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 Formulary Chapter 26: A5 - Wound management products and elasticated garments - Full Chapter
Notes:

 Please note: silk garments are non-formulary

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A5.01  Basic wound contact dressings
A5.01.01  Low adherence dressings
Atrauman
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First Choice
Green
Type of wound product is suitable for
For flat granulating and epithelising wound for non to heavy exudate where adherence may occur. To be used as a primary dressing with a secondary for absorption.

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
1-7 days, depending on levels of exudate

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.
Known product or component sensitivity

Rationale for inclusion in formulary
Used to reduce adherence to wound bed. Most cost effective non adherent dressing.
Dressing impregnated with neutraltriglycerides to prevent penetration of granulation tissue.
Petroleum free.
 
N/A Ultra
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Second Choice
Green
Type of wound product is suitable for
For flat granulating and epithelising wound for non to heavy exudate levels where
adherence may occur. To be used as a primary dressing with a secondary for absorption.

Duration dressing remains on wound before changing
7 days maximum

Frequency of dressing change
1-7 days, depending on levels of exudate

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known product or component sensitivity eg silicone
Use with care if wound is bleeding heavily

Rationale for inclusion in formulary
To be used to reduce adherence to wound bed
 
   
A5.01.02  Absorbent dressings
A5.01.02  For lightly exuding wounds
Softpore - self adhesive
(alternative to Cosmopore)
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First Choice
Green
Type of wound product is suitable for
Low to moderately exuding wounds, superficial wounds (closed), light amounts of
exudate.
Use alone without other products, also can be used as a protective dressing for sutured
post operative wounds. Can be used as a protective dressing for newly epithelialised wounds. Can be used for minor traumatic wounds

Duration dressing remains on wound before changing
Maximum 7 days, dependent on exudate levels

Frequency of dressing change
If daily change is required; review dressing type

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known product or component sensitivity

Rationale for inclusion in formulary
Sutured/Post-surgical wound for protection . Most cost effective option.
Can be used as a protective dressing for newly epithelialized wounds. Can be used for minor traumatic wounds
 
Mepore
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Second Choice
Green
Type of wound product is suitable for
Post operative closed surgical wounds or simple wounds with up to light amounts of exudate.
Can be used as a protective dressing for sutured post operative wounds. Can be used as a protective dressing for newly epithelialized wounds. Can be used for small traumatic wounds.

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
1-7 days. If daily change is required - review product choice

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known product or component sensitivity

Rationale for inclusion in formulary
Sutured surgical wounds for protection. Can be used as a protective dressing for newly epithelialized wounds. Can be used for small traumatic wounds. 
   
Telfa
(Podiatry only )
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Formulary
Green
Thin absorbent cotton pad with non adherent film

Type of wound product is suitable for
Dry or lightly exuding wounds

Duration dressing remains on wound before changing
1-7 days

Frequency of dressing change
As exudate levels determines

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
None

Rationale for inclusion in formulary
Cost effective. Non adherent dressing for dry or lightly exuding wounds
 
   
A5.01.02  For moderately to heavily exuding wounds to top
Zetuvit E
(sterile and non-sterile)
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Formulary
Green
Absorbent cellulose pad with fluid repellent backing

Type of wound product is suitable for
Moderate exuding wounds . Secondary dressing.
Available in non sterile and sterile.
Only sterile to be used for wound care.

Duration dressing remains on wound before changing
1-7 days

Frequency of dressing change
Usually 1-2 days or when wet. If using daily consider Zetuvit Plus

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known product or component sensitivity
Do not cut or tear

Rationale for inclusion in formulary
Required for absorbency, for moderately exuding wounds
Step down from Zetuvit Plus
 
   
Zetuvit PLUS
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Formulary
Green
Super absorbent dressing

Type of wound product is suitable for
Moderate to heavily exuding acute and chronic wounds. Secondary dressing only

Duration dressing remains on wound before changing
1-7 days

Frequency of dressing change
1-3 days, if changing daily, review if needs more highly absorbent dressing, if lasting 7
days step down to Zetuvit E

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not use if sensitivity to dressing or components
Do not cut or tear

Rationale for inclusion in formulary
Moderate to heavily exuding wounds, higher absorbency than Zetuvit E. Cost effective.
 
   
A5.01.02  For heavily exuding wounds
Eclypse
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Formulary
Green

Approved June 2018 to replace Flivasorb®

 
   
KerraMaxCare
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Formulary
Red
Superabsorbent dressing
Type of wound product is suitable for
Highly exuding wounds as a primary or secondary dressing. Can be used under compression therapy
Stackable as no backing present to hold exudate

Duration dressing remains on wound before changing
1-7 days.
Frequency of dressing change
Dependent on level of exudate, usually daily or more frequently
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not cut or tear
Rationale for inclusion in formulary
Required for heavily exuding wounds. Hospital Use Only
 
   
A5.02  Advanced wound dressings
A5.02.01  Hydrogel dressings
A5.02.01  Hydrogel application (amorphous)
AquaForm
(alternative to Granugel)
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Formulary
Green
Hydrogel: Clear viscose sterile gel
Aids autolytic debridement and removal of devitalised tissue.

Type of wound product is suitable for
Low exuding, necrotic or sloughy wounds

Duration dressing remains on wound before changing
Up to 3 days

Frequency of dressing change
1-3 days

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.) Not suitable for heavily exuding wounds. Caution known product or component sensitivity.
Full thickness burns or infected wounds
Not for application to ischaemic wounds

Rationale for inclusion in formulary
Required for wound beds that need donation of moisture to rehydrate the wound bed and debride. Cost effective
 
   
A5.02.01  Hydrogel sheet dressings to top
ActiForm Cool
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Formulary
Green
Hydrogel Sheet
Type of wound product is suitable for
Necrotic or sloughy wounds that require hydration and cooling pain relief
Can be used on dry wounds with the backing left in place
Cut to shape of the wound
Requires a secondary dressing
Duration dressing remains on wound before changing
1-3 days if dressings become discoloured or opaque or at first signs of exudate strike
through
Frequency of dressing change
If dressing becomes discoloured or opaque or at first signs of exudate strike through. Do not allow to dry out
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Should not be used as a covering for deep narrow cavities or sinuses. Do not use on infected wounds.
Not suitable for heavily exuding wounds Known product or component sensitivity Not for application on ischaemic wounds
Rationale for inclusion in formulary
Dry necrotic, sloughy or painful wounds
For ease of application - sheet gel rather than liquid
Primary dressing
Can be used prior to larval therapy to maintain moisture levels
 
   
A5.02.01.01  Sodium hyaluronate dressings
A5.02.02  Vapour-permeable films and membranes
A5.02.02  Vapour-permeable Adhesive Film Dressing (Semi-permeable Adhesive Dressing)
Hydrofilm
View adult BNF View SPC online View childrens BNF
First Choice
Green
Vapour-permeable adhesive film

Type of wound product is suitable for
Dry non infected wounds, retention of lines, fixation of secondary dressings, protection of intact skin, protection of skin against friction, protection of newly epithelialized wounds

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
Up to 7 days

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Clinically infected wounds, bleeding or exuding wounds

Rationale for inclusion in formulary
Retention of lines, protection of intact skin, fixation of other dressings. Cost effective
Waterproof
 
C View
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Second Choice
Green
Vapour-permeable adhesive film

Type of wound product is suitable for
Dry non infected wounds, retention of lines, fixation of secondary dressings, protection of intact skin, protection of skin against friction, protection of newly epithelialized wounds

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
Up to 7 days

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Clinically infected wounds, bleeding or exuding wounds

Rationale for inclusion in formulary
Retention of lines, protection of intact skin, fixation of other dressings. Waterproof
 
   
A5.02.02  Vapour-permeable Adhesive Film Dressing with absorbent pad
C-View Post-Op
View adult BNF View SPC online View childrens BNF
Formulary
Green
Vapour-permeable adhesive film with absorbent pad
Type of wound product is suitable for
Dry non infected wounds, low exuding wounds, minor burns, protection of intact skin, protection of newly epithelialized wounds
Duration dressing remains on wound before changing
Up to 7 days
Frequency of dressing change
Up to 7 days
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Clinically infected wounds, bleeding or exuding wounds
Rationale for inclusion in formulary Protection of intact skin, low exuding wounds. Waterproof
 
   
A5.02.02  For intravenous and subcutaneous catheter sites to top
IV 3000
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Formulary
Amber Recommended

Fixation dressing
Type of wound product is suitable for
For fixation of intravenous and subcutaneous catheter sites
Duration dressing remains on wound before changing
Up to 7 days
Frequency of dressing change
Up to 7 days or when wet/soiled
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Sensitivity to any of the product components
Not for use on pressure ulcers, burns or donor sites
Strips and documentation label are not to be used as suture replacements or primary wound closure methods
Rationale for inclusion in formulary
Fixation of intravenous and subcutaneous devices

 
   
A5.02.03  Soft polymer dressings
A5.02.03  Without absorbent pad
Urgotul
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Formulary
Green
A non-adherent flexible wound contact layer containing TLC Healing Matrix.

Type of wound product is suitable for
Non to low exuding wounds, dermabrasions, traumatic, superficial, blistering. Can be
used as a contact layer in cavity wounds with secondary absorbent dressing. Difficult to dress
areas – fingers and toes.

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
Depends on clinical needs up to 7 days

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known sensitivity to any components

Rationale for inclusion in formulary
Pain free dressing changes. Promotes healing, interactive. Cost effective. Large range of sizes available
 
   
Mepitel
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Formulary
Amber Recommended

Soft polymer non-adherent dressing without pad

Type of wound product is suitable for
Primary wound contact layer, non adherent, traumatic and chronic wounds
Requires secondary dressing

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
Up to 7 days

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Heavily bleeding wounds
Any sensitivity to silicone

Rationale for inclusion in formulary
Non-adherent primary wound contact layer to protect skin tears, fragile skin, primary contact layer for use under topical negative pressure

 
   
A5.02.03  With absorbent pad
Allevyn Life
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Formulary
Amber Recommended

Hydrocellular foam dressing
Type of wound product is suitable for
Shallow granulating wounds, acute and chronic exuding wounds, full and partial thickness wounds
such as leg ulcer, malignant wound, surgical wound. Primary dressing
Silicone adhesive
Duration dressing remains on wound before changing
Up to 7 days dependent on dressing indicators
Frequency of dressing change
Up to 3 times a week maximum
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.) Do not use with oxidising agents such as hypochlorite solutions or hydrogen peroxide Discontinue if reddening or sensitivity occurs.
Do not cut
Caution under compression where exudate levels are moderate to high
Rationale for inclusion in formulary
Fragile skin with absorbency and conformability, problematic healing wounds. Odour control.

