Wound Healing

The geko™ device increases blood circulation to promote wound healing naturally from the inside1

Canadian Education Modules for geko™ Wound Therapy

List of Courses:

  • Course 1 Introduction to geko™ Wound Therapy
  • Course 2 How to use the geko™ Wound Therapy Device
  • Course 3 Frequently Asked Questions
  • Course 4 The geko™ Effect Anatomy, Physiology and Treat the Cause


To access these courses:
Open the Online Learning Course Instructions (PDF) and follow the instructions.

Click on the following link: http://perfusemedtec.litmos.com/self-signup/  



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
  • Infection
  • Edema
  • 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 flow3.

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 inside1.


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 45%11.

Arterial ulcers

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 Welsh Wound Innovation Centre

 Professor Kieth Harding


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 movement
  • Weighs just 10g
  • Is easy and quick to fit
  • Silent operation

g-OnPulse_technology leg graphic_v2

The geko™ device - blood flow increase

Blood Flow
Please click to enlarge


Increased blood circulation generates a natural healing response

  • Chronic wounds, including venous, arterial and diabetic ulcers often have impaired blood flow2,3
  • Non-healing venous ulcers correlate with impairment of the calf muscle pump1,3,5
  • 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 following when:

  • 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 pain
  • 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.


Case 1

Evidence Cases 1
Please click to enlarge


Case 2

Evidence Cases 2
Please click to enlarge


Case 3

Evidence Cases 3
Please click to enlarge

Webinar: Innovation through stimulation - The geko™ circulation support for lower limb wounds.


Presentation: Using Low Frequency Nerve Stimulation to "Treat the Cause" in Chronic Venous Insufficiency (Wounds Canada, 2017)

  Wounds Canada Video Splash

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://windsoctvnews.ca/video?clipId=814112



Contact us:

For further information contact:

Perfuse Medtec Inc, Firstkind's exclusive Canadian distributor

Information / Demonstration / Ordering

T: +1 888 244 5579
Email: info@perfusemedtec.com



  1. Quigley FG, Faris IB.Clin Physio .1991 Jul:11(4):315-20
  2. Bruce E, Ruben MD. Internet Article: Wound Source May 28th, 2015.
  3. 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
  4. Michael G. Cioroiu, MD, Director. The Advanced Wound Healing Center, Beth Israel Medical Center, NY.
  5. Tucker AT,et al.  Int J Angiol. 2010 Spring; 19(1): e31-e37
  6. Williams KJ,et al. Poster. Vascular Society Annual Scientific Meeting Glasgow November 2014
  7. http://www.nhs.uk/Conditions/Leg-ulcer-venous/Pages/Introduction.aspx  [NHS  Choices website, accessed June 2014]
  8. Burrows Cet al.Best Practice Recommendations for the Prevention and Treatment of Venous Leg Ulcers: Volume 4, Number 1, 2006. 
  9. Shai A, Halevy S,2005 Int J Dermatol 44(2):006-9
  10. Etufugh CN, Phillips TJ, Clin Dermatol 25():121-130
  11. Canadian Diabetes Association (Internet). Toronto (ON): cited May 2012: http://goo.gl/Lf7XWm
  12. Lazarides MK, Giannoukas AD. Int J Low Extrem Wounds. 2007;6:254-261
  13. Mekkes JR, Loots MA, Der Wal AC Van, Bos JD. Br J Dermatol. 2003;148:388-401
  14. Renner R, Sim JC. J Dtsch Dermatol Ges. 2008;6:389-401 
  15. Canadian Society for Exercise Physiology, Canadian Physical Activity Guidelines: http://www.csep.ca/english/view.asp?x=949
  16. 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.
  17. 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
  18. Borg, G. (1998). Borg's Perceived Exertion and Pain Scales. Champaign, IL: Human Kinetics.
  19. Case studies on file. Firstkind Limited.
  20. 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. 2015.


Using the geko™ device in wound healing 






  • geko™ Wound Healing Brochure (ROW, 2016)Linked DocumentDownload button
  • geko™ Wound Therapy Brochure (Canada, 2017)Linked DocumentDownload button
  • geko™ Wound Therapy User Information Guide (Canada, 2017)Linked DocumentDownload button
  • geko™ Wound Therapy Patient Information Leaflet (Canada, 2017)Linked DocumentDownload button
  • Award: Spotlight on Innovation: Modernizing Home Care A Process to Evaluate and Adopt Innovation. Canadian Home Care Association 2016 (Canada)Linked DocumentDownload button
  • Award Quality and Innovation: Best New Long Term Care Product or Service of the Year. Ontario Long Term Care Association 2016 (Canada)Linked DocumentDownload button
  • The geko™ device Annotated BibliographyLinked DocumentDownload button
  • Abstract: Refractory venous leg ulcers: observational evaluation of innovative new technology (2017)Linked DocumentDownload button
  • Abstract: Evaluation of a muscle pump activating device for non healing venous leg ulcersLinked DocumentDownload button
  • Paper: An Innovative Technology for Healing Venous Leg ulcers: geko™ (Dr Keith Harding, 2016)Linked DocumentDownload button
  • Webinar: Innovation through stimulation – The geko™ circulation support for lower limb woundsLinked DocumentDownload button
  • Paper: Canadian Association of Wound Care Consensus Document Low Frequency Nerve Stimulation To Support The Healing Of Venous Leg Ulcers (Canada, 2016)Linked DocumentDownload button
  • Poster: Is it time for a paradigm shift using an adjunctive therapy with best practices for recalcitrant VLUs? (2018)Linked DocumentDownload button
  • Poster: Thinking outside the box (2018)Linked DocumentDownload button
  • Poster: A call to action (2018)Linked DocumentDownload button
  • Poster: Integrating early use of an innovative adjunctive therapy into venous leg ulcer pathways – a paradigm shift (2018)Linked DocumentDownload button
  • Poster: What is your Approach to Recalcitrant Leg Ulcers…Status Quo or Paradigm Shift Using New Technology to Achieve Healing? (2017)Linked DocumentDownload button
  • Poster: Stimulating Non-healing Venous Leg Ulcers: Evaluation of Innovative New Muscle Pump ActivatorLinked DocumentDownload button
  • Poster: Evaluation of an Exciting Neuromuscular Electrostimulation Device for Chronic, Non-healing Venous Leg UlcersLinked DocumentDownload button
  • Poster: Using a Neuromuscular Electrostimulation Device for Non-healing Lower Leg Wounds in Long Term Care Residents (2017)Linked DocumentDownload button
  • Poster: The geko™ a NMES device and its healing effect on diabetic foot and venous leg ulcersLinked DocumentDownload button
  • Poster: Adjunctive application of a muscle pump activator to improve blood flow in patients with lower limb ulcerations related to chronic venous insufficiency (2017)Linked DocumentDownload button
  • Poster: A NMES device…not just for routine wound careLinked DocumentDownload button
  • Poster: A role for a portable NMES device for treatment of refractory chronic wounds of the lower extremityLinked DocumentDownload button
  • Poster: Lessons Learned - The Implementation of a novel NMES DeviceLinked DocumentDownload button
  • Poster: The Effect of NMES on Venous Leg Ulcers and a Pressure UlcerLinked DocumentDownload button
  • Poster: The Implementation of a novel NMES device into a community home care programLinked DocumentDownload button
  • Case study: A targeted approach to healing complex wounds using the geko™ deviceLinked DocumentDownload button
  • Case study: Rapid Healing foot ulcer following the use of the geko™ deviceLinked DocumentDownload button
  • To request a printed copy of the geko™ device IFU through the postAddress details
  • (Archived IFU's)