Muscle pump activator devices in the treatment of chronic ulcers and wounds (literature review)
https://doi.org/10.25199/2408-9613-2026-13-2-24-34
Abstract
The problem of healing chronic ulcers and wounds is far from its final solution, many patients continue to live with them even after all standard treatment options have been exhausted.
Objective. The aim of this review is to summarize the published evidence on the effectiveness of muscle pump activator devices in the management of chronic ulcers and wounds, reflecting the clinical use of such devices.
Material and methods. A literature search was conducted in PubMed, Google Scholar, and e-Library for the period from 2010 to 2025. Seventeen full-text publications of any design were included for the review that assessed the effect of pump activator devices on blood flow and microcirculation or on wound healing in patients with chronic wounds and ulcers. Seven studies used a comparison with a control group, which received standard therapy for wound healing, the intervention group differed from the control group by the addition of pump activator devices physiotherapy. The total number of participants in the intervention/control group was 163/152 pers., the total number of patients from observational studies was 164.
Research results. Difficult-to-heal wounds of all etiologies showed a higher healing rate, reduced dressings, improved patient quality of life, pain and swelling control under the influence of pump activator devices than in cases of treatment with standard therapy alone. Given the lack of work on this topic in e-Library, the author finds it useful to draw the attention of the audience to pump activator devices as an additional option for healing chronic wounds of all etiologies.
Conclusion. The effectiveness of using muscle pump activators as an additional therapy to improve the function of the calf muscle pump in patients with chronic ulcers and wounds who cannot tolerate optimal compression therapy has been proven. However, further large-scale randomized clinical trials on the use of muscle pump activator devices are needed to confirm these benefits.
About the Author
V. G. MikhaylovRussian Federation
Vladimir G. Mikhaylov – Head of Department
185 Volgogradskaya str., Ekaterinburg, 620102
References
1. Bowers S, Franco E. Chronic wounds: evaluation and management. Am Fam Physician. 2020;101(3):159-166.
2. Bogachev VYu, Alukhanyan OA, Lobanov VN, Larina AR. Principles of the local treatment of venous trophic ulcers and the role of epidermal growth factor. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2024;21(2):11-21. (In Russ.) doi: https://doi.org/10.21518/akh2024-043
3. Stacey MC, Sibbald RG, Evans R. Continuous muscle pump activation by neuromuscular electrical stimulation of the common peroneal nerve in the treatment of patients with venous leg ulcers: A position paper. Int Wound J. 2024;21(9):e70040. doi: https://doi.org/10.1111/iwj.70040
4. Lim SLX, Chung RE, Holloway S, Harding KG. Modified compression therapy in mixed arterial-venous leg ulcers: an integrative review. Int Wound J. 2021;18(6):822-42. doi: https://doi.org/10.1111/iwj.13585
5. Limited F. Speckle imaging showing microcirculatory blood flow at baseline with the geko™ device switched on 2019. URL: https://www.gekodevices.com/
6. Das SK, Dhoonmoon L, Bain D, Chhabra S. Microcirculatory changes in venous leg ulcers using intermittent electrostimulation of common peroneal nerve. J Wound Care. 2021;30(2):151-155. doi: https://doi.org/10.12968/jowc.2021.30.2.151
7. Bogachev VYu, Golovanova OV, Kuznetsov AN, Shekoian AO. Electromuscular stimulation: a new method for the treatment of chronic venous insufficiency in the lower extremities. Flebologiya [Phlebology]. 2010;4(1):22-27. (In Russ.)
8. Bogachev VYu, Vasil'ev VE, Lobanov VN, et al. The application of electric muscle stimulation for the treatment of venous trophic ulcers. Journal of Venous Disorders. 2014;8(3):18-24. (In Russ.)
9. Griffin MA, Nicolaides AN, Bond D, et al. The efficacy of a new stimulation technology to increase venous flow and prevent venous stasis. Eur J Vasc Endovasc Surg. 2010;40:766-771. doi: https://doi.org/10.1016/j.ejvs.2010.06.019
10. Kamaev AA, Bulatov VL, Vakhratyan PE, et al. Clinical Guidelines. Varicose Veins. Flebologiya. 2022;16(1):41-108. (In Russ.). doi: https://doi.org/10.17116/flebo20221601141
11. Peters EJ, Lavery LA, Armstrong DG, Fleischli JG. Electric stimulation as an adjunct to heal diabetic foot ulcers: a randomized clinical trial. Arch Phys Med Rehabil. 2001;82(6):721-725. doi: https://doi.org/10.1053/apmr.2001.23780
12. Ud-Din S, Bayat A. Electrical stimulation and cutaneous wound healing: a review of clinical evidence. Healthcare (Basel). 2014;2(4):445-467. doi: https://doi.org/10.3390/healthcare2040445
13. Gianino E, Miller C, Gilmore J. Smart wound dressings for diabetic chronic wounds. Bioengineering (Basel). 2018;5(3):51. doi: https://doi.org/10.3390/bioengineering5030051