 
   
kliniderm Foam Silicone
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Formulary
Amber Recommended
  • November 2016: approved for use, replacing Mepilex®

    Polyurethane foam with adhesive silicone wound contact layer

    Type of wound product is suitable for
    Suitable for acute and chronic wounds including leg ulcers, pressure ulcers, superficial and partial thickness burns, donor sites, post operative wounds and skin abrasions. Suitable for low to moderately exuding wounds for patients with fragile skin
    Available in border and non border

    Duration dressing remains on wound before changing
    Up to 7 days

    Frequency of dressing change
    1-7 days – dependant on exudate level

    Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
    Known product or component sensitivity eg Silicone

    Rationale for inclusion in formulary
    Wound contact surface is coated with a layer of soft silicone which reduces trauma to delicate tissue. Range of shapes and sizes available.
 
   
A5.02.03  Bio-cellulose dressings
Suprasorb X
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Formulary
Amber Recommended

Biocellulose gel sheet dressing
Type of wound product is suitable for
Light to moderately, non infected exuding wounds
Duration dressing remains on wound before changing
1-7 days
Frequency of dressing change
1-7 days, dependent on exudate levels
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known sensitivity to any components of the dressing
Rationale for inclusion in formulary
Light to moderate exudate.

 
   
A5.02.04  Hydrocolloid dressings to top
A5.02.04  Without adhesive border
Duoderm range of dressings
View adult BNF View SPC online View childrens BNF
First Choice
Green
The adhesive layer forms a cohesive gel when in contact with wound exudate
Available as Extra thin or Signal (Bordered)

Type of wound product is suitable for
Dry to lightly exuding wounds
Non infected
Acute or Chronic wounds

Duration dressing remains on wound before changing
Up to 7 days maximum

Frequency of dressing change
3-7 days

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not suitable for infected wounds, full thickness burns or wounds with exposed bone, muscle or tendon or wounds that are likely to macerate, particularly on plantar surface of foot
Not for diabetic foot ulcers
Not for ischaemic wounds
Known product or component sensitivity

Rationale for inclusion in formulary
Conformable, waterproof, aids autolysis. Protect surrounding skin , reduced risk of
blistering. Cost effective
 
BeneHold TASA
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Formulary
Green

Approved April 2019

Hydrocolloid Range with film border

Type of wound product is suitable for
Lightly to moderately exuding wounds

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
Only when necessary - up to 7 days

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not use on third-degree burns. Should not be used on individuals who are sensitive to or have had an allergic reaction to the dressing or its components.

Rationale for inclusion in formulary
Reduced dressing changes. More cost effective. Reduce use of more expensive foam dressings.

 
   
Granuflex
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Formulary
Amber Recommended

Type of wound product is suitable for
Hyperkeratosis, granulating wounds, forms cohesive gel on contact with exudate

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
3-7 days

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known sensitivity to ingredients - contains pectin and gelatine
Not for diabetic foot ulcers or ischaemic wounds
Not for infected wounds

Rationale for inclusion in formulary
Comformable waterproof dressing, aids rehydration.
Reduces and softens hyperkeratosis

 
   
A5.02.04  With adhesive border
A5.02.04  Hydrocolloid-fibrous dressings
Aquacel range
(excluding Aquacel Ag)
View adult BNF View SPC online View childrens BNF
Formulary
Green
Type of wound product is suitable for
Moderate to heavy exudate, sloughy, necrotic or granulating wounds. Available in rope
for cavities

Duration dressing remains on wound before changing
Maximum 7 days

Frequency of dressing change
1-7 days depends on clinical need

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not suitable for dry wounds. Non dissolvable. Known product or component sensitivity
Do not cut

Rationale for inclusion in formulary
Aids debridement of slough or necrotic tissue
Remains intact so easily removed in one piece
Absorbs exudate which aids most wound healing facilitating atraumatic dressing change,
Cost effective
 
   
UrgoClean
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Formulary
Green

Type of wound product is suitable for

All non-infected sloughy wounds. Diabetic foot ulcers

Duration dressing remains on wound before changing

1-3 days during the wound desloughing phase, then as often as required (up to 7 days) depending on the level of exudate and the clinical condition of the wound.

Frequency of dressing change

1-7 days dependent on clinical assessment.  

Caution/Contraindications (when not to use the dressing, patient groups to avoid etc.)

Known sensitivity to any component of the dressing.

Rationale for inclusion in formulary

No other comparable dressing available.

 
   
A5.02.04  Polyurethane matrix dressing
A5.02.05  Foam dressings to top
A5.02.05  For lightly exuding wounds
A5.02.05  For lightly to moderately exuding wounds
Allevyn range
(excluding Allevyn Ag)
View adult BNF View SPC online View childrens BNF
Formulary
Green
Available in adhesive, non adhesive and gentle
Type of wound product is suitable for
Wound management by secondary intention on acute, chronic, full thickness or partial thickness or shallow granulating wounds including pressure ulcers, leg ulcers, diabetic foot ulcers, malignant wounds surgical wounds, malignant wounds donor sites and fungating ulcers
Can be used as a primary or secondary dressing
Duration dressing remains on wound before changing
Can stay in place up to 3-7 days

Frequency of dressing change
Dependent on exudate levels
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
In common with all adhesive products, some cases of irritation and/or maceration of the skin may occur.
It should be noted that inappropriate use or too frequent dressing changes, particularly in patients with fragile skin, can result in skin stripping. If this occurs change to the Allevyn gentle border range.
If redness or sensitisation occur, discontinue use
Caution under compression when exudate levels are moderate to high.
Rationale for inclusion in formulary
Can be used for low to moderate exudate levels
Different sizes and shapes available
Cost effective
 
   
A5.02.05  For moderately to heavily exuding wounds
ActivHeal Foam
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Formulary
Amber Recommended

Two layer dressing consisting of a polyurethane bacterial barrier membrane with a centrally located hydrophilic pad +/- acrylic adhesive border.

Type of wound product is suitable for
Moderately exuding wounds with signs of granulation, epithelialisation or slough. Can be used as primary or secondary

Duration dressing remains on wound before changing
1-7 days

Frequency of dressing change
Up to 7 days dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Full thickness burns
Surgical implantations

Rationale for inclusion in formulary
Cost effective
Simple to use on the foot and digits
Can be cut to shape

 
   
ActivHeal Foam (Tracheostomy)
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Formulary
Amber Recommended

Tracheostomy foam dressing

Type of wound product is suitable for
ActivHeal Foam Tracheostomy dressing has a fenestration, which allows the dressing to fit neatly around a tracheostomy tube. The dressing can also be used around intubation and cannula insertion procedures, external bone fixators and appropriately-sized wound drainage tubes.

Duration dressing remains on wound before changing
Dependant on clinical need and soiling

Frequency of dressing change
Up to 7 days, dependant on clinical need and soiling

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not use if reaction to any of its components

Rationale for inclusion in formulary
Specific dressing shaped and able to cut for tracheostomies.
Cost effective

 
   
Allevyn Cavity
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Formulary
Amber Recommended

Type of wound product is suitable for
Wound management by secondary intention on acute, chronic, full thickness or partial
thickness or shallow granulating wounds including pressure ulcers, leg ulcers, diabetic foot ulcers, malignant wounds surgical wounds, malignant wounds donor sites and fungating ulcers
Can be used as a primary or secondary dressing

Duration dressing remains on wound before changing
Can stay in place up to 3-7 days

Frequency of dressing change
Dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
In common with all adhesive products, some cases of irritation and/or maceration of the skin may occur.
It should be noted that inappropriate use or too frequent dressing changes, particularly in patients with fragile skin, can result in skin stripping. If this occurs change to the Allevyn gentle border range.
If redness or sensitisation occur, discontinue use
Caution under compression when exudate levels are moderate to high.

Rationale for inclusion in formulary
Can be used for low to moderate exudate levels
Different sizes and shapes available
Cost effective

 
   
Allevyn Non-Adhesive
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Formulary
Green
Type of wound product is suitable for
Wound management by secondary intention on acute, chronic, full thickness or partial
thickness or shallow granulating wounds including pressure ulcers, leg ulcers, diabetic foot ulcers, malignant wounds surgical wounds, malignant wounds donor sites and fungating ulcers
Can be used as a primary or secondary dressing

Duration dressing remains on wound before changing
Can stay in place up to 3-7 days

Frequency of dressing change
Dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
In common with all adhesive products, some cases of irritation and/or maceration of the skin may occur.
It should be noted that inappropriate use or too frequent dressing changes, particularly in patients with fragile skin, can result in skin stripping. If this occurs change to the Allevyn gentle border range.
If redness or sensitisation occur, discontinue use
Caution under compression when exudate levels are moderate to high.

Rationale for inclusion in formulary
Can be used for low to moderate exudate levels
Different sizes and shapes available
Cost effective
 
   
Biatain dressings
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Formulary
Amber Recommended

Polyurethane foam dressing with bevelled edges

Type of wound product is suitable for
Moderately exuding wounds with signs of granulation, epithelialisation or slough.
Can be used as primary or secondary

Duration dressing remains on wound before changing
1-7 days

Frequency of dressing change
Up to 7 days dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not use with oxidising solutions such as hydrogen peroxide
Full thickness burns
Surgical implantations

Rationale for inclusion in formulary
Simple to use on the foot and digits Can be cut to shape

 
   
PolyMem
(excluding PolyMem Ag)
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Formulary
Amber Recommended

Foam dressing that contains a cleansing agent and glycerol

Type of wound product is suitable for
Low to moderately exuding wound including skin tears, and other traumatic wounds,
superficial and partial thickness wounds, burns, donor and graft sites and radiotherapy induces reactions

Duration dressing remains on wound before changing
2-7 days

Frequency of dressing change
Up to 7 days dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Sensitivity to ingredients contained within the dressing
Not for full thickness burns Not for ischaemic wounds Not for diabetic foot wounds
Not in conjunction with solutions containing hypochlorite

Rationale for inclusion in formulary
Suitable for fragile and sensitive skin, Soft and comformable,
Easy to redress awkward areas
Wide range of sizes including digit shaped dressings

 
   
Tegaderm Foam Adhesive
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Formulary
Green
Type of wound product is suitable for
Wound management by secondary intention on acute, chronic, full thickness or partial thickness or shallow granulating wounds including pressure ulcers, leg ulcers, diabetic foot ulcers, malignant wounds, surgical wounds, donor sites and fungating ulcers
Can be used as a primary or secondary dressing
Film border increases adherence

Duration dressing remains on wound before changing
Can stay in place up to 3-7 days

Frequency of dressing change
Dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Care with fragile skin

Rationale for inclusion in formulary
Can be used for low to moderate exudate levels
Different sizes and shapes available
Conformability around difficult areas such as heels and elbows
Can be used on sacral and buttock wounds where incontinence is an issue due to film backing and border.
 
   
A5.02.06  Alginate dressings
Sorbsan range
(excluding Sorbsan Ag)
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First Choice
Green
Calcium alginate dressing

Type of wound product is suitable for
Use in moderate to highly exuding wounds with a sloughy or granulating wound bed. Also helps with haemostasis in wounds with minor bleeding or where blood is present in the exudate.
Available in flat and rope dressing
Primary dressing only. Secondary dressing will be required.

