FAQ Phovia

Yes it can be used on post-surgical patient with implants including plates, screws and pins.

One of the main mechanisms of Phovia and photo biomodulation is to dissociate the NO from the cytochtome c oxydase. The NO has a vasodilation effect so it can potentially modify the haemostasis process. Moreover, the lamp generates minor heat that stimulates.
_{NOTE: The molecule NO" is commonly named nitric oxide in the biochemical literature.}

We don't have data on this. Even if the gel contains urea peroxide we don't believe this could affect the suture material, especially when Phovia is used only once a week. If it is fast dissolving suture material/ short half-life, then consider waiting 7-10 days. However, we do not believe even if the gel contains urea peroxide it will affect the suture material, when Phovia is used only once a week.

Salvaggio A et al, 2019 publication (surgical wound study summary) – Phovia was used on the first day after surgery and every 3 days (as part of a clinical trial – not required for real life application). For surgical wounds, this could be done, but for real world application, utilising Phovia at 3 day check-up would be more practical.
For large, open wounds – case study has shown can use directly onto the wound once decontaminated, cleaned, and surgically debrided (as required). Would recommend for real world application, to start minimum 72 hours after initial wound/ once wound is stable. Often this process can take 7-10 days depending on the nature of the wound.

No.

The interaction between blue light and some bacterial molecules lead to the production of free radical like ROS. Free radical interfere with electrons from others molecules leading to a cascade that cause damage, leading to structural failure to vital parts of the microorganisms for example the cell wall, enzymes activities, etc.

Even if the lamp doesn’t emit a UV light, I would be precautious in using in such a photoinduced condition. We don't have clinical data about the use of Phovia in lupus. Information about the beneficial use of light therapy in such conditions is scarce and contradictory. We know that some forms of cutaneous lupus are triggered or aggravated by specific wavelengths in the range of UV light. Phovia doesn't emit UV light, so it should be safe; however, we don't have any pilot study supporting this, so we cannot take the responsibility to promote such use. A risk vs benefit discussion for vet and owner.

Indeed, in humans, one of the main indications of FLE is the management of chronic wounds. The FLE has an impact all three phases of the cicatrisation process (inflammation phase, proliferation phase and remodelling phase). Based on human clinical findings and also based on all the in vitro studies Phovia can clearly "reactivate" and "restart" the cicatrisation process.

No, the Phovia formulation is designed as a topical gel for external, topical use only and the formulation is not for mucosal surfaces such as gingival mucosa.

Either protocol gives the same result. Either use one session twice in one 7-day period or do once back-to-back protocol. Most popular and convenient for owners is the back-to-back protocol. Continue until clinical resolution seen.

Yes – 70% isopropanol or 70% ethanol will rapidly inactivate organic material including micro-organisms is sufficient. Phovia is not a surgical instrument and does not penetrate skin and is considered as far as cleaning semi-critical equipment (see reference below Disinfection, Sterilization, and Preservation, 5th ed. Philadelphia: Lippincott Williams and Wilkins, 2001. Canadian Committee on Antibiotic Resistance (CCAR).)

Our FAQ Version 1.0 for further details have listed: The lamp can be disinfected with 70% isopropanol or 70% ethanol, or chlorhexidine. The rubber cone can be removed to be cleaned separately but be careful not to lose it, there won’t be any replacement parts. The PHOVIA LED Lamp must be cleaned and wiped down with a non-fibrous wipe and disinfecting solution at the start and end of each usage. Gently wipe with slow regular strokes, across the entire surface of the lamp. A fresh spray of disinfectant shall be applied for each consecutive stroke.
PHOVIA LED Lamp is not intended to be sterile. Do not sterilize the lamp or the accessories.
Laser vs

Both laser and LED therapies rely on being able to deliver an adequate amount of energy to the target tissue in order to ‘work’ by photobiomodulation (PBM). There are differences between the two including the power, the specificity of wavelength, and the physical characteristics of the beam. Laser light is monochromatic, coherent, and collimated which make it ideal for certain uses, especially in deeper tissues and small areas. The single wavelength beam is ideal for stimulating chromophores in biological tissue that only respond to very specific wavelengths. The coherent nature minimises scatter and the depth of penetration is deeper due to the higher power/energy with the narrow path of the light.

LED light is better targeted on more superficial tissues and works at a lower power/energy level. For uses such as wound healing, minimal energy is needed for therapeutic benefit and there are less safety concerns than with lasers, it can be used on a larger area of tissue and costs less to run. With the blue light and chromophore gel, Phovia has the extra advantage of being able to generate multiple wavelengths that can penetrate the skin at different depths, targeting different structure and stimulating different biological mechanism at once and over the larger area that is possible with LED lights than laser.

