The potential benefits however are dramatic. The disease state is highly morbid and typically involves prolonged medical care and multiple surgical procedures. Despite intensive therapeutic intervention the state of the art still results in high morbidity and mortality at a high financial cost. The application of topical oxygen to diabetic wounds has the potential to dramatically impact the effectiveness of wound healing and to therefore improve limb salvage, decrease infection rates and mortality, and generally improve the quality of life of study participants receiving topical oxygen as well as the general population if efficacy is proved. Patients enrolled in the comparison groups will benefit by close follow-up and treatment using accepted comprehensive wound cares protocol.