Duration dressing remains on wound before changing
Can be left in place for approximately 4 days

Frequency of dressing change
1-4 days dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not use in individuals with a known sensitivity to any of the components of the dressing
Do no use on dry or lightly exuding wounds as adherence is an issue
Extreme caution if used for tumours with friable tissue

Rationale for inclusion in formulary
Sorbsan can facilitate debridement, absorb exudate and is a haemostat
Cost effective
Biodegradable
 
Urgosorb
(excluding Urgosorb Ag)
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Formulary
Amber Recommended

Type of wound product is suitable for
Management of moderate to heavily exuding wounds. Absorbs and gels on contact with
wound exudate which facilitates debridement of devitalised tissue. Dressing has haemostatic properties

Duration dressing remains on wound before changing
1-7 days dependent on exudate levels

Frequency of dressing change
1-7 days dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known sensitivity to any of the dressing components Contraindicated in 3rd degree burns, dry necrotic eschar
Low exudate or dry wounds

Rationale for inclusion in formulary
Can be used for moderate to heavily exuding wounds
Can be used for debriding sloughy and wet necrotic wounds
Haemostatic

 
   
A5.02.07  Capillary-action dressings to top
A5.02.08  Odour absorbent dressings

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First Choice
Green
Consider first line dressings appropriate to wound bed type and exudate level 
CarboFLEX
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Formulary
Amber Recommended

Odour absorbent wound contact dressings containing activated charcoal

Type of wound product is suitable for
For the management of moderate to heavily exuding malodorous wounds including
fungating

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
As exudate level determines

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known sensitivity to the dressing or its components
As soon as CarboFLEX becomes contaminated with exudate, odour control diminishes
The underlying cause of wound odour should be identified prior to commencement of product

Rationale for inclusion in formulary
CarboFLEX is a layered dressing to provide higher levels of fluid handling
On shallow or cavity wounds with moderate to heavy levels of exudate

 
   
Clinisorb
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Formulary
Amber Recommended

Odour absorbent charcoal dressing

Type of wound product is suitable for
Malodourous wounds such as fungating wounds

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
1-7 days dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not indicated as a primary dressing in dry wounds
Store at room temperature
Exudate levels will reduce the effectiveness of the charcoal

Rationale for inclusion in formulary
Clinisorb is an activated charcoal dressing which adsorb toxins removing malodour from the wound
Can be cut to size
Cost effective

 
   
A5.03  Antimicrobial dressings
 note 

Avoid routine or prophylactic use of antimicrobials on non-infected wounds.
Also see alternative indications for short-term use below.

A5.03.01  Honey
A5.03.01  Sheet dressing
Actilite (Honey Dressing)
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Formulary
Amber Recommended

Non-adherent viscose net dressing 99% Manuka honey and 1% Manuka oil.

Type of wound product is suitable for
A primary dressing for low to moderate shallow exuding wound with light slough. Granulating or
epithelialising wounds with clinical signs of infection. Requires a secondary dressing.

Max Duration dressing remains on wound before changing
3-7 Days

Frequency of dressing change
3 to 7 days depending on exudate

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known allergy to Bee Venom and Honey products
Blood sugars should be monitored in patients with diabetes
Stinging sensation may be experienced. If unacceptable for patient then discontinue.

Rationale for inclusion in formulary
For antimicrobial and de-sloughing properties
Ease of application
Can be cut to size
Easy removal in one piece
Availability of different sizes
Not found to be harmful to peri-wound skin
Malodour
Cost effective

 
   
Activon Tulle (Honey Dressing)
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Formulary
Amber Recommended

Knitted viscose mesh impregnated with 100% Manuka Honey.

Type of wound product is suitable for
Creates a moist healing environment effectively eliminates odour. Provides anti-microbial action.
Debrides and de-sloughs shallow wounds where the exudate level has started to decrease. Requires secondary dressing

Max Duration dressing remains on wound before changing
Up to 4 days

Frequency of dressing change
Daily in acute infection
Up to 4 days for chronic infection depending on exudate

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Wounds with active blood loss
Known allergies to bee Venom and Honey products
Blood sugars should be monitored in diabetic patients
Stinging sensation may be experienced – discontinue if not tolerant.

Rationale for inclusion in formulary
Anti-microbial and de-sloughing properties for wounds with reduced levels of exudate.
Control of odours
Ease of application and removal in one piece
Can be cut to size
Available to various size
Cost effective

 
   
Algivon (Honey Dressing)
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Formulary
Amber Recommended

Alginate dressing impregnated with 100% Manuka Honey.

Type of wound product is suitable for
Primary dressing for infected, shallow cavity wounds, particularly if necrotic or malodorous with
moderate exudate. Requires secondary dressing.

Max Duration dressing remains on wound before changing
Up to 4 days for chronic infection

Frequency of dressing change
Daily for acute infection
Up to 4 days for chronic infection/depending upon exudate

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Wounds with active blood loss
Known allergy to be venom and honey products
Blood sugars should be monitored in diabetic patients
Stinging sensation may be experienced – discontinue if not tolerated

Rationale for inclusion in formulary
Antimicrobial and de sloughing properties
Absorbent
Malodour
Ease of application and removal in one piece
Can be cut to size
Available in various sizes
Can be shaped to wound size and depth
Cost effective

 
   
L-Mesitran ®
(Hydro/ Hydro border)
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Formulary
Red
A hydro active gel dressing containing medical grade honey available without or with an adhesive film border. L- Mesitran has anti bacterial properties and can debride and reduce malodour.

Type of wound product is suitable for
Burns, chronic wounds, necrotic/sloughy wounds, surgical wounds, diabetic ulcers with caution, donor sites, fungating wounds.

Max Duration dressing remains on wound before changing
3-7 days

Frequency of dressing change
3- 7 days, dependent on exudate level

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known sensitivity to dressing and any of its components use with caution in patients with bee venom allergy
Not suitable for full thickness burns/deep narrow cavities
Caution must be exercised when applying to diabetic patients. Blood glucose levels must be monitored.

Rationale for inclusion in formulary
Desloughing, Antimicrobial, Deodorising 
   
A5.03.01  Honey-based topical application to top
Activon ®Tube
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Formulary
Amber Recommended

100% medical grade Manuka Honey.

Type of wound product is suitable for
Use as topical treatment for infected sloughy shallow or cavity wounds. Primary or addition to other Activon products. Requires secondary dressing.

Max Duration dressing remains on wound before changing
Up to 4 days

Frequency of dressing change
Daily in acute infection
Up to 4 days in chronic infection dependant on exudate

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Wounds with active blood loss
Known allergies to bee Venom and Honey products
Blood sugars should be monitored in diabetic patients
Stinging sensation may be experienced – discontinue if not tolerant.

Rationale for inclusion in formulary
Anti-microbial and de-sloughing properties
Control of odours
Benefit of adding to other action products and increasing honey
Suitable for use in cavities
Cost effective

 
   
A5.03.02  Iodine
Inadine ®
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First Choice
Green
Non-adherent dressing impregnated with povidone iodine (10%)

Type of wound product is suitable for
Mild local infection where there is low exudate levels, ischaemic wounds, dry, gangrenous digits with the aim to desiccate and auto-amputate.
Dry-manage fixator sites
Minor burns or skin trauma with local infection

Duration dressing remains on wound before changing
1-3 days depending on uptake of iodine from dressing

Frequency of dressing change
1-3 days depending on uptake of iodine from dressing
Look at colour change of dressing (orange initially to white when all used)

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Iodine allergy or sensitivity
Thyroid disorders
Renal impairment
Not suitable for children, pregnant or lactating women

Rationale for inclusion in formulary
Topical antimicrobial
Non-adherent/pain free use
No damage to granular or epithelial cells
Easy application and removal
Drying properties
Efficacy against bacteria, fungi and viruses
Cost effective. 
Iodoflex®
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First Choice
Green
Cadexomer dressing containing iodine

Type of wound product is suitable for
Iodine paste in mesh form for chronic infected, sloughy wounds with moderate exudate eg pressure ulcers, leg ulcers, diabetic foot ulcers
Can be used under compression bandaging

MAX Duration dressing remains on wound before changing
Up to 3 days

Frequency of dressing change
Daily for acute infection
Up to 3 days for chronic wounds and infection, depending on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Allergy or sensitivity to iodine
Precaution with large wounds due to absorption. Do not use more than 50g in a single application and no more than 150g in 7 days
Dry necrotic wounds
Thyroid disorders
Renal impairment
Not suitable for children, pregnant or lactating mothers
Concurrent Lithium therapy

Rationale for inclusion in formulary
Anti microbial, broad spectrum, long acting/high absorption capacity
Removes slough and debris to clean the wound bed
Can be moulded to shape of the wound
Alternative to honey products if allergy to bees 
Iodosorb®
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First Choice
Green
Cadexomer powder or ointment with iodine

Type of wound product is suitable for
Chronic exuding sloughy wounds eg leg ulcers, pressure ulcers, diabetic foot ulcers. Can be used under compression bandaging

Duration dressing remains on wound before changing
Up to 3 days

Frequency of dressing change
Daily for acute infection
Up to 3 days for chronic infection

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Allergy to iodine products
Dry necrotic tissue
Not suitable for Children, pregnant or lactating mothers
Thyroid disorders
Renal impairment
Needs at least twice weekly dressings for iodine to be effective

Rationale for inclusion in formulary
Antimicrobial, broad spectrum, long acting
De-slough and cleans wound debris
Non-adherant. Reduces trauma to wound and pain on dressing changes
Easy application. Can fill cavities or awkward shaped wounds
Alternative to honey based products if allergy to bees 
A5.03.03  Silver
A5.03.03  Low adherence dressings
Atrauman Ag®
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Formulary
Amber Recommended

Non adherent Primary Dressing containing metallic silver

Type of wound product is suitable for
For clinically infected shallow, granulating wounds with low exudate. To be used as a primary dressing with a secondary for absorption.

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
1-7 days, depending on levels of exudate

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known product or component sensitivity
Must be removed prior to x-ray, ultrasound, diathermy and MRI

Rationale for inclusion in formulary
Used to reduce adherence to wound bed with clinical signs of infection
Most cost effective non adherent dressing containing silver.
Dressing impregnated with neutral triglycerides to prevent penetration of granulation tissue.
Petroleum free.
Specialist Recommendation

 
   
A5.03.03  With charcoal
A5.03.03  Soft polymer dressings to top
A5.03.03  Hydrocolloid dressings
Aquacel® Ag + Extra range
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Formulary
Amber Recommended

Hydrofibre with silver

Type of wound product is suitable for
Management of clinically infected, sloughy, necrotic or granulating wounds with moderate to heavy exudate.
Moderate to highly exuding wounds.
Aquacel Ag Plus Extra can be used to break down biofilms
Requires a secondary dressing

Duration dressing remains on wound before changing
Dependent upon exudate 1 - 7 days

Frequency of dressing change
Dependent upon level of exudate and clinical presentation

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Should not be used on individuals who are sensitive to or have had an allergic reaction to the dressing or its components.
Not suitable for dry wounds.
No haemostatic properties.

