy?
AOTI describes Topical Wound Oxygen (TWO2) as therapy that combines oxygen, non-contact cyclical compression and humidification. AOTI says a member of its care team comes to the patient’s home or location to show how to use TWO2 therapy.[1]
What do the ADA Standards of Care say about topical oxygen?
Recommendation 12.32 (evidence grade A) names topical oxygen therapy as an add-on option for diabetic foot ulcers that haven’t healed with standard care.[3]
How does Supply Chain Butler work with AOTI?
Supply Chain Butler, Inc. is a Master Distributor for AOTI under its Master Distributor Agreement with AOTI.
Who is Dr. Matthew Garoufalis?
He is AOTI’s Chief Medical Officer, according to AOTI’s team page.[2]
Can TWO2 be used at home in rural areas?
AOTI says a member of its care team comes to the patient’s home or location to show how to use TWO2 therapy.[1] We help rural home health and senior living teams reach it.
How do I start?
Book a Business Conversation,
email Info@SupplyChainButler.com
or call 615.465.0582.