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DECEMBER 2012 n VSM


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“Manuka Hon- ey impregnated dressings are a popular choice to assist in de- bridement and decontami- nation of the wound bed”


Advazorb and Advazorb Lite hydro- philic foam dressings distributed by Dechra Veterinary Products Ltd; Al- levyn and Allevyn thin from Smith and Nephew Ltd; and Kruuse Foam from Kruuse UK Ltd.


wound dressing offering antimi- crobial and debridement proper- ties due to its high sugar compo- nent and natural enzymes, which are beneficial in sloughy and con- taminated wounds. Medical grade Manuka honey has become the gold standard for wound manage- ment based upon its preparation, research, gamma sterilisation and reliable efficacy on a wide range of over 150 common wound patho- gens.


M The usual antimicrobial rating


awarded to Manuka honey is known as the Unique Manuka Factor® and a rating of +10 or above guarantees genuine provenance and antimicro- bial efficacy. Food grade honey is not suitable for wound management as pasteurisation does not prevent microbial contamination (such as Clostridia, Bacillus sp and Proteus sp) becoming viable upon dilution in the wound environment. Filtering of food grade honey is also less refined being unlikely to remove all foreign material and wax which may cause foreign body reactions.


Manuka Honey impregnated


dressings are a popular choice to as- sist in debridement and decontami- nation of the wound bed. Applied di- rectly to the wound the ready-to-use dressings make it easier to keep hon- ey where it is required during the wear time of the dressing. Medical Grade Manuka Honey includes: Kruuse Manuka Gel, AD (absorbent) and ND


fective against over 150 pathogens including MRSA. Silver dressings only function in a moist or wet en- vironment as the ionic silver must be dissociated in solution to be free to bind and destroy the nega- tively charged cell wall of bacteria, virus, and fungi. Absorbent dress- ings combined with silver used for discharging, heavily contaminated wounds will enable good wound management. Silver dressings in- clude: Silvercel — Silver Alginate Dressing distributed by Vygon Vet; Acticoat — Nanocrystaline silver dressing from Smith and Neph- ew; and Flamazine — Silver and Sulphadiazine antibiotic from Smith and Nephew.


surgeon to clear nonviable tissue, bacteria, and contaminants from the wound bed using a dedicated handset. The handpiece has a jet of water that is projected across an aperture and it is sucked back through the de-


V


ersajet®: the Smith and Nephew Versajet® is a nov- el device that enables the


human healthcare being an effec- tive way to assist rapid formation of granulation tissue while ena- bling removal of excess exudate. Promising research conducted at Michigan State University showed the therapy to be valuable in dogs requiring preparation for recon- struction with an improved rate of granulation tissue and faster time to reconstruction achieved com- pared to more traditional methods. Several different reusable


N


systems are available to buy (prices range between £1,500 and £4,000) and others may be hired on a daily ba- sis (from around £30 to £50 per day). Some mini single-use systems also exist, but these may be limited in their ability to handle exudate. Consuma- bles and dressings will be required in addition to the vacuum system and will usually be supplied by the manu- facturer to suit the system being used. These dressings typically in- clude a foam or gauze that is applied to the wound bed and a film dress- ing to seal the wound and enable a vacuum to be achieved. The vacuum device is attached directly into the dressing and a typical suction of 125mm Hg applied over 48 hours. Exudate will be collected in the de- vice canister and discarded, and the dressing is changed and the wound re-assessed.


Benefits of using such a sys- tem are a more rapid vascular perfu-


egative Pressure Wound Therapy (NPWT): NPWT has become popular in


edical Grade Manuka Honey: honey has been used for centuries as a


(non-adherent) Dressings from Kruuse UK Ltd ; and Activon Manuka Honey Tube, Algivon impregnated alginate dressing, and Activon Tulle from Dechra Veterinary Products Ltd.


S


ilver dressings: silver has been used to reduce bacte- ria even before we knew that


was what we were achieving. Be- lieved to have kept the water pure in silver vessels carried by Roman soldiers, our modern wound dress- ings now incorporate its benefits to overcome bacterial colonisation, contamination, and resistance. Both ionic and elemental silver are used in dressings to eliminate the need for use of topical antibiotics. As with Manuka honey, silver is ef-


vice it twists creating a vortex us- ing the venturi effect. The smooth and targeted removal of layers of devitalised tissue and debris achieved using the Versajet® can make the difference between rapid granulation and wound closure, and more prolonged inflammation and healing delay.


Most commonly and success-


fully used in the equine patient, the system is best used early after injury under standing sedation meaning a fast, thorough clean is achieved be- fore the wound starts to close. The drawback is the system is not cheap. At around £5,000+VAT for the power console


and £230+VAT for each


handset it needs some consideration to be economically viable. However, some ex demo units


are available and Smith and Nephew has suggested they are open to nego- tiation. If you don’t have the turnover of wounded patients to justify the out- lay of a new system, you can at least hire a system for £250+VAT per day from Georgie Hollis of the Vet Wound Library. Delivery is included anywhere in the UK and can be made within 24 hours. Georgie can also provide training and can supply handsets if required. Contact georgie@intel- ligentwoundcare.com or call on +44 (0)7917 562 940.


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