Clinician FAQs

Within the United Kingdom (including the Channel Islands):

For Community Pharmacies in the UK, Accel-Heal Solo can be prescribed (PIP: 4195251) and ordered through Alliance and NWOS. It can also be obtained from most major wholesalers via the specials route.

Accel-Heal Solo is also available through the National Health Service supply chain: Blue Diamond (NHSSC code: ELZ85068).

Alternatively, to place a direct order, please contact: customerservices@accelheal.com

Outside the United Kingdom:

Accel-Heal Solo is available through our international distribution partners Distribution Partners

Samples are provided for healthcare professionals for specific patients as part of a formal evaluation.

Accel-Heal Solo is a single-use, automated treatment that is activated by the push of a single button. As such it can be easily used and monitored by all medical disciplines, carers and patients undertaking self-care.

Accel-Heal Solo is available on UK drug tariff in part 5a – appliances. Nurse prescribers and GPs in the UK are able to prescribe it on FP10.

It can be used in all clinical settings. Accel-Heal Solo is a novel electrical stimulation therapy, in that it is easy to use by patients, relatives, carers and health care professionals, as an adjunct to standard therapy, enabling the patient to continue with their normal routine and treatments. As with any electrical device, it should not come in contact with water. However, the device can be easily removed from the electrode pad wires, enabling showering, or the limb can be covered by a garment such as a Limbo to prevent the device becoming wet.

Electrical stimulation therapy (EST) in general has been used for healing wounds for many years. There is a vast range of in vitro, molecular and clinical evidence to support its use. In fact, EST is arguably one of the most evidence-based therapies in wound management today, with nine meta-analyses, eight systemic reviews and over 35 RCTs, with the first publications about it appearing in the 1980s.

However, there are many different treatment modalities and formats of EST. For example, there may be a requirement for different parameters to be adjusted during application; the electrical current can be delivered directly to the wound or be incorporated in a dressing. Some modalities can deliver unpleasant sensations, while some devices are very large and therefore not suitable for use in a community setting. As a result, the use of EST has largely been restricted to specialist clinics and research practice.

Accel-Heal Solo is a single-use, automated EST device which delivers pre-programmed, low voltage pulsed current to the wound over a 12-day period. This enables clinicians to easily use EST in everyday practice. Accel-Heal Solo has been developed in the UK over the last 12 years where it has been undergoing clinical trials and evaluations and, more recently, has become commercially available. Under new ownership, commercial availability is being extended to a greater number of countries and a larger number of evaluations and trials are also underway.

In-vitro studies (Greener 2018) have concluded that the current can travel up to 160cm between the two electrodes. However, in practice, the device incorporates a function which monitors current flow and adjusts voltage to enable it to deliver the prescribed treatment current, irrespective of distance between placed electrodes. This enables some flexibility in application across the anatomy. Should this not be possible then an indicator will flash orange to show an error.

Studies have demonstrated benefits to multiple wounds in the same vicinity using one Accel-Heal Solo therapy, e.g. multiple circumferential leg ulcers. However, the wound(s) need to sit between the two electrode pads. It is recommended to apply the electrode pads closest to the largest wound initially. If there is a response to the largest wound, but no response to the smaller wound(s) then a second Accel-Heal Solo therapy can be considered.

An in-vitro study (Greener 2018) demonstrated the electrical signal penetrates to at least a depth of 6cm, using gelatin to replicate human tissue.

Accel-Heal Solo is a low voltage biphasic and monophasic pulsed current device. Accel-Heal delivers a fixed automatic, pulsed electrical stimulation therapy with a current varying from 40 to 500micro Amps (μA) at a frequency varying from 10 to 900 Hz during a 30-minute treatment program. The treatment program is repeated every two hours in the first 24 hours and every four hours in the second 24-hour period. One device is supplied in the treatment pack and should remain applied continuously to deliver the 12-day therapy.

