Chronic wounds in the UK represents a significant burden to patients and the NHS, it is estimated that there are approximately 200,000 patients suffering chronic wounds¹. Common symptoms of ulceration include pain, exudate, inflammation and odour, these symptoms are frequently associated with poor sleep, loss of mobility and social isolation².
Patients are predominantly managed in the community by general practitioners (GPs) and nurses. The annual NHS cost is £1⋅94 billion to manage 731 000 leg ulcers³. With proper diagnosis and treatment, much of this burden should be avoidable.
The impact on a patient’s quality of life is well documented. One sufferer, Mr. Gordon Vickers, developed a leg ulcer following a skin biopsy on his left leg, which was negative for basal cell carcinoma. The biopsy site got infected and it quickly spread. Various tests excluded underlying arterial, venous or connective tissue disease. After six months of wound deterioration and failure of different dressing regimens, Mr. Vickers had lost hope that his ulcer would heal, until he was asked to try the geko™, a new medical device designed to increase blood flow for chronic wound healing.
Prescribed by his Vascular Consultant, Mr Sameh Dimitri, the geko™ device was introduced as an intervention when compression bandaging could be tolerated no longer. Within a few days of use his swelling was reduced and the wound started to heal rapidly, with full closure on the posterior aspect of the leg achieved after just five months of use.
The patient – Mr Vickers
Mr Vickers was a fit retired pilot, who enjoyed a good quality of life, running multiple businesses including a busy hotel and spa, which caters for over 130 guests. It was important that he was back up on his feet as soon as possible!
“The transformation has been truly remarkable. After months of suffering I had given up all hope that my wound would ever heal and was thinking the worst! I had not foreseen that a routine biopsy would lead to such infection and pain, requiring daily dressing changes and the need to take various forms of oral medication and antibiotics. Nothing seemed to be working and the ulcer was getting worse.
On three occasions I was admitted to hospital for intra venous antibiotics to fight the infection. After discharge in February 2016, I can remember feeling at my lowest point. I was unable to sleep due to the pain, and the swelling at my ankle meant I couldn’t wear shoes, limiting my mobility. When I could no longer tolerate the compression bandaging, my Vascular Consultant, Mr. Dimitri, suggested we try the geko™ device, I was willing to try anything!”
Worn at the knee, the geko™ looks a bit like a cross between a small wrist-watch and a sticking plaster. It stimulates a nerve activating muscles in the calf and foot which squeeze the veins causing an increase in blood flow. The sensation is painless, just a gentle twitch.
“Within days my swelling was greatly reduced, to the extent that a routine Doppler test could be carried out, something that had previously not been possible. It marked progress and was very uplifting.”
The speed the wound then healed surprised everyone, including the district nursing team. They said they had not seen a chronic wound heal so quickly and shared that an ulcer, the size of mine, and the site of where it was might typically never heal, requiring life-long conventional cleaning and dressing.
It is to the geko™ device that I owe my thanks, and to my Consultant Mr Dimitri for introducing the device into my treatment plan”. My return to work and full daily activities has been life changing! I’m now enjoying my jive classes, wearing normal shoes – the improvement to my quality of life is just immeasurable!
The geko™ device
The geko™ device is a battery powered, disposable, neuromuscular electrostimulation device designed to increase blood flow for the promotion of wound healing, the treatment and prevention of oedema (swelling) and the prevention of deep vein thrombosis (DVT), as approved by NICE⁴.
The geko™ device, through gentle electrical impulses, stimulates the common peroneal nerve activating the calf and foot muscle pumps, increasing venous, arterial and microcirculatory blood flow. The increase in blood flow transports oxygen to the wound bed promoting conditions favourable to wounds healing.
The blood flow increase is similar to that achieved by walking, up to 60%, without a patient having to move, but allowing full patient mobility while wearing the geko™ device.
A study that was conducted this year measured the effect of the geko™ device on blood flow in the deep veins of the calf. The study has shown significant volume and velocity increases within the gastrocnemius, peroneal and posterior tibial veins – the first time that a mechanical device has reported enhancement to blood flow in the deep veins. The result of the unique dorsiflexion (calf muscle and foot movement) achieved by the geko™ device.
The Consultant – Mr Dimitri
Mr Sameh Dimitri, a Vascular Consultant at the Countess of Chester says, “Mr Vickers ulcer was resistant to various treatment modalities and was suffering unremitting pain. Intervention with the geko™ device, as an adjunct therapy, helped to heal his wound, reduce his swelling, pain, and was met with good compliance”.
The Countess of Chester
“By fostering an environment that embraces innovation we are determined to ensure that the Countess of Chester remains a pioneer of new treatments and models of care so that our patients will be amongst the first to benefit from these hugely exciting medical advances”. We have recently adopted the gekoᵀᴹ device as part of our armamentarium of prophylaxis against deep vein thrombosis (DVT).
1. Posnett, J., Franks, P.J, (2008) The burden of chronic wounds in the UK. Nursing Times; 104: 3, 44–45.
2. Franks, P.J., Morgan, P.A. (2003) Health-related quality of life with chronic leg ulceration. Expert Review of Pharmacoeconomics and Outcomes Research; 3: 5, 611–622.
3. Guest JF, Ayoub N, McIlwraith T, et al. Health economic burden that different wound types impose on the UK’s National Health Service. International Wound Journal 2016:n/a-n/a. doi: 10.1111/iwj.12603
4. NICE medical technologies guidance (MTG19). Published date: June 20 2014