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.
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.
And A Sad Farewell To Bandaging Angel Caroline Moore
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.
If you are a product manufacturer or distributor who would like your product included in the review contact us at: firstname.lastname@example.org
It is already recognised in human wound care that the use of Medical Larvae is an acceptable and cost effective way to debride chronic wounds. To date it was thought that larvae effectively debride necrotic and sloughy tissue by producing proteases that break down the devitalised protein that delays healing, but new research suggests they may also 'sing' while they work!
Cellular resonance is a theory that is recognised to stimulate cell function and enable physiological optimisation. By exposing sub functional cells to specific frequencies of resonance they can be effectively stimulated to achieve a targeted response. The use of resonance for promotion of wound management is not a new idea and is the action attributed to magnetic therapy and products that utilise electrical impulses and piezoelectric sensors to stimulate cells at specific frequencies.
The research unit based at the school of pharmacy, Nottingham University (UK) is using nano-technology to measure a frequency range produced by larval therapy while they debride necrotic tissue within challenging wounds. Professor David Pritchard who has been instrumental in this study has said "We are astounded that maggots appear to sing within wounds showing a range of different 'voice' frequencies that appears as though they are almost harmonising". The resonance we think we have found produced by the medical larvae produces a vocal range that may promote optimal fibroblast proliferation and may enhance proteases activity. The resonance produced appears to be consistent with research demonstrated by Willemse, Janssen et al in 2007.
The PhD students responsible for the study, Louise Siller and Sarah Carter are currently assessing the range of frequencies produced by the medical larvae, much like listening to the individual altos, tenors and sopranos, It is thought that by encouraging maggots to sing for their supper researchers can identify the best strains from which to breed a new generation of medical maggot.
Since the start of the study David has dissected several of the best singers and identified structures that look like vocal chords. He has also managed to teach a small group to harmonise on command. Unfortunately due to the short life cycle of the fly his achievements are to date limited.
One of the most recent recordings he has made is on YouTube here:
Nature Biotechnology 25, 170 - 172 (2007)
doi:10.1038/nbt0207-170, ATP and FRET—a cautionary note Marieke Willemse1, Edwin Janssen 1,3, Frank de Lange 1,2,4, Bé Wieringa1 & Jack Fransen 1,2
For more information and a copy of the research please contact: email@example.com
Article by Georgie Hollis: written and published for www.vetwoundlibrary.com April 1 2018
Amelia Sherwood RVN highlights some of the signs and symptoms associated with this unusual disease.
Determining the prevalence of this idiopathic condition has been difficult due to the non-specific histopathological changes seen in biopsy samples of suspected CRGV lesions. (https://www.vettimes.co.uk/article/alabama-rot-update-on-uk-cases/) therefore diagnosis must be based on a combination of patient history, blood samples and urinalysis.
The pattern of disease starts with dermal lesions which can rapidly progress (in a matter of days) to acute kidney injury (AKI). Progression is rapid and the results often prove fatal.
From a wound management perspective, although still a rare condition, CRGV should be considered and investigated where the history may fit the bill. Managing the lesions alone will not be sufficient to control the progression of the disease and deterioration may be rapid.
Due to the lack of research into the cause of CRGV the only guidelines to aid prevention of this condition are to ensure any mud and dirt is sufficiently washed off dogs after walks and potentially avoid woodland areas.
Owner education is key and provision of an in-house owner fact sheet is advisable. A pro-active method of education will aid in awareness and possible prevention of cases of this disease.
Click here for an example kindly provided by Afon Veterinary Centre.
For more information on Alabama Rot including diagnoses and treatment we recommend the following article. https://www.vettimes.co.uk/article/alabama-rot-update-on-uk-cases/
We get lots of interesting skin and wound care questions on our Vet Wound Library facebook page. (Clinicians only). One of the recent queries being a request for advice of what to put on a case with fragile, inflamed skin caused by urine/faecal scald. These aren't classed as wounds as such (not until they deteriorate that is!) but the same rules apply when preserving healthy tissue and optimising healing.