Other types of electrical stimulation, for example TENS, are delivered at higher voltages above the threshold for sensory stimulation and in doing so interact with the nervous system to block pain signals. TENS can provide short-term pain relief while the TENS machine is being used. However, low voltage pulsed current electrical stimulation devices, such as Accel Heal Solo, are sub-sensory, acting locally at the cellular level and so contribute to modulating the underlying healing process and reducing those factors causing pain, which continues long after the Accel-Heal Solo device has been used.

Accel-Heal Solo is a low voltage biphasic and monophasic pulsed current device. Accel-Heal delivers a fixed automatic, pulsed electrical stimulation therapy with a current varying from 40 to 500micro Amps (μA) at a frequency varying from 10 to 900 Hz during a 30-minute treatment program. The treatment program is repeated every two hours in the first 24 hours and every four hours in the second 24-hour period. One device is supplied in the treatment pack and should remain applied continuously to deliver the 12-day therapy.

Other types of electrical stimulation, for example high voltage pulsed current (HVPC) and many forms of TENS are delivered above the threshold for sensory stimulation. Electrical stimulation therapy devices do not need to evoke such strong physical responses to stimulate the appropriate cellular effect in the wound bed. TENS can provide short-term pain relief while the TENS machine is being used. However, Accel-Heal Solo will enable the wound to continue healing with pain reduction, even after the 12-day therapy.

Typically, smaller wounds with lower duration are more likely to respond faster in terms of healing and wound contraction. However, it has been used on larger wounds with a long duration equally successfully but wound contraction is understandably slower and the clinical presentation/changes maybe more subtle.  Pain reduction can be seen in a range of different wound sizes and duration within a short period.

Accel-Heal Solo can be used on any chronic wound and is only contraindicated in fungating wounds. The holistic needs of the patient need also to be considered, including factors such as nutrition and pressure off-loading. A Cochrane review of the use of electrical stimulation for pressure ulcers has been undertaken (Arora et al 2020) and it has been recommended for use in recalcitrant category 2-4 pressure ulcers by NUPUAP 2014, with strength A evidence. Caution needs to be taken with the electrode wires, which could cause pressure injury if not protected. The recommended placement of the pads is away from any potential pressure points when the patient is sitting. Accel-Heal Solo monitors current flow through the electrode pads and automatically adjusts the voltage to ensure the required current program is delivered, regardless of variables such as distance between the electrode pads, and individual patient characteristics such as hydration level of the skin. Therefore, even when the pads are placed at quite some distance from each other, the required electrical stimulation will still be delivered. The electrode pads could be placed on the outer buttocks or hips, and they would still be effective.

It is important to determine the cause of the high exudate, whether it is due to the underlying aetiology such as venous/lymphatic drainage from the limb, infection, biofilm, heart disease, underlying fistula etc. The underlying aetiology needs to be addressed, such as compression therapy, wound infection management. However, due to a reduction in inflammation by the electrical stimulation, a marked reduction in exudate has been noted during and following Accel-Heal Solo therapy. In the case of moderate or heavy exudate it is recommended to change the dressings more frequently, at least initially, in order to monitor the exudate levels and the electrode pads. Place the pads horizontally to avoid the pads becoming too wet from gravitational moisture.

Always try to re-vascularise through angioplasty or by-pass surgery where possible. If, however, the patient is not suitable or where there is a large venous component of the arterial insufficiency, then that is the only place where reduced compression can be truly justified. Many of these wounds can be very painful. While there have been no studies undertaken yet by Accel-Heal specifically on arterial ulcers, there is no reason the science in terms of reduction in inflammation and gene expression which occurs, wouldn’t be transferable to mixed aetiology wounds.

Accel-Heal Solo might help with painful neuropathy and well as painless neuropathy. If the wound is stalled, and/or there is a biochemical imbalance and if you have also addressed any underlying factors, then you can apply the device to see if that starts the wound healing process. Pain reduction often happens very quickly and only needs one 12-day period of therapy. Similarly for treating a stalled or static wound, it is recommended to use it for the 12 days and wait and see. Often what you will find is a change in the healing trajectory from being plateaued, to being stimulated again with wound size reduction. Don’t use it again unless you see another plateau. So, it’s a very specific device to kick-start that wound in the next phase, it’s not like a product that we are saying you use over a long period of time, which would be an increased cost. It’s a short duration treatment for a specific need.

