Evidence Based Veterinary Medicine (EBVM) is the application of evidence to decision making in the course of a treatment or procedure. Evidence can take many forms from high level evidence consisting of expensive, highly controlled randomised trials to the lowest level being personal experience.
In practice Vets and Nurses adopting EBVM to guide their decision making will be actively seeking out the highest form of evidence to support their choice of care. In reality, this can only be taken into account based upon the resources and skills available to achieve the best outcome for the patient and owner.
Pharmaceutical and medicinal products are generally well supported in terms of their specific role and proposed medicinal effect. This is because it is a legal requirement to have conclusive clinical and safety data to support the marketing authorisation and Veterinary prescription medicine status (POMV) that will allow the product to be legally prescribed in practice.
When it comes to wound management products and medical devices evidence can be rather thinner on the ground. The legal requirement being that the products must not make medicinal or pharmaceutical claims without a marketing authorisation. However, they can claim to support healing, to create an optimal environment, to soothe or even provide the benefits of a natural ingredient (that may or may not cytotoxic). As long as the product makes no medicinal claims it can be promoted for Veterinary use without any regulatory restriction.
So why don’t we use the wound products with the best evidence?
Unfortunately most wound products are intended for human use, so data is often extrapolated from human trials on chronic rather than acute wounds. Furthermore, it is notoriously difficult to get high level randomised data for medical devices, even in humans, where a wound is made deliberately and a randomised controlled trial performed. For one, it is hard to blind a study where dressings vary markedly depending on brand and function, and that the variables involved with the stage of healing, patient profile and wound location mean the list of potential studies is endless.
In terms of veterinary use, the relatively small size of the market (compared to human healthcare) and the ethical constraints of deliberately wounding a control group large enough to prove a benefit means there is a dearth of quality evidence. We therefore rely on lower level evidence consisting of small group evaluation, individual experience and personal recommendations. This creates a lot of room for a lot of varied products that may be perceived to assist healing even when the wound may have healed anyway.
The result is a wealth of products aiming to be the product of choice for all wounds while users become confused about hypothetical benefits that are hard to substantiate with high level research. When many wounds heal anyway the lack of distinct clinical benefit can confuse and contradict leading to a loss of confidence and timely decision making.
EBVM Matters - RCVS Knowledge
RCVS Knowledge last year published Evidence-Based Veterinary Medicine Matters: Our commitment to the future with the charity Sense about Science, in which 15 of the major UK member organisations, vet schools and policy-making bodies have come together to affirm their commitment to veterinary medicine based on sound scientific principles.
EBVM Matters is a commitment to advocating and using EBVM that RCVS Knowledge and the contributing author organisations have made, and are encouraging veterinary professionals and organisations to make i.e. to make clinical decisions according to their professional judgement, based on the best available evidence at the time and what is right for the individual animal and owner. “When rigorous research underpins medical decisions, adverse events can be minimised and patient outcomes can be improved.” – RCVS Knowledge
Several organisations and individuals have since signed up to this commitment. Our Founder, Georgie Hollis BSc, has pledged her support to the RCVS Knowledge EBVM Matters commitment on behalf of The Veterinary Wound Library.
Georgie wrote: "I believe that a pledge to uphold animal welfare can only be sustained where decisions are made based on best available evidence. Our field of wound care tech and education relies upon extrapolation of evidence from human healthcare where animal studies are lacking and RCT's are too costly to industry to focus in this area. As an independent advisory service (Veterinary Wound Library) we pledge to question the products promoted in the Veterinary sector for wound care and to encourage an evidence based approach, both in practice and in industry. We are committed to independence, dissemination and support of ethical, evidence based research that enables modern technologies to benefit the veterinary sector and animal welfare."
Find out more about the EBVM Matters commitment and pledge your support
This year, the International Conference of The Veterinary Wound Healing Association (VWHA) is coming to the London ExCel! The conference will be held on 14-15th of May in association with the European Wound Management Association EWMA) Conference and the call for abstracts is now open, with your chance to win a full conference pass!
The theme for 2020 is Wound and surgical site infections in the modern veterinary clinic: prevention and treatment. “Our theme will address problems and questions we all encounter in everyday veterinary practice. Wound infections are caused by bacteria, and infections are prevented and treated with antibiotics… or are they? We live in a world where resistant bacteria cause increasing problems. What can we do to both reduce wound infections and the use of antibiotics? Do antibiotics prevent or increase surgical site infection rates? When are bacteria a problem in open wounds? If so, do we need antibiotics, or do we have alternative strategies? Or is it better not to treat bacteria at all? Join us to learn about the latest developments in the practical approach of wound infections.”
