The geko™ device increases blood circulation to promote wound
healing naturally from the inside1
Venous, arterial and diabetic leg ulcers, that will not heal,
are generally caused by five conditions that can be operating at
the same time2. These are:
- Poor Circulation
- Inadequate Nutrition
- Repetitive Trauma to the Wound
Healing is most efficient when there is easy access to and from a
wound site, through the body's circulatory system2, and
where there is increased calf muscle pump function and blood
Current established interventions address wound healing from the
outside4. Increasing blood circulation enhances
Transcutaneous Oxygen Tension (TCpO2) which is a
predictor of tissue viability and ischemic wound
healing1. The geko™ device increases venous, arterial
and microcirculatory blood flow in the lower limbs5,
reduces edema6 and increases TCpO2, promoting
conditions favourable to wounds healing from the
The burden of chronic wounds
Venous leg ulcers
A venous leg ulcer is a chronic wound caused by poor venous
circulation that takes more than six weeks to heal7.
The Medical Advisory Secretariat in Canada estimates the
prevalence of lower limb ulcers in the general population to range
between 50,000 to 500,0008. Half of the affected
population has an ulcer history spanning 5-10 years; a third
exceeding 10 years.
In the United Kingdom, VLUs affect approximately 1 in 500
people, including an estimated 1 in 50 people over the age of
807 and around 80% of leg ulcers are caused by
venous insufficiency9. The condition can lead to
several complications, including a loss of mobility and the risk of
infection7. Recurrences are common with rates
ranging from 54-78%10 and 20% of VLUs fail to heal
despite the use of compression.
Diabetic foot ulcers
With diabetes you have an increased risk of developing
peripheral arterial disease. This can reduce the blood flow to
various parts of the body, particularly the feet. Tissue with a
poor blood supply does not heal as well as normal and is more
likely to be damaged. A minor cut or injury may take longer to heal
and be prone to becoming worse and developing into an ulcer.
In Canada, 9 million people live with diabetes or 'pre-diabetes'
and have a 25% lifetime risk of developing a foot ulcer. These are
a concern because 85% of amputations in diabetics are the result of
non-healing diabetic foot ulcers. The five year mortality rate is
Arterial ulcers occur because of inadequate perfusion of skin
and subcutaneous tissue at rest. Arterial occlusive disease, common
among smokers, diabetics and the elderly, and also familial, can
lead to claudication, rest pain and gangrene, in addition to
localized ulceration. Other processes, such as venous stasis,
pressure, trauma, and vasculitis, can also cause ischemia. Arterial
ulcers are considered second most common after venous ulcers
accounting for between 10 and 30% of chronic
wounds12,13,14. A variety of arterial pathologies can
lead to ulceration but the common element is obstruction.
Ulcer patients are often obese and 35% of patients in one study
failed to walk ten minutes per week14. According
to Physical Activities Guidelines15,16,17 and the Borg
RPE rating scale18, adults need at least 150 minutes of
moderate-intensity aerobic activity (i.e. brisk walking) every
week. Walking is a great form of moderate intensity
exercise. With the geko™ device delivering
approximately 60%5 of the blood flow generated by
continuous walking, using the device can serve in both therapeutic
and prophylactic capacities.
The geko™ device - how it works
The geko™ device stimulates the common peroneal nerve activating
the calf and foot muscle pumps increasing venous, arterial and
microcirculatory blood flow5.
The increase in blood flow is similar to that achieved by
walking, up to 60%5.
Small, light and comfortable to wear, the self-contained,
battery powered geko™ device:
- Has no wires or leads - no tripping hazard or restriction of
- Weighs just 10g
- Is easy and quick to fit
- Silent operation
The geko™ device - blood flow increase
Increased blood circulation generates a natural healing
- Chronic wounds, including venous, arterial and diabetic ulcers
often have impaired blood flow2,3
- Non-healing venous ulcers correlate with impairment of the calf
- There is evidence that improved blood circulation results in
improved wound healing6,7,12
- Increasing blood circulation increases Transcutaneous Oxygen
Tension (TCpO2) which is a predictor of tissue viability
and ischemic wound healing8
- The geko™device increases venous, arterial and microcirculatory
blood flow in the lower limb9, reduces
edema10 and increases TCpO2- promoting
conditions favourable for wound healing
The geko™ device is ideal for any or all of the
- A wound has healed less than 30% in 4 weeks of care
- Compression cannot be tolerated or is contraindicated
- Patient has a fixed ankle joint or poor ankle flexion
- Lower limb muscle pumps are impaired or inactive
- Edema management has been a factor in wounds healing
- Wound, ischemia and edema may be the underlying cause of
- Patient has an increased risk of Venous Thromboembolism
Various case studies have demonstrated rapid healing in
diabetic, venous and arterial ulcers when these have been
refractory or difficult to heal with traditional therapies. Use of
the geko™ device as an adjunctive therapy, consistently resulted in
healing when patients were adherent to instructions and the wound
was not severely infected. Once infection was actively managed,
healing continued. In arterial ulcers, the healing process
was slower but progress was achieved20.