In treating this disease you need to ensure you have the correct diagnosis and biopsies. High doses of topical steroids are helpful. If a good result is achieved with those, then the patient may benefit from compression. While it is difficult to obtain a clear-cut definition of how to manage this disease, due to scattered numbers and not many people building up a vast experience of managing these wounds, but if painful, Accel-Heal Solo could be used as an enabler to have compression. Also, sometimes systemic steroids can be beneficial.

Patients with lympho-venous disease require a multi-disciplinary approach to this long-term condition, which mainly involves compression therapy, intensive skin care and in some cases, manual lymphatic drainage or surgery. However, there is evidence that Accel-Heal Solo can reduce peri-wound oedema and is a therapy that should be considered within the multi-disciplinary approach. (See http://accelheal.com/app/uploads/2020/07/Study-to-evaluate-the-effect-of-low-intensity-pulsed-electrical-currents-on-levels-of-odema.pdf)

Patients with lympho-venous disease require a multi-disciplinary approach to this long-term condition, which mainly involves compression therapy, intensive skin care and in some cases, manual lymphatic drainage or surgery.  However, there is evidence that Accel-Heal can reduce peri-wound oedema and is a therapy that should be considered within the multi-disciplinary approach.  (See  http://accelheal.com/app/uploads/2020/07/Study-to-evaluate-the-effect-of-low-intensity-pulsed-electrical-currents-on-levels-of-odema.pdf)

Accel-Heal Solo is not contraindicated in children but users should proceed with caution as there have been no published studies or evaluations in children.

Accel-Heal Solo is contraindicated for use in patients with active cancer, including any risk of malignancy in the wound. Patients with pacemakers should consult their medical practitioner and the device should not be placed near the chest wall. Do not use near the head for patients with epilepsy. As a precaution, due to lack of evidence, patients who are pregnant or under 18 should consult their medical practitioner. Do not place the electrode pads over broken capillaries, varicose veins, or main arteries.

Accel-Heal Solo is contraindicated for use in patients with active cancer, including any risk of malignancy in the wound. Patients with pacemakers should consult their medical practitioner and the device should not be placed near the chest wall in this patient group. Do not use near the head for patients with epilepsy. As a precaution, due to lack of evidence, patients who are pregnant or under 18 should consult their medical practitioner. Do not place the electrode pads over broken capillaries, varicose veins, or main arteries.

To date, over 12,500 devices have been applied to patients and there have only been a handful of reports of reactions to the skin under the pads.  Clinicians sometimes report some redness under the pads, but often this is when the pads were placed too close to the wound edge which caused exudate leakage underneath it.

The pads are hydrogel based and are therefore easily removed without causing skin trauma.  In patients with known sensitivities, it is recommended to check the pads more frequently during early use, rotate the position of the pads during dressing changes, and, in the case of heavy exudate, ensure the pads are placed well away from the wound bed and positioned horizontally across the wound to avoid gravitational moisture.  Where there is friable skin immediately adjacent to the wound, it is recommended the pads are placed farther apart. The device will automatically adjust to ensure the same level of current is supplied irrespective of the distance and individual skin conductivity.

There is no reported experience of using Accel-Heal Solo with hyperbaric oxygen therapy (HBOT) and there have been no safety assessments of its use within the hyperbaric oxygen chamber. Given the mode of action is different, it could conceivably be synergistic in accelerating healing and reducing pain if used in between hyperbaric oxygen therapy sessions, but further studies would be needed to validate this.

Evidence (Greener 2018) has reported that Accel-Heal Solo does not affect the cardiac function of the heart. However, although suitable for lower limb wounds, patients with cardiac pacemakers should not wear the device near the heart (Philbin et al 1998; Badger et al 2017).