With loads of suggestions for creams (intended for humans) its hard to know what is best. The favourites included Sudocrem, Bepanthen, Kamilosan and many others promoted for nappy rash and cracked nipples caused by breast feeding. These products have to be safe if they are used on babies? Don't they?
Well, you guessed it, we say beware - read the ingredients on these products to check they are REALLY what you need in contact with fragile skin. To quote Emeritus Professor Derek Knottenbelt (aka our guru). "If you wouldn't put it in your own eye, then why would you put it in a wound". Further more, when using creams on pets consider some may be toxic if they are licked off.
Very often skin creams (EVEN if intended for human babies) contain more than is needed including antiseptics, perfumes and preservatives that may be unnecessary or even detrimental to healing.
Antiseptics: Savlon, Bepanthen and Sudocrem all contain cetrimide. Its an antiseptic used widely in topical creams. Toxic to fibroblasts it may inhibit progression through proliferative phase of healing.
Other antiseptics and additives featured in products claim 'natural' benefits which is really a reassuring excuse for us to trust them on hearsay.
Natural doesn't mean safe: Many plant based antiseptic compounds are powerful phenolic compounds of which Tea Tree oil is a perfect example. They can be highly sensitising (causing an unnecessary inflammatory reaction) and toxic if ingested, especially in cats. So yes these things may be natural and antimicrobial, but they can also be cytotoxic and damaging. They could be killing the very cells we need that are crucial to healing. So natural does not mean safe or hypoallergenic and the choice may be between antimicrobial effect OR healing progression. Rarely are there antiseptics that do not inhibit cell proliferation in one way or another. We need to decide what is more important.
Preservatives, parabens and perfumes are also a key ingredient of commercially produced creams used for nappy rash. After all, they have to last on the bathroom shelf for months without being an impromptu agar dish!. That is what parabens do, they are the preservatives will ensure doesn't happen.
Ever said, "Ahhhh.... this product reminds me of my Mum." or "its just like the smell of our bathroom when i was a child!". perfumes will help us favour certain products and may even appeal to our sense of memory. They will help us differentiate from one product to another. Natural essential oils (see above!) will be generally be more expensive than synthetically produced agents..
Both parabens and perfumes (even naturally derived) can cause sensitivities and allergic reactions so we are better off choosing products without them if we can.
Keep it simple and use the products intended for the problem: If your skin is inflammed and damaged ask why. Urine or faecal scald, constant contact with wound exudate or a wet environment will warrant a dedicated barrier film designed for the job. Products available include Cavilon® or Sorbaderm®.
Developed specifically for fragile skin these products create an invisible film barrier that prevents penetration of caustic fluids into epidermis leading to a breakdown of the natural waterproofing and protection of the skin. A light layer of cream, or spray will last 24-48 hours and will break the cycle of cell damage and the inflammation that results.
Prevention is better than cure: The key is to deal with the source of the excoriation and inflammation and plan for its resolution. If in doubt ask for help - that is what we are here for.
Barrier sprays and creams do no harm if used as a preventative and are non toxic if the animal licks the area. Applied every other day, with some brands able to protect for longer periods they can be used infrequently enough to avoid stress for the patient and to compliment longer wear times for bandages and dressings.
The following article is a fascinating insight into some of the ingredients you may find in common creams and potions. You might be surprised to find out what you're putting on your own bits and pieces!
"67 Products to avoid in personal care products"
Join the discussion https://www.facebook.com/groups/vetwoundlibrary/
Abstracts are now available in our member area.
We're posting the full range of conference abstracts in the VWL member area this week. We will have everything online for Thursday the 14th of December.
Our first dedicated wound management conference sets a precident for 2018!
An amazing turnout at a fantastic venue for our very first Extravaganza. Expert speakers across small animal, equine and exotic species. Everything caught on film ready to stream onto our website in the new year. We are editing like fury and can't wait to make over 40 hours of CPD available to our members in 2018!
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