Where patients had adhered to the geko™ device treatment plan
and severe infection was not present, healing was observed.
CTV News Windsor
The CTV News Windsor in Canada broadcast a 3 minute news
bulletin featuring a case study for use of the geko™ device to
relieve chronic pain in wound patients. February 2016. To watch the
feature click here http://windsor.ctvnews.ca/video?clipId=814112
For further information contact:
Perfuse Medtec Inc, Firstkind's exclusive Canadian
Information / Demonstration / Ordering
T: +1 888 244 5579
- Quigley FG, Faris IB.Clin Physio .1991 Jul:11(4):315-20
- Bruce E, Ruben MD. Internet Article: Wound Source May
- Katherine J, Williams, MBBS, MA (Cantab), MRCS, Olufemi
Ayekoloye, Hayley M. Moore, MBBS, MA (Cantab), MRCS, and Alun H.
Davies, BM, BCh, MA (Cantab), FRCS, DM (Oxon), FHEA, London, United
Kingdom. The calf muscle pump revisited. Journal of Vascular
Surgery: Venous and Lymphatic Disorders 07/2014;
DOI: 10.1016/j.jvsv.2013.10.053 Feb 12, 2014
- Michael G. Cioroiu, MD, Director. The
Advanced Wound Healing Center, Beth Israel Medical Center, NY.
- Tucker AT,et al. Int J Angiol. 2010 Spring; 19(1):
- Williams KJ,et al. Poster. Vascular Society Annual Scientific
Meeting Glasgow November 2014
[NHS Choices website, accessed June 2014]
- Burrows Cet al.Best Practice Recommendations for the Prevention
and Treatment of Venous Leg Ulcers: Volume 4, Number 1,
- Shai A, Halevy S,2005 Int J Dermatol 44(2):006-9
- Etufugh CN, Phillips TJ, Clin Dermatol 25():121-130
- Canadian Diabetes Association (Internet). Toronto (ON): cited
May 2012: http://goo.gl/Lf7XWm
- Lazarides MK, Giannoukas AD. Int J Low Extrem Wounds.
- Mekkes JR, Loots MA, Der Wal AC Van, Bos JD. Br J Dermatol.
- Renner R, Sim JC. J Dtsch Dermatol Ges.
- Canadian Society for Exercise Physiology, Canadian Physical
Activity Guidelines: http://www.csep.ca/english/view.asp?x=949
- More than half of all Australian adults are not active enough.
Source: Australian Bureau of Statistics (ABS) 2013. Australian
Health Survey: Physical Activity, 2011-12. ABS Cat. No.
4364.0.55.004. Canberra: ABS.
- How much physical activity to adults need? Division of
Nutrition, Physical Activity and Obesity. Centres for Disease
Control & Prevention. http://www.cdc.gov/physicalactivity/basics/adults/index.htm
- Borg, G. (1998). Borg's Perceived Exertion and Pain Scales.
Champaign, IL: Human Kinetics.
- Case studies on file. Firstkind Limited.
- Brooke J (Saint Elizabeth Health Care), Loney A (Bayshore Home
Health). The geko™ a neuromuscular electrostimulation (NMES) device
and its healing effect on diabetic foot and venous leg ulcers.
Using the geko™ device in wound
- The role of the geko™, a portable neuromuscular
electrostimulation device, in assisted healing of an intractable
arterial leg ulcer. (PDF)
- The role of the geko™, a portable electrical
stimulation device, in assisted healing of an intractable mixed
arterio-venous leg ulcer (PDF)
- The role of the geko™, a portable electrical
stimulation device, in assisted healing of a diabetic foot ulcer.
- The role of the geko™, a portable
electrical stimulation device, in assisted healing of an
intractable mixed arterio-venous leg ulcer (PDF)
- The role of the geko™, a portable
electrical stimulation device, in assisted healing of a venous leg