VWHA are calling for abstracts to be submitted within the theme. Five abstracts will be presented at the conference and the authors will receive a 3 day pass to the full EWMA conference!
You’ll need to be quick- the deadline for abstract submission is 15th March 2020.
Download Instructions for preparation of abstracts EWMA 2020 London
Now submit your abstract here: https://form.jotform.com/200402862249349
We are delighted to announce the winners of the Andover Healthcare/Milliken Bandaging Art Competition (supported by VWL) which took place during November and December 2019. We would like to thank everyone who took the time to submit their entry and for participating in the competition promoting best practice in bandaging. The entries were all of a very high standard with much thought and effort put in, making it a great success. Congratulations to all of the above winners who each receive some great Petflex products!
Veterinary Practice interview with Georgie Hollis BSc on the latest advancements in veterinary wound care
Jennifer Parker, Senior Editor of the Veterinary Practice magazine, recently interviewed Georgie Hollis to gain her thoughts on the latest advancements within veterinary wound care.
To read the full article providing an insight into Georgie's thoughts from telemedicine to tilapia
Get Creative! Bandaging Art Competition 2019 - Andover Healthcare/Milliken (Supported by The Veterinary Wound Library)
Now's your chance to get creative with your bandaging skills for your chance to win some Andover Healthcare/Milliken Pet Flex products.
Georgie Hollis BSc, The Veterinary Wound Library & Bandaging Angels Founder, will be presenting a FREE live webinar on Bandaging Techniques on Tuesday 19 November at 12.30pm to illustrate the correct way to apply a bandage. Don't worry if you're not available at this time as the webinar will be free to view until the end of November.
In order to register for and access the webinar all you need to do is sign up to receive our Newsletter (opposite) and we will email you with all the log in details.
Further details of the competition along with the terms and conditions and online entry form can be found at: https://www.vetwoundlibrary.com/bandaging-art-competition-2019.html
You have until midnight (GMT) on 15 December 2019 to submit your entry - GOOD LUCK!
Avian wound management skills prove a popular theme for The Vet Wound Library exotics day on 23 November 2019 - only 5 places left!
On the 23rd of November 2019 we will host our 2nd Exotics Wound Management Event at Twycross Zoo, East Midlands UK. This year we have chosen to cover the practical skills to help first opinion and wildlife clinicians better approach the needs of the avian casualty. The day will be headed up by Dr Neil Forbes BVetMed, DipECZM(Avian), FRCVS loyally supported by Matthew Rendle RVN, Samantha Ashfield RVN C&G VNES, and Georgie Hollis BSc
Delegates will begin the day with insight into the fundamentals of avian wound management, tissue repair and challenges, followed by a practical lab to get hands on experience including the technique of Imping, management of sternal and carpal injuries, and beak repair.
We are delighted to have had a fantastic response to this event with only 5 places left with 2 months still to go!
This is a one off event so please book now to avoid missing out. Registration is £225 (+vat) for non-members and £175 (+vat) for VWL members.
For the full agenda visit: https://www.vetwoundlibrary.com/events--cpd.html
Georgie Hollis, Founder of the Vet Wound Library is delivering 2 FREE Webinars at the end of August to open the Webinar programme that will continue through 2020. The following webinars are FREE to members and Non-Members and will be recorded live on the 27th and 30th of August.
The Veterinary Wound Library Advanced Surgical Skills For Small Animal Practice CPD Day | 18th September 2019, Cambridge Vet School
For those Veterinary Surgeons who were unable to join us earlier
in the year, we are repeating this invaluable day for any
clinician who has faced prolonged healing post lumpectomy, frustrating wounds over joints, and those unsure if they
should refer or give it a go.
If your practice is a member of The Veterinary Wound Library
then you can attend for the reduced fee of just £245 (+ vat).
Spaces are limited due to the practical nature of the session
so book now to avoid disappointment!
BOOK ONLINE HERE!
Image showing delegates at our Advanced Surgical Skills CPD on 20th March 2019 watching a practical demonstration by Laura Owen
Vet Wound Library
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