Despite advances in wound care, treatment of lower limb ulceration remains suboptimal, with poor outcomes often attributed to inadequate diagnosis, failure to follow evidence-based practice, and variations in care delivery. These shortcomings result in delayed healing, reduced quality of life (QoL), and a significant economic burden on healthcare systems. Compression therapy is the recommended treatment for venous ulcers and ulcers with mixed aetiology, however there are some individuals who may not respond to compression alone or who are unsuitable due to arterial status. Recent advances in adjunctive therapies, such as the geko^® device, offer promising results for these patients. This muscle pump activation (MPA) device activates the calf and foot muscle pumps,
increasing venous, arterial and microvascular blood flow. This article examines the impact of leg ulceration on healthcare services and patient outcomes, while exploring the potential of the geko^® device to improve healing rates and reduce associated costs.