Increasing blood flow after orthopaedic surgery – the options
There is strong evidence that maintaining good blood flow in the legs after surgery can improve patient outcomes in a number of areas including DVT prevention, oedema reduction and wound healing through improved oxygen and nutrient perfusion.
To increase blood flow in the legs after orthopaedic surgery the options available to date have been passive or active physical therapy to activate the calf and foot muscle pumps, intermittent pneumatic compression (IPC) and compression hosiery, except when contraindicated because of peripheral vascular disease, severe leg oedema, fragile skin or cardiac failure.
Patients are also given anti-coagulation therapy to help with the prevention of DVT, this however carries with it an increased risk of bleeding-related complications, and may also be contraindicated.
A new development is the geko™ device which is the size of a wrist-watch and worn at the knee. The geko™ device stimulates the common peroneal nerve activating the calf and foot muscle pumps to increase venous, arterial and microcirculatory blood flow, up to 60 per cent to that achieved by walking [1]. By this same mechanism of action, the geko™ device delivers pre-operative and post-operative oedema reduction [2], which left unmanaged can impair surgical wound healing.
The geko™ device is recommended by NICE (MTG19) [3] for patients who have a high risk of VTE and for whom pharmacological or other mechanical methods of VTE prevention are impractical or contraindicated.
To find out more about the geko™ device and how it can benefit your patients, visit www.gekodevices.com or call 0845 2222 921.
References
- Tucker A, et al. Augmentation of venous, arterial and microvascular blood supply in the leg isometric neuromuscular stimulation via the common peroneal nerve. Int J Angiol.2010 Spring; 19(1):e31-e37.
- Wainwright T, et al. An RCT comparing the effect of the geko™ device and TED stockings on post-operative oedema in Total Hip Replacement patients. Physiotherapy UK 10-11 Oct 2014, Birmingham.
- NICE medical technologies guidance (MTG19). Published 20 June 2014.