Philbin DM, Marieb MA, Aithal KH, Schoenfeld MH. Inappropriate shocks delivered by an ICD as a result of sensed potentials from a transcutaneous electronic nerve stimulation unit. Pacing Clin Electrophysiol. 1998;21(10):2010-2011. doi:10.1111/j.1540-8159.1998.tb00027.x

Badger J, Taylor P, Swain I. The safety of electrical stimulation in patients with pacemakers implantable cardioverter defibrillators: A systematic review. J Rehabil Assist Technol Eng. 2017;4:2055668317745498.doi:10.1177/2055668317745498

There is currently no evidence to support the use of the Accel-Heal Solo in fungating wounds, and indeed it is contraindicated in patients with cancer in the wound as it may stimulate tumour growth. However, if informed consent is obtained from the patient, and the benefits such as pain reduction and exudate reduction outweigh any potential risks, then it can be considered for palliative care.

There are 23 published articles, including 10 papers and 13 posters, which describe the effects of Accel-Heal Solo. These articles published in clinical literature describe the results from 160 patients treated with Accel-Heal Solo. For more details see http://accelheal.com/clinical-evidence/

Accel-Heal Solo is indicated for use in all types of recalcitrant wounds (apart from malignant wounds), to kick-start the healing process by replacing the reduced or absent electrical energy often found in chronic wounds. Accel-Heal Solo is also indicated for use in painful wounds, which may be affecting a patient’s quality of life and/or where a patient is unable to tolerate other necessary wound treatments such as debridement and compression therapy.

Accel-Heal Solo is a low voltage biphasic and monophasic pulsed current device. Accel-Heal delivers a fixed automatic, pulsed electrical stimulation therapy with a current varying from 40 to 500micro Amps (μA) at a frequency varying from 10 to 900 Hz during a 30-minute treatment program. The treatment program is repeated every two hours in the first 24 hours and every four hours in the second 24-hour period. One device is supplied in the treatment pack and should remain applied continuously to deliver the 12-day therapy.

High compression therapy can be applied over the two electrode pads. However, under compression, caution needs to be taken with the electrode wires connecting the pads to the device, which could cause pressure injury.

Therefore, the recommended placement of the pads on a diabetic foot ulcer should be away from areas such as the sole of the foot. Try to place the electrodes either side of the wound, with the wires away from any weight-bearing areas. Accel-Heal Solo automatically adjusts the voltage to ensure the required current program is delivered, regardless of variables such as distance between the electrode pads, and individual patient characteristics such as hydration level of the skin. Therefore, even when the pads are placed at some distance from each other, the required electrical energy will still be delivered to the wound. The electrode pads can therefore be placed to the sides of the foot or the dorsum and the treatment to the wound is still effective. (See the Accel-Heal Solo application guide) http://accelheal.com/app/uploads/2020/03/Accel-Heal-Application-Poster-20_S1_WEB.pdf

One commonly used method is to place a foam dressing or other cushioning dressing under the wires up to the top of the hosiery.

Accel-Heal therapy is used alongside standard wound care, including compression therapy, so changing the dressings or bandages should be done based upon normal practice intervals. The electrode pads can either be left in place at dressing change (up to a maximum of 7 days) or changed at the same time. Sufficient electrodes are present in each 12-day therapy pack to allow for changes every 2 days if required.

You need at least 12 days to change the many chemical mediators that are below the wound so it important that the patient receives the full 12-day therapy course, similar to how patients would complete a seven-day antibiotic regime.

This question relates to compression therapy rather than electrical stimulation with Accel-Heal Solo. Compression therapy is indicated for use to aid venous return, thereby preventing, or healing venous leg ulceration.

Yes. Accel-Heal Solo monitors current flow through the electrode pads and automatically adjusts the voltage to ensure the required current program is delivered, regardless of variables such as distance between the electrode pads. In-vitro studies (Greener 2018) have demonstrated that the electrical signal was present in all foot pad positions when using Accel-Heal Solo (including the dorsum, plantar, heel, ankle and hallux).

