Purpose Cyclical topical wound oxygen therapy can significantly increase the likelihood of healing and reduce time to healing for chronic diabetic foot ulcers. Topical oxygen therapy was recently introduced in the Vascular Surgery Department at the Sunshine Coast University Hospital using the Topical Wound Oxygen Therapy (TWO2) device (AOTI) as an adjunctive therapy for non-healing ulceration following unsuccessful conservative management. This project outlines our experience with implementation of topical oxygen therapy and reports initial outcomes of this novel treatment. Methodology All patients who have undergone topical oxygen therapy since implementation in June 2023 were included. Data regarding wound size and characteristics were collected prospectively throughout the treatment course. Patients were continued on therapy until the wound was healed, or therapy was ceased due to skin grafting, poor tolerance or adherence. Results Ten patients received topical wound oxygen therapy since June 2023. Five patients were treated for diabetic foot ulceration (50%), four (40%) for radiation induced ulceration, and one (10%) for other causes. Four patients (40%) achieved wound healing, three (30%) underwent treatment until biodegradable temporising matrix or split thickness skin grafting occurred, two (20%) ceased treatment due to poor tolerance, and one (10%) is ongoing. Challenges to implementation included staff education, cost, and logistic considerations as treatment is currently only available for daily outpatient clinic use. Conclusion Implementation of topical wound oxygen therapy is feasible and treatment is well tolerated. Early results suggest a positive effect in patients with previously non-healing ulcers.