Rationale for inclusion in formulary
Specialist antimicrobial product
Moderate to high exudate levels
Can be used to break down biofilms
Remains intact on wound bed and easily removable in one piece (non dispersible)

 
   
A5.03.03  Foam dressings
Allevyn Ag®
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Restricted Drug Restricted
Red
A non adherent foam dressing impregnated with silver sulphadiazine that can be cut to suit the patient
Type of wound product is suitable for
For use around infected pin sites
Duration dressing remains on wound before changing
Daily or as directed
Frequency of dressing change
Daily
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Patients who have a known sensitivity to Silver Sulphadiazine or Sulphonamides
Females who are at or near full term pregnancy or lactating
Not for use on neonates or new born infants during the first month of life
Rationale for inclusion in formulary
Used around infected pin sites in patients with external metalwork to help reduce bacterial load
HOSPITAL USE ONLY 
   
A5.03.03  Alginate dressings
Urgosorb Silver® range
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Formulary
Amber Recommended

Alginate and hydrocolloid dressings containing silver
Type of wound product is suitable for
Management of moderate to heavily exuding wounds that are clinically infected. Absorbs and gels on contact with wound exudate which facilitates debridement of devitalised tissue.
Dressing has haemostatic properties
Duration dressing remains on wound before changing
1-3 days dependent on exudate levels
Frequency of dressing change
1-3 days dependent on exudate levels
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known sensitivity to any of the dressing components
Contraindicated in 3rd degree burns, dry necrotic eschar
Low exudate or dry wounds
Removal on those undergoing MRI scans
Avoid contact with electrodes or conductive gels during electronic measurement procedures
Rationale for inclusion in formulary
Can be used for moderate to heavily exuding clinically infected wounds
Can be used for debriding sloughy and wet necrotic wounds
Haemostatic
Specialist Recommendation

 
   
A5.03.04  Other antimicrobials
Flaminal ® Forte Gel
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First Choice
Green
Alginate gel. Moderate to heavily exuding wounds. Contains antimicrobial enzymes.

Type of wound product is suitable for
Colonised wound bed. More suited to sloughy wounds. Can be used on all wound types
Useful for cavity wounds and sinus’s
Requires a secondary dressing

Duration dressing remains on wound before changing
1-7 days

Frequency of dressing change
1-7 days dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Sensitivity to alginate dressings or polyethylene glycol
Full thickness burns

Rationale for inclusion in formulary
1st line antimicrobial in paediatrics
Consider as first line product if signs of colonisation or clinical infection
Does not cause cellular damage 
Kytocel®
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First Choice
Green
Absorbent gelling fibre wound dressing

Type of wound product is suitable for
Moderate to heavily exuding chronic and acute wounds that are sloughy and clinically infected.
Haemostatic properties for minor bleeds in superficial wounds
Autolytic debridement properties

Duration dressing remains on wound before changing
1-3 days

Frequency of dressing change
1-3 days, dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Allergy to Shellfish (Chitin)
Full thickness burns
Heavily bleeding wounds
Dry wounds

Rationale for inclusion in formulary
Cost effective
Alternative to available antimicrobials
Can be used on heavily exuding wounds 
Flaminal ®Hydro Gel
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Formulary
Green
Alginate gel. Low to moderate exuding wounds. Contains antimicrobial enzymes

Type of wound product is suitable for
Colonised wound bed. More suited to sloughy wounds. Can be used on all wound types
Useful for cavity wounds and sinus’s
Requires a secondary dressing

Duration dressing remains on wound before changing
1-7 days

Frequency of dressing change
1-7 days dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Sensitivity to alginate dressings or polyethylene glycol
Full thickness burns

Rationale for inclusion in formulary
1st line antimicrobial in paediatrics
Consider as first line product if signs of colonisation or clinical infection
Does not cause cellular damage 
   
Cutimed ®Sorbact
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Formulary
Amber Recommended

DACC coated dressings providing antimicrobial properties, available in a pad, gel, gel sheet, ribbon, round swab and rectangular swab

Type of wound product is suitable for
Colonised or clinically infected moist wound, suitable for any wound type

Duration dressing remains on wound before changing
1-3 days

Frequency of dressing change
1-3 days dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not use in combination with oils and creams
Known hypersensitivity to ingredients
Not for dry wound
Not for heavily exuding wounds

Rationale for inclusion in formulary
Alternative to available antimicrobials

 
   
Kendall AMD®
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Formulary
Red
Absorbent, non adherent foam disc impregnated with PHMB. Double sided with a centre hole and radial slit
Type of wound product is suitable for
For use on pin sites, drains and tubes.
Duration dressing remains on wound before changing
1-7 days
Frequency of dressing change
1-7 days dependent on exudate levels
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not intended as a primary treatment for infection
Do not use as a primary treatment for full thickness burns
Not for patients sensitive to PHMB
Rationale for inclusion in formulary
Provides local exudate management and antimicrobial properties
Absorbent
Non adherent and semi occlusive
For specialist use only 
   
Prontosan Wound Gel 30ml
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Formulary
Amber Recommended

A gel containing betaine, a surfactant to remove biofilm and debris and PHMB to help control bacterial bioburden.

Type of wound product is suitable for
Cleansing, decontamination and moisturising of acute and chronic wounds including 1st and 2nd degree burns.

Duration dressing remains on wound before changing
Apply at each dressing change

Frequency of dressing change
As determined by the wound and exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
None

Rationale for inclusion in formulary
Gel to cleanse and decontaminate wounds
Antimicrobial
Breaks down biofilms in chronic wounds

 
   
Prontosan Wound Irrigation Solution
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Formulary
Green
Wound irrigation solution containing betaine a surfactant to remove biofilm and debris and PHMB to help control bacterial bioburden.

Type of wound product is suitable for
Cleansing, decontamination and moisturising of acute and chronic wounds including 1st and 2nd degree burns.

Duration dressing remains on wound before changing
Apply at each dressing change

Frequency of dressing change
As determined by the wound and exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
None

Rationale for inclusion in formulary
Solution to cleanse and decontaminate wounds
Antimicrobial
Breaks down biofilms in chronic wounds
Can be used as an irrigation fluid with VAC Veraflow 
   
Suprasorb X + PHMB
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Formulary
Amber Recommended

Biocellulose gel sheet dressing with PHMB antimicrobial properties

Type of wound product is suitable for
Light to moderately, critically colonised or infected exuding wounds
Can be used on all wound types at all stages of wound healing
Can be cut or folded to wound shape size

Duration dressing remains on wound before changing
1-3 days

Frequency of dressing change
1-3 days, dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known sensitivity to PHMB or any components of the dressing
Heavily exuding wounds

Rationale for inclusion in formulary
Light to moderate exudate in clinically infected wounds.
Suitable for all wounds at all stages of wound healing
Doesn’t affect healthy cells, suitable for long term use when necessary
Specialist recommendation

 
   
A5.04  Specialised dressings to top
A5.04.01  Protease-modulating matrix dressings
UrgoSTART® range
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Formulary
Amber Recommended

A non adherent foam and contact layer impregnated with TLC-NOSF healing matrix to promote healing and prevent the detrimental effects of MMPs.
Type of wound product is suitable for
Low to moderately exuding chronic wounds
Duration dressing remains on wound before changing
Up to 7 days
Frequency of dressing change
1-7 days dependent on exudate levels.
Treatment must be a minimum duration of 4-5 weeks.
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not use on infected or critically colonised wounds
Known sensitivities to dressing components
Rationale for inclusion in formulary
Various sizes available including a shaped heel dressing in the foam range
Pain free dressing changes
Promotes wound healing
Interacts with the wound bed to prevent the detrimental effects of MMPs on wound healing

 
   
A5.04.02  Silicone keloid dressings
A5.04.02  Silicone sheets
Cica-Care
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Formulary
Amber Recommended

Silicone sheet for scar treatment

Type of wound product is suitable for
Not for use on open wounds- to be applied on healed scar only.
This is not a dressing but a scar treatment

Duration dressing remains on wound before changing
23 hours

Frequency of dressing change
Daily

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not use on open or infected wounds. Do not use on skin affected by acne. Discontinue use if a rash or itching occur.

Rationale for inclusion in formulary
Scar therapy
Silicone sheets have been shown to soften, flatten scarring aiding movement, nerve sensations and function. Self adherent, Re-usable

 
   
Mepiform
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Formulary
Amber Recommended

Silicone sheet for scar treatment

Type of wound product is suitable for
Not for use on open wounds- to be applied on healed scar only.
This is not a dressing but a scar treatment

Duration dressing remains on wound before changing
23 hours

Frequency of dressing change
Daily

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not use on open or infected wounds. Do not use on skin affected by acne. Discontinue use if a rash or itching occur.

Rationale for inclusion in formulary
Scar therapy
Silicone sheets have been shown to soften, flatten scarring aiding movement, nerve sensations and function.
Cost effective.

 
   
A5.04.02  Silicone gel
A5.05  Adjunct dressings and appliances to top
A5.05.01  Gauze and tissue
A5.05.01  Surgical absorbents
A5.05.01  Cotton
Sterile Gauze swabs 7.5cmx7.5cm ONLY
(non woven)
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Formulary
Green
7.5cm x 7.5cm only
Type of wound product is suitable for
Cleansing wounds via aseptic technique
Duration dressing remains on wound before changing
N/A
Frequency of dressing change
N/A
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not to be applied to a wound as a dressing
Necessity for wound cleansing
Cost effective
Included in Sterile wound packs or used to supplement sterile packs
 
   
Gamgee
(UHB burns unit ONLY)
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Formulary
Red
Sterile or non sterile highly absorbent cotton wool enclosed in an absorbent cotton cover
Type of wound product is suitable for
Full thickness burns
Can be cut to required size
Secondary dressing
Duration dressing remains on wound before changing
Dependent on exudate levels
Frequency of dressing change
Dependent on exudate levels
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not to be used as a primary dressing
Only to be used in UHB burns unit
Rationale for inclusion in formulary
UHB burns unit only
 
   
A5.05.01  Lint
A5.05.01  Pads to top
Xupad range
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Formulary
Green
Latex free absorbent dressing pad
Type of wound product is suitable for
Low exuding closed surgical wounds only
Duration dressing remains on wound before changing
1 – 7 days depending on exudate
Frequency of dressing change
1 – 7 days depending on exudate
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not for moderate or highly exuding wounds. Always consider an interactive dressing. Not suitable for any wound type except for closed surgical wounds
Rationale for inclusion in formulary
Cost effective
Various sizes available 
   
A5.05.02  Wound drainage pouches

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First Choice
Green
Consider standard interactive dressings first 
Oakmed Option Wound Manager
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Formulary
Amber Recommended

Wound drainage system consisting of a hydrocolloid adhesive wafer and a drainable drainage bag

Type of wound product is suitable for
Complex abdominal wounds, moderate to large fistula’s, orthopaedic wounds or
fungating wounds with high levels of exudate, that are unmanaged with conventional dressings.

Max Duration dressing remains on wound before changing
Empty drainage bag as required. If no port for drainage, change as required.

