Atul Khurana
Country Manager-India,
Firstkind Ltd.

The geko device – providing increased blood flow for enhanced recovery

Population ageing, lengthening life spans, and the rising prevalence of obesity and other chronic conditions are increasing the demand for vascular health solutions. Globally, more than 20 million people annually suffer from strokes, post-surgical swelling, and non-healing wounds that are not being adequately treated by current therapies, and the patients are at further risk of medical complications – and poor circulation can be related to many of the diseases and conditions these patients suffer1 from.

Sky Medical Technology’s (parent company of Firstkind Ltd.) mission has been to provide clinicians with an innovative solution that addresses poor circulation and delivers safe recovery and accelerated healing. Sky/Firstkind has developed and commercialized a bio-electronic nerve-stimulation technology, clinically proven to increase blood circulation2. The award-winning device, called geko, uses the body’s own internal compression system (specific nerves and muscles) to provide a significant increase in blood circulation on-demand in the hospital or at home.

External compression, multi-layer bandages, and drugs are currently the standard of care for increasing blood circulation, but do not work for all conditions. Existing compression (IPC devices and stockings) has poor compliance; multi-layer bandaging can be difficult to apply; and drugs can cause an unpredictable bleed risk3,4. The geko device overcomes these challenges, and is uniquely positioned to address significant unmet need when drug and current compression devices are impractical or contraindicated5,6. The size of a wristwatch and worn at the knee, the battery-powered geko device gently stimulates the common peroneal nerve with painless electrical pulses, activating the calf and foot muscle pumps, increasing blood flow in the deep veins of the calf at a rate equal to 60 percent2 of walking, without a patient having to move.

The device provides safer and faster recovery by reducing post-surgical complications, and accelerated healing. It does this by eliminating post-operative swelling, e.g., after knee, hip, or foot surgery7, reducing the risk of deadly blood clots, e.g., in stroke patients5, and accelerating the healing of wounds8, e.g., in people with poor blood circulation.

The geko’s clinical effectiveness has been demonstrated through early real-world studies. These studies have helped the company achieve regulatory approval in many countries, including the US (510k clearances), Europe, the Middle East, and Asia, with the result that key opinion leaders are now actively using and recommending the geko device, moving geko from early adoption to repeat use in key reference centers across 31 countries – and now in India also, with a focus in three analogous medical pathways: Orthopedic – studies show the geko device reduces swelling and pain post-operatively7 and accelerates readiness for surgery when surgery is prevented by excessive pre-operative swelling6;  venous thromboembolism (VTE) – complications caused by VTE are significant in patients suffering acute stroke. The geko device provides preventive circulation therapy to all at-risk hospital patients9; and wound care – the geko device delivers markedly increased blood flow to heal complex wounds10.

UK NHS geko studies of note
A 1000 patient real-world study has shown that, of the 463 acute stroke patients treated with IPC, as the standard of care, 11 patients (or 2.4 percent) suffered a VTE event. Of the 203 patients treated with the geko device there was no incidence of VTE reported. The study measured VTE events at 90 days post-stroke5. A major trauma centre has also investigated geko use to reduce pre-operative oedema in ankle fracture patient requiring surgery (ORIF). Fitted above the backslab plaster, the study measured patient compliance and readiness to surgery, matched to the historical cohort and reported a 2 days improvement in readiness to surgery per patient (average), good patient compliance and a cost saving of £569 per patient (average)6.

References
Science Daily. Mechanisms of impaired blood flow. September 2015.

Tucker A. et al. Augmentation of venous, arterial and microvascular blood supply in the leg by isometric neuromuscular stimulation via the peroneal nerve. The International journal of angiology: 2010 Spring; 19(1): e31-7.

Rabe E. et al. Risks and contraindications of medical compression treatment–A critical reappraisal. An international consensus statement. Phlebology–The journal of venous disease. March 2, 2020

Whiteley WN. et al. Targeted use of heparin, heparinoids, or low molecular-weight heparin to improve outcome after acute ischaemic stroke: An individual patient data meta-analysis of randomised controlled trials. The Lancet Neurology 2013;12, 539-545.

Williams J. et al. The use of the geko device and the activation of the foot and calf pumps for prevention of venous thromboembolism in patients with acute stroke. Data on file, 2018. Firstkind Ltd.

Baker P. Mahmood I. et al. James Cook Hospital. Data on file, April 2017, Firstkind Ltd.

Wainwright W. et al. A feasibility randomised controlled trial to evaluate the effectiveness of a novel neuromuscular electro-stimulation device in preventing the formation of oedema following total hip replacement surgery. Heliyon, Volume 4. Issue 7, July 2018, e00697.

Harris C. et al. Evaluation of a Muscle Pump-Activating Device for Non-Healing Venous Leg Ulcers.Int Wound J. 2017 Dec;14(6):1190-1198. Doj:101111/iwj.12784.Epib 2017 Aug 2.

NICE Guidelines (MTG19). Published date June 2014.

Jones J. Harding K. et al. Neuromuscular electrostimulation on lower limb wounds. British Journal of Nursing Vol. 27, No. 20. Online: 12 Nov 2018. 

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