Microlyte Evaluation Enrolment Form
Please complete each section as fully as possible. If you have any problems or queries you can contact us on info@vetwoundlibrary.com
Your Name
First Name
Last Name
Place of work
Role
Post Nominals
Email
example@example.com
Best Contact Number
Work Address
Your samples will be
Post Code
Corporate, Buying or Charity Group
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Your case load:
This section also contributes to a larger project that will help us understand how to help practices reduce complications. This information will be anonymised in our research.
Which species do you typically manage in your practice?
Types of surgery
Number Per Month
Select if you are actively involved in these cases?
Routine Surgery
Open wound management (post trauma)
Out of hours trauma management
Skin grafting
Wound closure post trauma or open wound management (ie. Undermining of edges with direct apposition of margins)
Advanced Surgical reconstruction (eg.Transposition and axial pattern flaps)
Skin grafts - mesh, pinch, punch.
Oncologic surgery
Orthopaedic surgery
Physiotherapy and rehabilitation
Are there any other services provided by your practice that you would closely associate with wound management?
Choose the best option for frequency of occurrence in your practice and your 'gut' feeling in terms of comparison to other practices.
Frequency
How do you think you compare to the other similar practices?
Routine Surgery - Wound breakdown within 1 month post op.
Always - 100% of the time
Most of the time - 75% of the time or more
Frequently - 50%-75% of the time
Some of the time - 25-50% of the time
Not often - 10% - 25% of the time
Rarely - less than 10% of the time
Never - 0%
Above average
Below average
About the same
Open wound management where the time to heal is greater than 2 months.
Always - 100% of the time
Most of the time - 75% of the time or more
Frequently - 50%-75% of the time
Some of the time - 25-50% of the time
Not often - 10% - 25% of the time
Rarely - less than 10% of the time
Never - 0%
Above average
Below average
About the same
Wounds are lavaged with over 1 litre of tap water, saline or hartmanns within 3 hours of admission.
Always - 100% of the time
Most of the time - 75% of the time or more
Frequently - 50%-75% of the time
Some of the time - 25-50% of the time
Not often - 10% - 25% of the time
Rarely - less than 10% of the time
Never - 0%
Above average
Below average
About the same
Wounds over 24 hours old are managed open until granulation tissue is established.
Always - 100% of the time
Most of the time - 75% of the time or more
Frequently - 50%-75% of the time
Some of the time - 25-50% of the time
Not often - 10% - 25% of the time
Rarely - less than 10% of the time
Never - 0%
Above average
Below average
About the same
A dedicated/nominated wound nurse is available at your practice to assist with dressing selection and continuity of care.
Always - 100% of the time
Most of the time - 75% of the time or more
Frequently - 50%-75% of the time
Some of the time - 25-50% of the time
Not often - 10% - 25% of the time
Rarely - less than 10% of the time
Never - 0%
Above average
Below average
About the same
Our team seeks support for challenging cases using telemedicine or referral practice support.
Always - 100% of the time
Most of the time - 75% of the time or more
Frequently - 50%-75% of the time
Some of the time - 25-50% of the time
Not often - 10% - 25% of the time
Rarely - less than 10% of the time
Never - 0%
Above average
Below average
About the same
A skilled team member is can confidently advise clients on closure options for challenging wounds.
Always - 100% of the time
Most of the time - 75% of the time or more
Frequently - 50%-75% of the time
Some of the time - 25-50% of the time
Not often - 10% - 25% of the time
Rarely - less than 10% of the time
Never - 0%
Above average
Below average
About the same
Wounds (other than basic closure) are referred within 7 days of presentation for specialist reconstruction.
Always - 100% of the time
Most of the time - 75% of the time or more
Frequently - 50%-75% of the time
Some of the time - 25-50% of the time
Not often - 10% - 25% of the time
Rarely - less than 10% of the time
Never - 0%
Above average
Below average
About the same
Our practice performs and manages wide margin excision of common types of tumour/ neoplasia.
Always - 100% of the time
Most of the time - 75% of the time or more
Frequently - 50%-75% of the time
Some of the time - 25-50% of the time
Not often - 10% - 25% of the time
Rarely - less than 10% of the time
Never - 0%
Above average
Below average
About the same
Does your practice have a protocol in place for monitoring/measuring the incidence of post op complications?
Yes
No
We are considering it
Other
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Having learned about MicroLyte Vet what kind of wounds do you see frequently that could be a candidate for product evaluation?
How many of these cases are you likely to see in the next 3 weeks?
Best guess based on normal caseload
What size are these wounds most likely to be?
What do you normally use to manage wounds of this type and what intervals would you expect for dressing changes?
How many dressing changes would you expect to perform over the duration of healing in a patient of this type.
How much would you expect a standard quote to be to manage this type of wound?
Assuming progression is as expected.
What challenges or complications would you usually consider with these cases?
What benefit do you think MicroLyte Vet can offer over your usual approach?
What obstacles do you think would prevent you adopting this product in practice should your experience be positive.
We will follow up on your progress and may ask you to share images of the case with us as you progress. How would you prefer us to contact you?
E-mail
Mobile (text)
WhatsApp
Phone (call)
Other
Type a question
I will gain client consent along with permission from my practice manager/partners to participate in the product evaluation. (A form will be provided by Vet Wound Library)
I understand that the products used in this evaluation are readily available, are not experimental and meet the required standards for Veterinary use meeting Veterinary Medicines Directorate and FDA standards.
I understand that clinical support and guidance for appropriate product use is available free of charge from the Veterinary Wound Library during the evaluation and that i will seek immediate support in the event of any deterioration of the wound or patient status.
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