Following requests for some CPD from RVNs in the South West of the UK via our Bandaging Angels Facebook page, Veterinary Wound Library Bandaging Angel for the South West, Shelly Jefferies RVN NCertPT, is holding a CPD Day entitled ‘Wound Worries, Bandaging Breakdown and Dressing Dissection’ at Paignton Zoo on Tuesday 7th May 2019, which is open to both veterinary nurses and Veterinary Surgeons. 

The aim of this CPD day is to update delegates on the latest in wound management, dressing selection and bandaging techniques. 

The following areas will be covered: 

•      The physiology of wound healing - recognising stages of positive progression
•      Wound bed preparation for optimal healing
•      Dressing selection - which product when?
•      Bandaging principles, complications and how to avoid them
•      Troubleshooting for problem wounds and their practical solutions

 
Time: 9.00am  - 3.00pm
Cost: £99 (+VAT) VWL Members, £149 (+VAT) Non-VWL Members
Price includes refreshments and lunch, printed notes, CPD Certificate, and free entry to the zoo after!

Further information and a full agenda can be found here
CLICK HERE for our online booking form to reserve your place!

From wives tales to modern day:  
Using honey for wounds is nothing new. From ancient egyptian texts to roman times its properties have been extolled as an aid to healing and for reducing inflammation. For many a miracle cure, for the more scientific it is a case that the high sugar (84%) low pH environment created by honey will aid debridement and help to decontaminate wounds to enable the wound to progress from inflammation through to the proliferative. 

Honey (of all types) offers the wound several benefits due to its ‘natural’ high sugar content which creates an osmotic effect in the wound, a low pH which inhibits microbial proliferation, and some key enzymes which create an antimicrobial effect related to the release of low levels of hydrogen peroxide. In fact this ‘peroxide  effect’ is similar to that adopted by neutrophils in defence of pathogens during inflammation. 

Manuka honey from New Zealand is considered 'gold standard' for wound management since research led by Dr. Peter Molan at the University of Waikato began to explore its properties as an antimicrobial and debridement aid. The research identified that honey derived from nectar from the Manuka bush (Leptospermum scoparium) had an additional antimicrobial effect independent of that associated with standard mixed floral honey being independent of the pH, Enzymes and sugars. In 2008 Maveric et al reported that they had found methylgloxal to be the chemical responsible. The level of antimicrobial effect being directly proportional to the concentration of methylgloxal in the honey. A method of testing potency of antimicrobial effect was registered to give batches of Manuka honey a rating and guarantee of the presence of this unique manuka factor or UMF®. Some manufactures will choose to use an NPA statement or logo instead of the UMF®  mark. NPA stands for non-peroxide activity and can be used to demonstrate that the product has been tested similarly to  guarantee an antimicrobial activity that is maintained without the presence of glucose oxidase. 

So why not just use it from a jar?
Manuka honey is one of the worlds most expensive honeys. For comparison a few years ago a tonne of standard mixed floral honey may have cost you around £5,000 per tonne with an equivalent amount of Manuka honey being nearer £50,000. Unfortunately where there is money to be made there is also the temptation for fraud. In May 2015 the Grocer magazine reported on a commissioned special investigation into the Manuka honey market in the UK and found that only 1 in 7 of the jars they tested were positive for the presence of methylgloxal at a level matching the NPA or UMF® rating on the label. Furthermore they stated that the maximum volume of Manuka honey being shipped out of New Zealand in one year was less than 2,000 tonnes, whereas the shelves around the UK appear to be stocked with over 11,000 tonnes. 

Risk and reward: 
Despite its potent and evidenced antimicrobial effect even Manuka honey is not immune to harbouring bacterial spores. When cold gamma sterilised (to preserve valuable antimicrobial enzymes) spores are rendered inert while the potent antimicrobial effect is preserved. This is the standard process for medical grade honey which will normally be sterilised in batches that will be guaranteed through a batch number and expiry date. The expiry date does not apply to the efficacy of the honey itself, but the guarantee that the packaging (if stored as advised) will ensure sterility to that point.

Pasteurisation is used for honey intended for consumption and being a heating process will inhibit some of the enzymes that we consider beneficial for assisting wound management. When eating honey we deliver it into an environment that is  hostile enough to deal with many bacterial threats through digestive and immune system. Its a good job as pasteurisation is ineffective at inhibiting spores of some of the most pathogenic bacteria we face, specifically Clostridium botulinum. Most adults will have become immune to proliferation of this dangerous pathogen, but if ingested by children under one year of age the consequences can be lethal. This is why most honey meant for consumption will be labelled as not suitable for children under 1 year of age. 

​When using a jar of food grade honey for wound management there is a risk of contamination, regardless of the rating of the honey. Evidence of such complications are scarce, but such infection or contamination that delays healing may not even be recognised by the clinician, it may be considered simply as a failure of the wound to progress for a period of time. While we research this a little more it is worth considering the image below. The plates were used as part of a study looking at the efficacy of a range of honeys against equine wound pathogens. (Pollock and Regan). The plate on the left was a the growth resulting from a 'value' range of honey where more species proliferated than had been inoculated.

If you wish to use honey from a jar for wound management there is nothing to stop you. However, if you are a clinician you have a duty of care to your patients and clients. That means that you are obliged to do no harm, however small the risk. Only medical grade, cold gamma sterilised honey (Manuka or otherwise) will have all its benefits preserved while guaranteeing it safety through a batch number system. The fear is that it is more expensive to buy as a medical product but if you consider buying 15g versus a whole jar, you'll find the its the Jar that costs you more! 