Frequency of dressing change
As long as adhesive remains intact whilst being mindful of skin integrity

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known product component sensitivity to hydrocolloid (Gelatine and Pectin)
Low to moderate exuding wounds
Do not use if a conventional dressing can manage the exudate levels

Rationale for inclusion in formulary
Various size selection with drainage ports and windows
For highly exuding wounds that conventional dressings cannot manage the exudate levels

 
   
A5.05.03  Physical debridement pads
UCS® Debridement
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Formulary
Green

Single use pre- moistened cloth for wound debridement.  Can be used to remove hyperkeratosis.


Type of wound product is suitable for

All acute and chronic wounds including pressure ulcers, leg ulcers, diabetic foot ulcers.

Hyperkeratosis


Duration dressing remains on wound before changing
Not applicable


Frequency of dressing change
At each dressing change or as required


Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Heavy slough and necrotic tissue may require autolytic debridement to soften prior to use
Thick hyperkeratosis may take more than one treatment


Rationale for inclusion in formulary
Lifts wound debris, superficial slough and exudate, without inhibiting granulation tissue formation
Compatible with subsequent use of any type of dressing.
Lifts hyperkeratosis and dry flaking skin to peri-wound
Convenient, pre- moistened,  easy to use, disposable single use cloth

 
   
Debrisoft®
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Formulary
Red
£££
Debridement pad to cleanse and debride wounds.
Type of wound product is suitable for
Acute or chronic wounds with surface debris eg pressure ulcers, leg ulcers, diabetic foot ulcers
Hyperkeratosis
Duration dressing remains on wound before changing
Not applicable
Frequency of dressing change
At each dressing change or as required
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known sensitivity to polyester
Heavy slough and necrotic tissue may require autolytic debridement to soften prior to
use
Thick hyperkeratosis may take more than one treatment
Must be wet with clean warm water prior to use
Do not get an emollient on the pad as this blocks the monofilaments
Rationale for inclusion in formulary
Lifts debris, superficial slough and exudate without damaging new granulation or
epithelial cells
Removes biofilms
Lifts hyperkeratosis and dry flaking skin peri-wound
Recommended by NICE
Treatment well tolerated
Convenient, easy to use, disposable single use pad
 
   
A5.06  Complex adjunct therapies
A5.06.01  Topical negative pressure therapy

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First Choice
Green
Consider standard interactive dressings first. Dressings advised by TVN
Topical Negative Pressure Therapy
(Dependent on Trust contract)
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Formulary
Amber Recommended

The use of sub atmospheric pressure to promote or assist wound healing or to remove fluids from a site. Required components: Pump, Dressings foam or gauze, tubing and canister.

Type of wound product is suitable for
Acute, chronic and traumatic wounds. Can be used as a adjunct to surgery and for
salvage procedures such as wound dehiscence. Benefits are that it removes excess fluid that may contain bacterial pathogens, reduces soft tissue oedema, promotes granulation and provides a moist wound healing environment.
Consider standard interactive dressings first.
Duration dressing remains on wound before changing
Every three days
Frequency of dressing change
Determined by exudate levels. Different canister sizes available
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
It should not be used on: Grossly infected or bleeding wounds
Malignancy
Exposed blood vessels
Organs
Unexplored fistulae
Extensive necrotic wounds
Caution with foam, document the number inserted, ensure all pieces are retrieved.

Rationale for inclusion in formulary
It removes excess fluid that may contain bacterial pathogens, reduces soft tissue
oedema, promotes granulation and provides a moist wound healing environment. Both companies products are included due to different contracting arrangements. Can be used on large open wounds to increase speed of wound healing

 
   
A5.06.01  Vacuum assisted closure products to top
A5.06.01  Wound drainage collection devices
PICO products
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Formulary
Amber Recommended

Disposable and portable system designed to kick start wound healing. Required
components: One PICO device, 2 dressings per kit.
Type of wound product is suitable for
Acute, chronic, dehisced, partial thickness burns, flaps, grafts and traumatic wounds.
Consider standard interactive dressings first.
Duration dressing remains on wound before changing
Twice a week dressing change, PICO device weekly change
Frequency of dressing change
Determined by exudate levels.
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
It should not be used on:
Confirmed and untreated osteomyelitis
Malignancy in wound bed or wound margins
Exposed blood vessels
Organs
Unexplored fistulae Necrotic wounds Anastomotic sites
Emergency airway aspiration
Pleural, mediastinal or chest tube drainage and surgical suction
Rationale for inclusion in formulary
These devices promote patient mobility at a cost effective price and is available on drug
tariff which other comparable models are not.

 
   
Renasys products
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Formulary
Amber Recommended

The use of sub atmospheric pressure to promote or assist wound healing or to remove fluids from a site. Required components: Pump, Dressings foam or gauze, tubing and canister.

Type of wound product is suitable for
Acute, chronic and traumatic wounds. Can be used as a adjunct to surgery and for
salvage procedures such as wound dehiscence. Benefits are that it removes excess fluid that may contain bacterial pathogens, reduces soft tissue oedema, promotes granulation and provides a moist wound healing environment.
Consider standard interactive dressings first.
Duration dressing remains on wound before changing
Every three days
Frequency of dressing change
Determined by exudate levels. Different canister sizes available
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
It should not be used on: Grossly infected or bleeding wounds
Malignancy
Exposed blood vessels
Organs
Unexplored fistulae
Extensive necrotic wounds
Caution with foam, document the number inserted, ensure all pieces are retrieved.

Rationale for inclusion in formulary
It removes excess fluid that may contain bacterial pathogens, reduces soft tissue
oedema, promotes granulation and provides a moist wound healing environment. Both companies products are included due to different contracting arrangements. Can be used on large open wounds to increase speed of wound healing

 
   
V.A.C. products
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Formulary
Amber Recommended

The use of sub atmospheric pressure to promote or assist wound healing or to remove fluids from a site. Required components: Pump, Dressings foam or gauze, tubing and canister.

Type of wound product is suitable for
Acute, chronic and traumatic wounds. Can be used as a adjunct to surgery and for
salvage procedures such as wound dehiscence. Benefits are that it removes excess fluid that may contain bacterial pathogens, reduces soft tissue oedema, promotes granulation and provides a moist wound healing environment.
Consider standard interactive dressings first.
Duration dressing remains on wound before changing
Every three days
Frequency of dressing change
Determined by exudate levels. Different canister sizes available
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
It should not be used on: Grossly infected or bleeding wounds
Malignancy
Exposed blood vessels
Organs
Unexplored fistulae
Extensive necrotic wounds
Caution with foam, document the number inserted, ensure all pieces are retrieved.

Rationale for inclusion in formulary
It removes excess fluid that may contain bacterial pathogens, reduces soft tissue
oedema, promotes granulation and provides a moist wound healing environment. Both companies products are included due to different contracting arrangements. Can be used on large open wounds to increase speed of wound healing

 
   
A5.06.01  Accessories
A5.07  Wound care accessories
A5.07.01  Dressing packs
Polyfield Nitrile Patient Pack  (primary care and BCHC, other Trusts as per contract)
View adult BNF View SPC online View childrens BNF
Formulary
Green
Sterile dressing pack
Type of wound product is suitable for
To be used on all wounds requiring aseptic dressing procedures
Duration dressing remains on wound before changing
Single use
Frequency of dressing change
Determined by wound type
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
None listed
Rationale for inclusion in formulary
Available on drug tariff, cost effective and incorporates a measure guide which would
be an additional cost with other packs
 
   
A5.07.02  Woven and fabric swabs to top
gauze swabs, non-woven swabs
(GENERIC PRESCRIBING)
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Formulary
Green
7.5cm x 7.5cm only

Type of wound product is suitable for
Cleansing wounds via aseptic technique

Duration dressing remains on wound before changing
N/A

Frequency of dressing change
N/A

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not to be applied to a wound as a dressing

Rationale for inclusion in formulary
Necessity for wound cleansing
Cost effective
Included in Sterile wound packs or used to supplement sterile packs
 
   
A5.07.03  Surgical adhesive tapes
A5.07.03  Permeable adhesive tapes
Clinipore
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First Choice
Green
Permeable non woven, synthetic adhesive tape
For securing bandages

Frequency of dressing change
Determined by wound type and dressing change

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
None listed

Rationale for inclusion in formulary
Available on drug tariff, cost effective and evaluated as meeting the requirements of a tape including adherence.
 
Mefix
View adult BNF View SPC online View childrens BNF
Second Choice
Green
Permeable, aperture non woven, synthetic adhesive tape
For securing dressings.

Frequency of dressing change
Determined by wound type and dressing change

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
None listed

Rationale for inclusion in formulary
Available on drug tariff. Different availability of sizes in comparison to Clinipore for
difficult to dress areas. Some stretch and flexibility to improve conformity and adhesion. Can be used to secure dressings rather than bandages.
 
   
A5.07.03  Occlusive adhesive tapes
A5.07.04  Adhesive dressings
A5.07.04  Vapour permeable adhesive dressings to top
A5.07.05  Skin closure dressings
A5.07.05  Skin closure strips, sterile
Omnistrip®
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Formulary
Green
Adhesive wound closure strip
Type of wound product is suitable for
For atraumatic closure of minor wounds or surgical incisions
Require a secondary dressing
Duration dressing remains on wound before changing
As necessary, up to 14 days
Frequency of dressing change
As necessary
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
None
Rationale for inclusion in formulary
Cost effective
Essential for closure of minor injuries
 
   
A5.08  Bandages
A5.08.01  Non-extensible bandages
A5.08.02  Light-weight conforming bandages to top
Knit -band®
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Formulary
Green
Cellulose contour bandage used for retention of non adhesive dressing products

Type of wound product is suitable for
Retention bandage

Duration dressing remains on wound before changing
Change in line with dressing change

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Take care to apply joint below to joint above. Always use a primary dressing

Rationale for inclusion in formulary
Most cost effective choice.
 
   
A5.08.03  Tubular bandages and garments
A5.08.03  Elasticated
Clinifast
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Formulary
Green
££
Elasticated Sub bandage lining

Type of wound product is suitable for
To be used under retention and compression bandages when conformity is required
Can be used for wet/dry wrapping.

Duration dressing remains on wound before changing
As required

Frequency of dressing change
As required

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Ensure the correct size for a limb is selected

Rationale for inclusion in formulary
Cost effective choice when conformity to a limb is required
 
   
Cotton Stokinette BP
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Formulary
Green
Sub bandage lining

Type of wound product is suitable for
To be used under retention and compression bandages

Duration dressing remains on wound before changing
As required

Frequency of dressing change
As required

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not to be used under Coban compression therapy
Not to be used under compression hosiery
Does not conform to a limb shape. If conformity is required, choose Clinifast

Rationale for inclusion in formulary
Cost effective choice when conformity to a limb is not required
 
   
A5.08.03  Non-elasticated
A5.08.03  Silk Clothing
 note 

All Silk garments are non-formulary in view of only poor evidence to support prescribing of silk garments in children and adults with eczema/ atopic dermatitis.  

Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care

NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs

 

A5.08.04  Support bandages to top
K- Lite
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Formulary
Green
Lightweight knitted bandage

Type of wound product is suitable for
Designed for use on sprains/strains
Can be used to prevent oedema, would require a wadding bandage to be applied
beneath
It is the second layer of a four layer compression bandage kit
Where there is open skin, a primary dressing must be used

Duration dressing remains on wound before changing
Change in line with primary dressing

Frequency of dressing change
1-7 days

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known allergy to any components
Not suitable for application of pressure on its own and therefore should be used with other bandage components for the treatment of venous ulcers
Caution over bony prominences where the bandage can cause pressure

Rationale for inclusion in formulary
Cost effective
Essential for providing support to a limb and as part of a bandage compression therapy kit


 
   
A5.08.05  Adhesive bandages
A5.08.06  Cohesive bandages
A5.08.06  Cohesive extensible bandages
Ko-Flex®
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Formulary
Green
A water resistant vapour permeable cohesive bandage

Type of wound product is suitable for
Venous ulceration, oedema, Managing sprains and strains and following orthopaedic
surgery
Forms part of the K four bandage system

Duration dressing remains on wound before changing
1 to 7 days

Frequency of dressing change
Dependant on exudate levels if wound present or oedema management .

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not recommended on those patients with an ABPI lower than 0.8.
Contains latex

Rationale for inclusion in formulary
Cohesive bandage that can be used alongside other formulary products
Forms the 4th layer of a four layer compression bandage system
 
   
A5.08.07  Compression bandages
A5.08.07  High compression bandage to top
A5.08.07  Short stretch compression bandage
Actico®
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Formulary
Green
Cohesive inelastic high compression bandage. Short stretch bandage

Type of wound product is suitable for
Venous leg ulceration
Lymphoedema
Management of chronic oedema

Duration dressing remains on wound before changing
Daily to 7 days

Frequency of dressing change
Dependant on exudate levels if wound present or oedema management.

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not recommended on those patients with an ABPI lower than 0.8. Caution in diabetic patients
Caution when cardiac overload or renal failure present or suspected.

Rationale for inclusion in formulary
Only cohesive short stretch bandage. Nurses competent in its usage.
 
   
Comprilan®
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Formulary
Amber Recommended

100 % cotton short stretch compression bandage

Type of wound product is suitable for
Venous leg ulceration
Varicosis
Management of chronic oedema
Management of primary and secondary lymphoedema
Deep venous thrombosis
Thrombophlebitis

Duration dressing remains on wound before changing
1 to 7 days

Frequency of dressing change
Dependant on exudate levels if wound present or oedema management.

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Advanced Peripheral arterial occlusive disease
Decompensated cardiac insufficiency
Septic phlebitis
Phlegmasia coerula doleris

Rationale for inclusion in formulary
Cotton short stretch bandage. Used by lymphoedema nurse specialists

 
   
A5.08.07  Sub-compression wadding bandage
Cellona®
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Formulary
Amber Recommended

Sub compression wadding bandage to pad and shape a limb prior to compression therapy

Type of wound product is suitable for
Provides padding for larger limbs under compression.

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
Daily up to weekly dependant on exudate and oedema management.

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Advised not to apply directly to skin as can cause irritation.

Rationale for inclusion in formulary
Cost effective for use in larger quantities when used in lymphoedema management.

 
   
K Soft®
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Formulary
Green
An absorbent non –woven, sub bandage wadding.

Type of wound product is suitable for
Provides padding , shaping and protection of the limb prior to the application of
compression bandage therapy.

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
Daily up to weekly dependant on exudate and oedema management.

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Advised not to apply directly to skin as can cause irritation.

Rationale for inclusion in formulary
Essential for protecting a limb, padding and shaping
Forms part of the compression bandage regime. Suitable for use with other formulary products.
 
   
A5.08.08  Multi-layer compression bandaging
A5.08.08  Four layer systems
UrgoK4®
(Previously known as K-Four)
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Formulary
Green
Multi layer compression system

Type of wound product is suitable for
Venous and mixed aetiology leg ulcers and associated conditions

Duration dressing remains on wound before changing
1 to 7 days

Frequency of dressing change
Daily up to weekly dependant on exudate and oedema management.

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not recommended for patients with a ABPI of less than 0.8
Contains latex
Kit size determined by measuring the ankle after padding with the tape measure pulled
taught

Rationale for inclusion in formulary
Compression system consisting of k-soft , k-lite, k plus 3a or K three c (dependent on
ankle size) and Ko flex
Component bandages available in longer lengths for larger limbs
 
   
A5.08.08  Two layer systems to top
Coban, Coban Lite®
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Formulary
Amber Recommended

Two layer compression system available in full and reduced compression (Coban Lite). Comprises of a latex free foam padding and cohesive bandage.

Type of wound product is suitable for
Treatment of venous and mixed aetiology leg ulcers

Duration dressing remains on wound before changing
1 to 7 days

Frequency of dressing change
Daily up to weekly dependant on exudate and oedema management.

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Arterial disease
Not to be used with other padding or wadding

Rationale for inclusion in formulary
Two layer compression kit, Once applied the two layers form a band to become a single
layer bandage.
Bandage technique can be adapted to reduce forefoot oedema (Extra training required)

 
   
UrgoKTwo®
(previously know as K-Two)
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Formulary
Green
Two layer bandage system consisting of elastic and inelastic components that provide a sustained graduated compression,.
Available in K two reduced.

Type of wound product is suitable for
Treatment of venous leg ulcers, venous oedema and lymphoedema

Duration dressing remains on wound before changing
1 to 7 days

Frequency of dressing change
Daily up to weekly dependant on exudate and oedema management.

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Arterial disease
Diabetic Microangiplathy
Ischaemic Phlebitis
Septic thrombosis
Allergy to any components in particular latex (available in latex free )

Rationale for inclusion in formulary
Two layer compression kit.
Essential for treating venous leg ulceration
2 layer less bulky for community use and enabling patients to wear foot wear
Available in latex free option and reduced compression option
 
   
A5.08.09  Medicated bandages
Ichthopaste
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Formulary
Amber Recommended

Zinc and Ichthammol bandage.

Type of wound product is suitable for
Venous leg ulcers Chronic eczema Dermatitis

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
Daily up to weekly dependant on skin and wound management.

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not use in any cases of sensitivity or allergy to ingredients

Rationale for inclusion in formulary
For treatment of dermatitis and chronic eczema when
venous insufficiency is present.

 
   
Viscopaste
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Formulary
Amber Recommended

Zinc paste bandage.

Type of wound product is suitable for
Venous leg ulcers. Where venous insufficiency exists, the paste bandage should be used
under graduated compression bandaging. Chronic eczema
Dermatitis

Duration dressing remains on wound before changing
Up to 7 days

Frequency of dressing change
Daily, up to weekly dependant on skin and wound management.

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not use in any cases of sensitivity or allergy to ingredients

Rationale for inclusion in formulary
For treatment of dermatitis and chronic eczema when venous insufficiency is present

 
   
A5.08.09  Medicated stocking
A5.09  Compression hosiery and garments
A5.09.01  Graduated compression hosiery
Graduated compression hosiery
View adult BNF View SPC online View childrens BNF
Formulary
Green
Based on assessment 
   
A5.09.01  Accessories to top
A5.09.01  Suspender
A5.09.01  Anklets
A5.09.01  Knee caps
A5.09.02  Lymphoedema garments
Lymphoedema garments
View adult BNF View SPC online View childrens BNF
Formulary
Green
Based on assessment 
   
A5.10  Larvae to top

View adult BNF View SPC online View childrens BNF
Formulary Consider standard dressings first 
   
LarvE
(free range or in BioFOAM dressing)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

Free range: Biomonde Larvae 100/200 or BioBag
Biosurgical treatment for the debridement and cleansing of wounds consisting of aseptically produced living larvae.
The BioBag is presented in the five (5) configurations listed below. The larvae are Lucilia sericata contained in a sterile polyester net bag with a sterile PVA spacer cube, presented in a sterile transport container.
BioBag 50 at least 50 larvae 25 x 40mm 1 8x8x10
BioBag 100 at least 100 larvae 50 x 40mm 1 12x12x10
BioBag 200 at least 200 larvae 60 x 50mm 1 25x10x10
BioBag 300 at least 300 larvae 120 x 60mm 2 25x10x10
BioBag 400 at least 400 larvae 100 x 100mm 2 25x10x10
Free range larvae, larvae and 30 x 30 flat retention net plus kit pack, larvae and 40 x
60cm boot retention net plus kit pack. Additional 100 or 200 larvae available.
Type of wound product is suitable for
The BioMonde Larval Debridement Therapy Products are indicated for debridement of non-healing necrotic skin and soft tissue wounds, including pressure ulcers, venous stasis ulcers, neuropathic foot ulcers, and non-healing traumatic or post-surgical wounds.
Duration dressing remains on wound before changing and frequency of dressing change
An application of BioBag can be left in place for up to 4 days, dependent on the
condition of the wound. If the wound is not sufficiently debrided after 4 days, the treatment can be repeated with a fresh application of BioBag. The treatment should be stopped as soon as the wound is sufficiently debrided or if no improvement is observed after 3 or more applications. The total number of treatment cycles will depend on the characteristics of the wound, the response of the patient to LDT and the aim of the therapy. Most ulcers are completely debrided within 1 to 6 treatment cycles. If exudate production is excessive, the secondary dressing may be changed as required while leaving the BioBag undisturbed. Frequent removal of the outer dressing will also help to control the odour associated with the liquefied necrotic tissue
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Larvae should not be used in patients with known hypersensitivities to fly larvae, polyester, PVA (polyvinyl alcohol) or the components of the media on which the larvae are raised (including soya protein, yeast protein, potato starch and bovine protein) as this may result in dermatitis or more severe immunological reactions in susceptible individuals. If treatment is undertaken then these patients should be under strict medical supervision for the duration of the treatment with immediate access to care. Patients with life or limb-threatening, rapidly advancing infections should not be
treated with as LDT may interfere with the close and frequent observation that these
patients require.
Should not be used as first line therapy of infected tendon and bone. These wounds
should be treated surgically and/or with antibiotics before using LDT.
Should not be used to treat wounds which are not directly exposed to the outside.
Wounds should never be allowed to close over the larvae either intentionally or unintentionally.
Should not be used on wounds with an inadequate blood supply as this ultimately reduces the ability of the wound to heal. LDT will enlarge the wound as necrotic tissue is debrided but the resulting clean wound is at risk from re-infection.
Although some mild bleeding is common during LDT, larvae should not be used on wounds that have a tendency to bleed or wounds close to an exposed major blood vessel, especially if considered to be necrotic as this can lead to rupture of the blood vessels which could be life-threatening. If LDT is attempted, the patient must remain under strict medical supervision for the duration of the treatment.
Should not be used on patients with an inborn or medication-induced coagulopathy or
in patients being treated with anticoagulants. If these patients are treated with LDT, they should remain under strict medical supervision for the duration of the treatment. Should never be used in sterile body cavities.
Should be used with caution on wounds over adjacent exposed organs or leading to a body cavity, and only under close medical supervision for the duration of the treatment. Data are not available concerning the antibiotic / antiseptic activity of maggots and therefore any infected wound should receive standard antibiotic care.
Rationale for inclusion in formulary
Only available larval therapy on prescription.
Rapid debridement of chronic wounds
Can be utilised in the community

