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Application for ESRA Abstract Prizes:Background and Aims Low ejection fraction and poor perfusion can not only delay wound healing but can also result in ischaemic pain in the foot. We report a case of successfully managing neuropathic pain and improving perfusion thus promoting wound healing using repeated treatment with Biowave external neurostimulation in a patient who had a non-healing trophic ulcer of the foot following mine-blast injury 10 months ago and complicated by deep vein thrombosis and dilated cardiomyopathy.Methods Patient was initially treated with a 30-minute Biowave neurostimulation as per protocol twice a day as per protocol and from day 14 onwards this was increased to three times a day. Pain scores were monitored with VAS and other quality of life indicators were monitored over a 16-day period. Perfusion was measured using thermography and progress of wound healing was also documented. General improvement reported by the patient were also noted.Results Baseline VAS was 9/10 preventing independent mobilisation. VAS was reduced to 5/10 after the first stimulation and the effect lasted more than 8–10 hours. Following twice daily stimulation, VAS was reduced to 0/10 after three days. No nocturnal pain was reported after two days improving sleep hygiene. Patient resumed independent mobilisation after five days. Improved perfusion and enhanced granulation were observed, and no systemic analgesia was required for maintenance analgesia; there was reduction of rescue analgesia for wound dressing.Conclusions Repeated treatment with Biowave external neurostimulation not only improves neuropathic pain but also facilitates wound healing of trophic ulcer in conditions of poor ejection fraction and perfusion.