Click here to read the 2015 article from "The Grocer" 

Join us for a special Webinar on the role of Maggot Therapy in Wound Management. We'll be joined by specialists Dr Dylan Gorvy and Patrick Pollock as well as Medical Maggot producers Biomonde. 

Open to all Vets and Nurses in veterinary practice. Click here to register. 

Fiona visited Vets4pets Burscough last week to provide her first full day of in-house CPD covering both wound management and bandaging techniques and said the experience was awesome! Fiona extends her thanks to the practice team who made her feel so welcome and relaxed on her debut as a Bandaging Angel!

DON'T FORGET - If your Bandaging Nightmares are keeping you awake, we CAN help! 
The Veterinary Wound Library Bandaging Angels are a team of specially trained nurses who come to your practice when it suits your team. Your Angel will help you review your practice and help you overcome your bandaging demons and dressing dilemmas. 
Our CPD also include a year’s membership of the Veterinary Wound library providing your team with specialist clinical support for any issue you have in the future - and all for JUST £575 + VAT.  
To book your CPD visit:  www.vetwoundlibrary.com

We are VERY excited to announce that our Bandaging Angels are extending their wings into the 'Exotic' sector with new recruits Matthew (Matt)  Rendle RVN and Samantha (Sam) Ashfield RVN.

We expect that many of you will already have heard of or know Matt due to his 25 years experience of nursing exotic species, after qualifying in 1992 at a mixed and exotics practice in Watford, and during this time he has lectured at numerous veterinary nursing events on many aspects of nursing exotic species from elephants to caecilians!
After promotion to Senior Theatre Nurse in 1994 Matt left this practice in 2003 to pursue his interest in zoo and wildlife nursing at the Zoological Society of London and has since left (April 2017)  to look for new challenges within exotic and wildlife nursing. 
Matt is passionate about veterinary nursing and is keen to try and promote the profession and is now an elected member of the RCVS VN Council as well as the current chair of the Association of Zoo and Exotic Veterinary Nurses (AZEVN). 

In celebration of developing the VWL Bandaging Angels team to include Exotic Angels we thought it was only right to organise a full day of Exotic wound management which Matt and Sam will be presenting at, along with the hugely experienced and knowledgeable Dr Neil Forbes BVetMed, FRCVS, Recgonised Specialist Zoo and Wildlife (Avian). 
Open to both veterinary nurses and Vets, the day will consist of a mix of lectures and two practical sessions which will provide you with a chance  to get 'hands on' with Bumblefoot and Chelonia Shell Traumas which are commonly seen within practice.
Being held at Twycross Zoo on Saturday 24th November 2018 we are offering a discounted price of £125 + VAT to VWL Members (non-members price £175 + VAT) which includes course notes, lunch and refreshments, CPD Certificate, plus free entry  to the zoo should you wish to look around during lunch or at the end of the day. Spaces are limited so book now to avoid disappointment! For further details and to book click here: https://www.vetwoundlibrary.com/events--cpd.html

The Veterinary Wound Library is excited to announce 2 new additions to their team of Bandaging Angels and would like to extend a very warm welcome to Fiona Leathers RVN and Emma Storer RVN.
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Following completion of the Delving Deeper Into Wounds Certificate (Accredited by Lantra), which VWL deliver in association with BVNA (British Veterinary Nursing Association), and passing with flying colours, both Fiona and Emma are excited to join the Bandaging Angels Team to help us educate other veterinary nurses and Veterinary Surgeons in 'Best Practice' of Wound Management whilst also fulfilling their passion for wounds.​

​It is with a heavy heart that we wish to announce Caroline Moore, our Small Animal Bandaging Angel for North West UK, has decided to step down from her role so she can spend more quality time with her family and husband, Dan.
 
We would like to take this opportunity to thank Caroline for all her inspiration, support and hard work in developing the Bandaging Angels to become the success that they are today.
 
As a founder member of the Bandaging Angels team, having written numerous case studies and articles based on her experience and passion with wounds, Caroline will be sorely missed but we would like to wish her every success in her future endeavours.

On the 19th June 2018 we held our very first meeting of minds to establish an independent viewpoint on Laser Therapy. The meeting brought together leading specialists from human and animal healthcare with the aim of producing an outline guide and position document to support the role of Laser Therapy in wound management in animals. 

Georgie Hollis, founder of the Vet Wound Library set up this first consensus meeting based on a growing awareness and reliance on Laser and Light Therapy (Photobiomodulation) in Veterinary practice. This is a contentious area where tremendous benefits are claimed against various levels of evidence. Different systems can vary greatly depending on the power, wavelength and duration of use. Assumptions and extrapolations made based on variable standards of evidence can promise anything from accelerated healing, nerve regeneration and cure of cancer and its time we shed some light on what is fact and what is wishful thinking. 

This independent review aims to outline the basics while offering an  appraisal of the available evidence for the use of Photobiomodulation in wound management and related conditions. We hope to offer some clarity on mode of action and limitations as well as setting some simple guidelines for safe and effective use based on the science available. 

The full consensus process will take around 3 months to complete and will involve collaboration across industry and healthcare to ensure the fairest process possible. 

To ensure complete independence we have not taken any commercial funding or sponsorship to produce this review.
We do however, welcome information from any provider of a product within this category and will ensure a right to reply to those covered in our review prior to publication.
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If you are a product manufacturer or distributor who would like your product included in the review contact us at: info@vetwoundlibrary.com