 
   
A5.11  Protectors and aids
Magnide
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Formulary
Green
Application aid for closed toe stockings/ compression garments 
   
Easy-Slide
View adult BNF View SPC online View childrens BNF
Formulary
Green
Application aid for open toe compression hosiery garments  
   
LimbO Waterproof protector
View adult BNF View SPC online View childrens BNF
Formulary
Green
Waterproof protector, non slip latex free with a flexible seal at the opening
Type of wound product is suitable for
Used to keep arm, PICC, leg and foot dressings dry, can be fully submerged in water
Rationale for inclusion in formulary
Multiple sizing for legs and arms  
   
Seal-Tight Wound care protector
View adult BNF View SPC online View childrens BNF
Formulary
Green
Waterproof protector, non slip latex free
Type of wound product is suitable for
Used to keep leg and foot dressings dry, can be fully submerged in water
Rationale for inclusion in formulary
Multiple sizing for leg including extra large limb
No adjustments required
 
   
A5.12  Wound irrigation
Irripod
View adult BNF View SPC online View childrens BNF
Formulary
Green
Sterile sodium chloride solution
Type of wound product is suitable for
Wound cleansing, for topical irrigation of the eye
Duration dressing remains on wound before changing
As required
Frequency of dressing change
As required
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Single use
External use only
Rationale for inclusion in formulary
Cost effective
Cleansing of wounds
 
   
Prontosan Wound Irrigation solution
View adult BNF View SPC online View childrens BNF
Formulary
Green
See under antimicrobials

 
   
A5.13  Emollients
Cetraben Pump cream
View adult BNF View SPC online View childrens BNF
Formulary
Green
Emollient containing white soft paraffin and light liquid paraffin
Type of wound product is suitable for
For inflamed, dry, chapped skin
Frequency of use
Daily
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Allergy or hypersensitivity to any of the ingredients
Rationale for inclusion in formulary
Treatment of dry skin
Dermatology approved  
   
Dermatonics Once Heel balm
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

Cream containing 25% urea
Type of wound product is suitable for
To moisturise dry skin on the soles of feet
For use on adults and children over 12 years of age
Frequency of use
Reapply daily
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Allergy or hypersensitivity to any of the ingredients, contains beeswax and lanolin
Not to be used on children under 12
Rationale for inclusion in formulary
Treatment of dry skin conditions of the foot. Dermatology approved

 
   
Dermol 500 Lotion
(Please note:- can only be prescribed by Independent prescribers))
View adult BNF View SPC online View childrens BNF
Formulary
Green
Emollient lotion containing an antimicrobial
Type of wound product is suitable for
For dry and pruritic skin conditions including eczema and dermatitis. Can be applied to skin as an emollient or used as a soap substitute
Frequency of use
Reapply daily
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Allergy or hypersensitivity to any of the ingredients, contains benzalkonium chloride,
0.1%, chlorhexidine hydrochloride 0.1%, liquid paraffin, isopropyl myristate. Should not be used unless infection is present or is a frequent complication
Rationale for inclusion in formulary
Treatment of dry skin requiring antimicrobial properties
Dermatology approved
 
   
Liquid paraffin / white soft paraffin 50:50
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Formulary
Green
Emollient ointment containing liquid paraffin and white soft paraffin
To assist the skin in retaining moisture
Type of wound product is suitable for
For use on all dry skin conditions including eczema and psoriasis
Frequency of use
Daily or more frequently if required
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Allergy or hypersensitivity to any of the ingredients
Rationale for inclusion in formulary
Treatment of dry skin conditions. Dermatology approved
 
   
ZeroAQS cream®
View adult BNF View SPC online View childrens BNF
Formulary
Green
Emollient cream that occludes and moisturises the skin.
Type of wound product is suitable for
For external application for use as an emollient and as a skin cleanser/soap substitute
in the management for dry skin conditions.
Frequency of use
Daily or more frequently if required
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Allergy or hypersensitivity to any of the ingredients
Rationale for inclusion in formulary
Dermatology approved
Does not contain sodium lauryl sulphate (SLS) 
   
Zerobase®
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Formulary
Green
Emollient ointment containing liquid paraffin, to moisturise dry or chapped skin
Type of wound product is suitable for
Symptomatic treatment of dry or chapped skin
Can be used as a pre bathing emollient for dry skin to alleviate drying effects
Frequency of use
Daily or more frequently if required
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Allergy or hypersensitivity to any of the ingredients
Rationale for inclusion in formulary
Dermatology approved
 
   
Zerocream®
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Formulary
Green
Emollient cream containing liquid paraffin and soft white paraffin, to moisturise dry skin
Type of wound product is suitable for
Symptomatic treatment of flaking, dry skin, sunburn, dry eczema and dry cases of
psoriasis
Frequency of use
Daily or more frequently if required
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Allergy or hypersensitivity to any of the ingredients
Rationale for inclusion in formulary
Dermatology approved
 
   
Zeroderm ointment
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Formulary
Green
Emollient ointment containing liquid paraffin and white soft paraffin To assist the skin in retaining moisture
Type of wound product is suitable for
For use on all dry skin conditions including eczema and psoriasis
Can be used as a soap substitute/skin cleanser
Frequency of use
Daily or more frequently if required
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Allergy or hypersensitivity to any of the ingredients
Rationale for inclusion in formulary
Treatment of dry skin conditions. Dermatology approved
Free from fragrance and colours, sodium lauryl sulphate, additives and preservatives 
   
Zeroguent
View adult BNF View SPC online View childrens BNF
Formulary
Green
Rich emollient ointment containing light liquid paraffin, white soft paraffin and soya bean oil
To assist the skin in retaining moisture
Type of wound product is suitable for
For use as a barrier and moisturiser for symptomatic treatment of dermatitis, ichthyosis, eczema and psoriasis
Can be used as a pre bathing emollient for dry skin to alleviate drying effects
Frequency of use
Daily or more frequently if required
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Allergy or hypersensitivity to any of the ingredients
Rationale for inclusion in formulary
Dermatology approved
 
   
A5.14  Soap substitutes
Emulsifying Ointment
View adult BNF View SPC online View childrens BNF
Formulary
Green
Emollient ointment containing emulsifying wax, white soft paraffin and liquid paraffin
Type of wound product is suitable for
For treatment of dry skin conditions
Frequency of use
Daily
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Allergy or hypersensitivity to any of the ingredients
Rationale for inclusion in formulary
Treatment of dry skin
Dermatology approved
 
   
Epaderm ®Ointment
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Formulary
Green
Emollient ointment containing liquid paraffin, yellow soft paraffin and emulsifying wax
Type of wound product is suitable for
For use on all dry skin conditions and with dry or wet wrapping techniques
Frequency of use
Daily or more frequently if required
Caution/contraindications
Non listed
Rationale for inclusion in formulary Treatment of dry skin conditions. Dermatology approved
 
   
A5.15  Barrier preparations to top
3M Cavilon Durable Barrier Cream
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First Choice
Green
Skin protectant
Type of wound product is suitable for
Intact skin
As a barrier against bodily fluids, prevention of skin damage associated with incontinence
Can be used alongside containment products
Can be used to prevent friction to vulnerable areas of skin
Frequency of use
Reapply sparingly twice daily
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not use on infected skin
Not be used as an emollient
Not to be used around the peri wound
Can increase adherence of some dressing products and therefore care should be taken when adhesive products are being used in conjunction with the cream on people with fragile skin
Rationale for inclusion in formulary
The only barrier cream that can be used in conjunction with containment products without blocking the absorption of the pad
Cost effective, does not require reapplication at every episode of hygiene
 
3M Cavilon No Sting Barrier Film Pump Spray and applicators
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First Choice
Green
Protective transparent barrier film
Type of wound product is suitable for
Superficial broken skin and abrasions
As a barrier against bodily fluids, prevention of skin damage associated with incontinence
Can be used alongside containment products
Can be used to prevent friction to vulnerable areas of skin
Can be used on superficial abrasions caused by incontinence
Can be used to protect peri wound from exudate
Can be used to protect against aggressive adhesive products
Can be used to protect the skin surrounding stoma sites
Frequency of use
Every 72 hours
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not use on infected skin
Allow product to dry before applying the containment products, dressings or clothing (30 seconds)
Too many layers can make the area of skin feel stiff
Can affect electrode readings in the treated area
Rationale for inclusion in formulary
Available in a foam applicator and spray to aid application
Non sticky after use
Can be used on broken areas of skin
Cost effective, does not require reapplication at every episode of hygiene
 
Proshield plus ®
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Second Choice
Green
Skin protectant
Type of wound product is suitable for
To treat injured skin associated with incontinence where a dressing seal cannot be achieved
Frequency of use
Apply at each episode of hygiene
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
External use only
Avoid contact with eyes
Known allergic sensitivity to any of the components
Keep out of reach of children
Do not apply to pressure ulcers or leg ulcers
Not to be used as a first line barrier cream
Not to be used to protect peri wound
Not to be used as an emollient
Rationale for inclusion in formulary
For treatment of incontinence lesions where a standard dressing seal cannot be achieved
 
   
Conotrane cream
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Formulary
Green
Barrier cream
Type of wound product is suitable for
Intact skin, not to be applied to a wound.
To protect the skin from moisture, irritation and chafing.
Frequency of use
Application at every episode of hygiene. Apply a thin layer sparingly
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not to be used in conjunction with containment products for incontinence due to the inclusion of liquid paraffin in the ingredients, which will repel urine/faeces back onto
the skin.
Any allergy to the listed ingredients
Rationale for inclusion in formulary
Dermatology approved
 
   
MediHoney barrier cream
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Formulary
Amber Recommended

Barrier cream containing active Medihoney.
Helps to reduce inflammation

Type of wound product is suitable for
Treatment of incontinence related lesions
Treats blistered skin
Prevention and treatment of maceration and excoriation
Treats candidiasis and intertrigo

Frequency of use
At each episode of hygiene

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Patch test before use

Rationale for inclusion in formulary
Suitable for neonates and children
Treats fungal infections as well as incontinence associated lesions
Reduces inflammation
Can be applied to broken skin

 
   
Metanium ointment
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Formulary
Amber Recommended

Barrier preparation
Type of wound product is suitable for
For relief of the symptoms of nappy rash
Frequency of use
Spread the ointment thinly so the skin texture can be clearly seen through it. Repeat at each nappy change.
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not to be used on adults in conjunction with containment products for incontinence
due to the inclusion of light liquid and white paraffin in the ingredients, which will repel urine/faeces back onto the skin.
Any allergy to the listed ingredients
Overdose is unlikely when Metanium Nappy Rash Ointment is used as instructed for treating nappy rash. However, as this product contains titanium salicylate, accidental ingestion or excessive topical application could lead to symptoms of salicylate poisoning.
Rationale for inclusion in formulary
Dermatology approved