14. Bull RH, Clements D, Collarte AJ, Harding KG. The impact of a new intervention for venous leg ulcers: a within-patient controlled trial. Int Wound J. 2023;20(6):2260-2268. doi: https://doi.org/10.1111/iwj.14107
15. Aquil S, Sharma H, Alharbi B, et al. The impact of a muscle pump activator on incisional wound healing compared to standard stockings and compression devices in kidney and kidney-pancreas transplant recipients: a randomized controlled trial. Can Urol Assoc J. 2019;13(11):E341-E349. doi: https://doi.org/10.5489/cuaj.5822
16. Williams KJ, Moore HM, Ellis M, Davies AH. Pilot trial of neuromuscular stimulation in human subjects with chronic venous disease. Vasc Health Risk Manag. 2021;17:771-778. doi: https://doi.org/10.2147/VHRM.S320883
17. Das SK, Dhoonmoon L, Chhabra S. Neuromuscular stimulation of the common peroneal nerve increases arterial and venous velocity in patients with venous leg ulcers. Int Wound J. 2021;18(2):187-193. doi: https://doi.org/10.1111/iwj.13510
18. Harding KG, Blow M, Ashton F, Bosanquet DC. Neuromuscular Electrostimulation Increases Microcirculatory Flux in Mixed Etiology Leg Ulcers. Adv Skin Wound Care. 2025;38(1):25-30. doi: https://doi.org/10.1097/ASW.0000000000000261
19. Bosanquet DC, Ivins N, Jones N, Harding KG. Microcirculatory flux and pulsatility in arterial leg ulcers is increased by intermittent neuromuscular electrostimulation of the common peroneal nerve. Ann Vasc Surg. 2021;71:308-314. doi: https://doi.org/10.1016/j.avsg.2020.07.030
20. Harris C, Loney A, Brooke J, et al. Refractory venous leg ulcers: observational evalua
21. tion of innovative new technology. Int Wound J. 2017;14(6):1100-1107. doi: https://doi.org/10.1111/iwj.12766
22. Harris C, Ramage D, Boloorchi A, et al. Using a muscle pump activator device to stimulate healing for non-healing lower leg wounds in long-term care residents. Int Wound J. 2019;16(1):266-274. doi: https://doi.org/10.1111/iwj.13027
23. Yilmaz S, Mermi EU, Zobaci E, et al. Augmentation of arterial blood velocity with electrostimulation in patients with critical limb ischemia unsuitable for revascularization. Vascular. 2017;25(2):137-141. doi: https://doi.org/10.1177/1708538116649317
24. Jones NJ, Ivins N, Ebdon V, et al. Neuromuscular electrostimulation on lower limb wounds. Br J Nurs. 2018;27(20):S16-S21. doi: https://doi.org/10.12968/bjon.2018.27.Sup20.S16
25. Ingves MV, Power AH. Two cases of transcutaneous electrical nerve stimulation of the common peroneal nerve successfully treating refractory, multifactorial leg edema. J Investig Med High Impact Case Rep. 2014;2(4). doi: https://doi.org/10.1177/2324709614559839
26. Sibbald RG, Geng R, Slomovic J, Stacey M. The muscle pump activator device: from evidence to lived experiences. Int Wound J. 2024;21(8):e14949. doi: https://doi.org/10.1111/iwj
27. Tuson R, Metry A, Harding K. Cost-effectiveness analysis of the geko™ device (an NMES technology) in managing venous leg ulcers in UK healthcare settings. Int Wound J. 2024;21(10):e70048. doi: https://doi.org/10.1111/iwj.70048
28. Murray H, Duong R, Bain DS. Healing Rate and Time to Closure of Venous Leg Ulcers: A Real-World Service Evaluation of Neuromuscular Electrostimulation as an Adjunct to Compression Therapy. Advances in Skin & Wound Care. 2025;38(5):246-250. doi: https://doi.org/10.1097/ASW.0000000000000299
29. Collarte A, Dee N. Muscle pump activation for hard-to-heal leg ulcers. Journal of Community Nursing. 2025;39(1).
30. Bosanquet DC, Blow M, Ashton F, Harding K. Neuromuscular Electrostimulation of the Common Peroneal Nerve Increases Microvascular Flux in the Wound bed of Diabetic Foot Ulcers. Int J Low Extrem Wounds. 2025:15347346251331254. doi: https://doi.org/10.1177/15347346251331254
31. Robson MC, Hill DP, Woodske ME, Steed DL. Wound healing trajectories as predictors of effectiveness of therapeutic agents. Arch Surg. 2000;135(7):773-777. doi: https://doi.org/10.1001/archsurg.135.7.773
32. Gelfand JM, Hoffstad O, Margolis DJ. Surrogate endpoints for the treatment of venous leg ulcers. J Invest Dermatol. 2002;119(6):1420-1425. doi: https://doi.org/10.1046/j.1523-1747.2002.19629.x
33. Driver VR, Gould LJ, Dotson P, et al. Identification and content validation of wound therapy clinical endpoints relevant to clinical practice and patient values for FDA approval. Part 1. Survey of the wound care community. Wound Rep and Reg. 2017;25(3):454-465. doi: https://doi.org/10.1111/wrr.12533
34. Warwick D, Shaikh A, Worsley P, et al. Microcirculation in the foot is augmented by neuromuscular stimulation via the common peroneal nerve in different lower limb postures: a potential treatment for leg ulcers. Int Angiol. 2015;34(2):158-165.
35. Stacey MC, Sibbald, RG, Evans, R et al. Canadian Consensus Statement for the Management of Venous Leg Ulcers. Int Wound J. 2025;22:e70415. doi: https://doi.org/10.1111/iwj.70415
Review
For citations:
Mikhaylov V.G. Muscle pump activator devices in the treatment of chronic ulcers and wounds (literature review). Wounds and wound infections. The prof. B.M. Kostyuchenok journal. 2026;13(2):24-34. (In Russ.) https://doi.org/10.25199/2408-9613-2026-13-2-24-34
JATS XML
