Phovia can benefit the inflammation associated with yeast infections. Yeast affects the surface layer of the epidermis only and usually responds well to topical therapy. It would seam a shame to use Phovia to target the epidermis only. Would propose target the yeast with anti-fungal topicals and shampoos and where inflammation associated, use Phovia. We believe that Phovia will cause free radical oxygen species creation and damage to yeast, similar to other microbes such as bacteria.

Neoplastic masses and Phovia? - Any contraindications…
Phovia and photobiomodulation, in general, are safe, and they didn’t cause or induce neoplastic transformation. The in vitro results of the genotoxicity tests (mammalian cell gene mutation test and bacterial reverse mutation assay) confirmed the absence of a genotoxic effect.
Concerning the use of light therapy in a neoplastic (cancerous) lesion, it’s a subject of controversy. Some lab-based studies have shown a pro-neoplastic effect. However, other studies have shown the opposite effect. At the moment, considering that we don't have enough data, we cannot encourage using Phovia on masses.

Stelfonta®?
There are some unknowns to using FLE on some of these treated wound. Informational internationally is that approximately 30% Mast Cell Tumours do not respond or relapses to Stelfonta® (international data on file for the product). Global have advised that theoretical possibility for non-respond or relapses tumours to be present, this portion should not be treated by Phovia (see above). At the moment, considering that we don't have enough data, we cannot encourage using Phovia on masses.
As it can be difficult to know what portion of cases are in the 30%, the veterinarian can make a risk vs benefit basis for the use of Phovia. We can advise the above FAQ to enable veterinarians to make their decision based on their individual case.

We know from clinical feedback that Phovia works well in multiple indications for cats. Hairless cats? The case of ‘we don’t know / we do not have data on hairless breeds’. Providing that the cat’s do not have photo-sensitivities or medication that will increase their photo-sensitivity, then Phovia would probably be beneficial.

Indeed, in humans, one of the main indications of FLE is the management of chronic wounds. The FLE has an impact all the three phases of the cicatrisation process (inflammation phase, proliferation phase and remodelling phase). Based on human clinical findings and also based on all the in vitro studies Phovia can clearly "reactivate" and "restart" the cicatrisation process.

No problems expected if the owner touches the gel, but the gel could stain some furniture/clothing pink. The gel is safe for the skin, even if some quantities are leftover. For example, in the acute wound study, the gel was left under the bandage for seven days until the next Phovia application

The lamp is classified as “Risk Group 2” based on safety limits defined in IEC 62471 = does not pose a hazard due to aversion response to bright light or thermal discomfort - if you look at the direct or the scattered light for a short amount of time, there is no risk. See instructions for use (IFU) for further details.
A LASER (Class 3B and 4) has direct or scattered light that can cause severe eye hazards The orange glasses are important as they filter the blue light and lower the intensity of the light that reaches the eye. Eyes of the pet are to be covered with hands or with goggles if the lamp is used on their face. If the lamp is used in other anatomical region, turn the dog’s head away

This video was made during the COVID 19 and the masks were required in relation to this and not the Phovia system.

The absorbed light can only lead to emission of light of the same or longer wavelength - blue light can lead to emission of green, yellow, orange, and red, but red would not be able to do the same in reverse.

Sunlight can be beneficial but need a lot of exposure and leads to harmful UV exposure which is why we use other lights that do not involve UV

A form of light therapy that utilises non-ionizing light sources, including laser, LED, FLE, in the visible and near infrared spectrum. It is non-thermal process involving endogenous chromophores.

Short answer for owners – the LED activates specialised molecules within the gel known as chromophores. These molecules are important in in releasing FLE. Phovia utilises this unique energy to target various conditions affecting the soft tissue and skin. FLE stimulates the skin’s own repair mechanisms and accelerates healing.
More Technical answer for vets - Chromophores are molecules that absorb light. Chromophores are part of the molecule that is responsible for colour by interacting with wavelengths of visible light. The chromophores in the gel, when activated by the LED blue lamp, convert the blue light into FLE. This is important as the FLE then triggers beneficial effects by stimulating the healing mechanisms in the multiple layers of skin.
The skin consists of a range of chromophores at different depths within the skin. Selected wavelengths of blue, green, yellow, and red are released during the FLE process. Every colour of light has its own wavelength. As a result, individual wavelengths penetrate the skin at different levels and trigger intracellular biochemical reactions. Living cells will absorb each of these wavelengths and use them for different benefits.
Overall effect: in mitochondrial cellular energy production. By stimulating natural chromophores within cells (especially within mitochondria), the efficiency of the mitochondrial electron transport chain can be increased, accelerating healing, cell repair, and cell division (FerroniL, Z et al,. 2020).