Accel-Heal Solo delivers a sub-sensory level of pulsed current. Most patients have no sensation from the therapy. If some tingling is felt, this may be due to either the patient being dehydrated or the wound bed being very dry. Rehydrating the patient and the wound can be beneficial in these cases. In general terms, patient feedback and concordance to treatment from patients when using Accel-Heal Solo is excellent as they feel engaged in the treatment, happy to see their pain addressed and the healing of the previously stalled or slow healing wound, stimulated. Patient videos:

• https://www.youtube.com/watch?v=h5ZugSVEoYs
• https://www.youtube.com/watch?v=X14aaq-Ahj4

In some cases, Accel-Heal Solo reduces the pain within a few hours after application. However, in the majority of patients who experience a significant reduction or complete removal of pain, this generally occurs within a few days of application. Pain reduction is normally sustained throughout and beyond the 12-day treatment period. (See http://accelheal.com/resources-downloads/ for more details)

Clinicians rarely experience barriers from patients to using the therapy. Explanations should be given to patients in language that they understand. As one clinician has told us: “Getting patients to understand how electrical stimulation can stimulate wound healing is a huge challenge. – I have to scratch my head to understand the science behind all that.  But I have never had a barrier from the patient from a pain point of view.”  The non-medicated action of the treatment instead of taking pain killers is beneficial so weI have not had any barriers to it. (See patient story at https://www.youtube.com/watch?v=kEjlpNxKGmo&feature=youtu.be )

One 12-day therapy is usually sufficient to reduce the pain to enable full strength compression therapy. The pain reduction should then be sustainable after the 12 days as wound healing moves forward. Should pain return then a second treatment may be appropriate based upon clinical judgement. Further work is ongoing to look at multiple sequential uses of Accel-Heal Solo in certain patients with particularly recalcitrant non-healing wounds, and more guidance will be provided on this in the future.

For most wounds, once the 12-day Accel-Heal Solo therapy has been completed, the wound continues to progress towards healing. For some of long duration (i.e. over 12 months), for very large wounds, or patients with challenging comorbidities that have weak underlying healing potential, a second treatment with Accel-Heal Solo may be necessary to maintain the wound on a healing trajectory.

A second therapy is appropriate, if there was some response to the first treatment (i.e. pain reduction and/or wound size reduction) but the wound healing subsequently stalls or deteriorates. This can be the case in the event of a wound infection.

In general, it is recommended to wait approximately four weeks, to enable the first therapy to have its full effect, as the wound continues to heal after the therapy has been completed. However, there is no issue in using consecutive treatments if deemed clinically appropriate.

(Tadej M, Young S, Hampton S. Accel- Heal® : A new therapy for chronic wounds. J Community Nurs. 2010;24(5):16-21.)

Further research is being undertaken to identify the types of wounds/patients who may benefit from two or three 12-day periods of Accel-Heal Solo therapy, but for the majority of chronic wounds one 12-day dose is generally sufficient to both reduce pain and kick-start the wound healing process. Should there be a good initial response to the therapy, but then the wound becomes stalled again, or the pain increases, then a second 12-day therapy can be considered to re-initiate healing and/or reduce the pain. This is more likely to be in particularly recalcitrant wounds or in patients with many underlying co-morbidities. The second 12-day treatment can be applied immediately especially if pain is a major consideration but generally, it is recommended leaving for a few weeks to see if healing re-starts without further intervention.

Further research is being undertaken to identify the types of wounds/patients who may benefit from two or three 12-day periods of Accel-Heal Solo therapy, but for the majority of chronic wounds one 12-day dose is generally sufficient to both reduce pain and kick-start the wound healing process. Should there be a good initial response to the therapy, but then the wound becomes stalled again, or the pain increases, then a second 12-day therapy can be considered to re-initiate healing and/or reduce the pain. This is more likely to be in particularly recalcitrant wounds or in patients with many underlying co-morbidities.