 
   
ProShield®
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Formulary
Green
Skin cleanser for use in patients with chronic diarrhoea or incontinence of urine.
Type of wound product is suitable for
To cleanse intact or injured skin from contamination of urine or faeces
Frequency of use
Apply at each episode of hygiene
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
External use only
Avoid contact with eyes
Known allergic sensitivity to any of the components
Keep out of reach of children
Rationale for inclusion in formulary
For skin cleansing related to incontinence.
Only skin cleanser available on drug tarrif  
   
Sudocrem ®
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Formulary
Green
Barrier cream
Type of wound product is suitable for
Intact skin, not to be applied to a wound.
To protect the skin from moisture, irritation and chafing. To protect the peri wound when utilising free range larvae
Frequency of use
Application at every episode of hygiene. Apply a thin layer sparingly. Remove with olive oil.
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not to be used in conjunction with containment products for incontinence due to the inclusion of lanolin in the ingredients, which will repel urine/faeces back onto the skin. Any allergy to the listed ingredients
Rationale for inclusion in formulary
Dermatology approved
 
   
Zinc and castor oil ointment
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Formulary
Green
Barrier cream
Type of wound product is suitable for
For relief of the symptoms of nappy rash and as a protective water resistant cream for
dry, chapped skin
Frequency of use
As required, up to four times daily or at each nappy change.
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not to be used on adults in conjunction with containment products for incontinence due to the inclusion of peanut oil in the ingredients, which will repel urine/faeces back onto the skin.
Any allergy to the listed ingredients
May mask x-ray images
Rationale for inclusion in formulary
Dermatology approved
 
   
A5.16  Miscellaneous
Appeel ®
(Adhesive remover)
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Formulary
Green
available in 4 different applications
Type of wound product is suitable for
Adhesive dressing or appliance removal where skin stripping, loss of skin integrity and
pain is a concern
  • Sachet– suitable for larger dressing removal
  • Wipes – ideal for adhesive around tubes
  • Foam applicator – ideal for infants or use of the face
  • Spray, single patient, multiple use product for all dressings and/or urinary sheath removal

    Frequency of use
    Use at each dressing change
    Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
    Should not be used when there is a known sensitivity to any of the ingredients
    If in doubt, patch test a small area, prior to use
    The product is flammable and should be used in a well ventilated area
    Avoid use around, flames and sources of ignition
    Rationale for inclusion in formulary
    For pain free removal of dressings where fragile skin is a concern

     
  •    
    Fludroxycortide tape
    (previously known as Haelan® tape)
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    Formulary
    Amber Recommended

    Adhesive, waterproof, occlusive tape impregnated with 4mg/cm2 fludroxycortide (topical steroid)
    Type of wound product is suitable for
    Chronic overgranulation, non acute or weeping.
    Duration dressing remains on wound before changing
    Cut the tape to size. Apply for 12 hours at a time, remove and discard. Apply to clean, dry skin that is shorn of any hair.
    Frequency of dressing change
    Apply daily for 12 hours at a time. Maximum treatment time 7 days.

    Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
    Chicken pox
    Tuberculosis of the skin
    Hypersensitivity to any components in the tape (steroid fludroxycortide)
    Facial rosacea
    Acne vulgaris
    Perioral dermatitis
    Perianal and genital pruritis
    Dermatoses in infants Dermatitis napkin eruption Bacterial, viral and fungal infections
    Keep away from the eyes
    Avoid prolonged use on the face
    Not for untreated bacterial, fungal or viral skin lesions
    Rationale for inclusion in formulary
    Treatment of overgranulation

     
       
    Kerraped
    (Multi-use Boot)
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    Formulary
    Green
  • First consider client's own footwear options.

    A shoe to accommodate bandages and offload pressure from the front of the foot

    Type of wound product is suitable for
    Neuropathic foot ulcers or patients with bulky bandages who cannot wear their own footwear

    Duration product remains on wound before changing
    As required

    Frequency of use
    As required

    Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
    Ensure correct size is selected

    Rationale for inclusion in formulary
    Only footwear available for patients with neuropathic ulcers or bulky bandages
     
  •    
    KerraPro®
    (Pressure reducing pads)
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    Formulary
    Green
    Silicone pads designed to redistribute pressure from bony prominences.
    Type of wound product is suitable for
    Prevention and treatment of category (Stage/Grade) 1 pressure ulcers
    Duration dressing remains on wound before changing
    As required. Check skin daily.
    Frequency of dressing change
    As required, check skin daily. Pads will last up to 3 months

    Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
    Must only be used as part of a pressure ulcer prevention programme
    Not to be used on a grade 2, 3 4, unstageable or deep tissue injury pressure ulcer unless directed by a clinical specialist
    Known sensitivity to silicone
    Do not use as a wound dressing
    Do not apply directly onto broken skin
    If skin macerates beneath, ensure the area is being checked and washed daily and consider utilising a cotton stockinette to reduce humidity
    Rationale for inclusion in formulary
    Cost effective
    Available in a large range of shapes and sizes
    Accessible pressure ulcer prevention medical device
    Reusable on the same patient for up to 3 months by washing with soap and water and thoroughly drying
     
       
    metronidazole 0.75% gel (Anabact®)
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    Formulary
    Amber Recommended

    Type of wound product is suitable for
    Malodourous fungating wounds. Requires a secondary dressing

    Duration preparation remains on wound before changing
    Apply 1-2 times daily following cleansing
    Frequency of use
    1-2 times daily for a maximum of 8 weeks.
    Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
    Avoid exposure to strong sunlight or UV light
    Not to be used on a patient with known sensitivity to any components
    Avoid contact with eyes
    Not for use of any other aetiology of wound as odour control.
    Rationale for inclusion in formulary
    Odour control for fungating tumours

     
       
    Silver nitrate
    (Caustic pencil)
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    Formulary
    Amber Initiation

    NOT 1ST LINE TREATMENT
    ONLY TO BE USED IN A CLINIC SETTING OR BY A CLINICAL SPECIALIST
    Type of wound product is suitable for
    For treatment of chronic overgranulation, non acute or weeping.
    Duration product remains on wound before changing
    Apply moistened caustic pencil tip for 1-2 mins, whilst protecting the surrounding skin with soft paraffin.
    Frequency of use
    Maximum treatment: 3 applications
    Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
    Keep away from the eyes
    Not suitable for use on the face, ano-genital region or large areas
    Not for untreated bacterial, fungal or viral skin lesions
    Can cause chemical burns
    Rationale for inclusion in formulary
    Treatment of overgranulation

     
       
    A5.17  Burns/ Plastics speciality
    Jelonet®
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    Formulary
    Red
    Paraffin gauze dressing
    Type of wound product is suitable for
    As a primary layer for use with Flamazine® or Flammercerium®
    Duration dressing remains on wound before changing
    24 hours
    Frequency of dressing change
    Daily- occasionally alternate day
    Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
    Allergy to any ingredients.
    Rationale for inclusion in formulary
    Cost effective primary layer
     
       
    Kerlix ®
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    Formulary
    Red
    Gauze roll containing 0.2% Polyhexamethylene Biguanide (PHMB)
    Type of wound product is suitable for
    Colonised or infected wounds, with moderate to heavy exudate
    Duration dressing remains on wound before changing
    3 days
    Frequency of dressing change
    3 days
    Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
    Allergy to PHMB
    Do not use with Sodium hypochlorite ( Eusol) solutions, as this will deactivate PHM Do not apply gauze circumferentially as it has no stretch, and can become tight restricting circulation
    Rationale for inclusion in formulary
    Broad-spectrum antimicrobial agent that reduces bacterial colonization within the dressing and bacterial penetration through the dressing.
    Can be used in conjunction with Renasys Negative Pressure Therapy
     
       
    silver sulfadiazine 1% (Flamazine®)
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    Formulary
    Amber Recommended

    Type of wound product is suitable for
    Partial thickness & full thickness burn injuries. Sloughy burn wounds or areas of graft loss
    Duration preparation remains on wound before changing
    24-48 hours
    Frequency of use
    Daily- occasionally alternate day
    Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
    Allergy to any ingredients.
    Not to use in pregnancy or breast feeding
    Take care if: suffer kidney or liver problems, deficiency of the enzyme known as glucose
    6- phosphate dehydrogenase. Taking tablets prescribed for epilepsy
    Rationale for inclusion in formulary
    Prevent and treat bacterial infections in burns, skin graft donor sites.

     
       
    Silver sulfadiazine 1.0g & Cerium nitrate 2.2g (Flammercerium®)
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    Formulary
    Red
    Type of wound product is suitable for
    Partial thickness & full thickness burn injuries.
    Duration preparation remains on wound before changing
    24-48 hours
    Frequency of use
    Daily- occasionally alternate day
    Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
    Allergy to any ingredients.
    Not to use in pregnancy or breast feeding, infants or babies under the age of 2 years.
    Take care if: suffer kidney or liver problems, deficiency of the enzyme known as glucose
    6- phosphate dehydrogenase. Taking tablets prescribed for epilepsy
    Rationale for inclusion in formulary
    Prevent and treat bacterial infections in burns
     
       
     ....
     Non Formulary Items
    Advadraw

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
    Discontinued January 2017.

    Suitable alternative is Aquacel
     
    DermaSilk

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    Non Formulary
    Black
    Link  Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care
    Link  NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs
     
    DreamSkin

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
    Link  Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care
    Link  NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs
     
    Flivasorb

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black

    Superabsorbent dressing
    Alternative to KerraMaxCare if patient discharged form hospital with.
    Type of wound product is suitable for
    For heavily exuding wounds
    Can be used under compression bandages
    Secondary Dressing Only
    Duration dressing remains on wound before changing
    Up to 7 days
    Frequency of dressing change
    When exudate levels determine
    Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
    Known sensitivity to any components of the dressing
    Lightly exuding wounds
    Must not be cut or torn
    Rationale for inclusion in formulary
    Management of heavily exuding wounds. Cost effective.
    Must be applied white side to the wound bed.

     
    Mepilex

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    Non Formulary
    Black
    Replaced by Kliniderm®
     
    Polyfax®

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    Non Formulary
    Black
    Product discontinued November 2017

    Type of wound product is suitable for
    Partial thickness facial burns & healing graft sites, infected/ colonised wounds
    Duration preparation remains on wound before changing
    2 days or 2-3 times/ day depending on injury site and type- as directed by Burns team
    Frequency of use
    2 days or 2-3 times/ day
    Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
    Allergy to Polymixin B Sulphate or Bacitracin Zinc
    No more than 200g of Polyfax ointment per day
    Rationale for inclusion in formulary
    Prevent and treat bacterial infections in burns
     
    Silicone gel products

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Skinnies

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black
    Link  Birmingham and Solihull CCG Policy for items which should not be prescribed in primary care
    Link  NHS Clinical Commissioners Items which should not routinely be prescribed in primary care: Guidance for CCGs
     
    Tegaderm Hydrocolloid range

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Black

    Non Formulary on wound care group recommendation April 2019

     

    Hydrocolloid Range with film border

    Type of wound product is suitable for
    Low to moderate exuding, granulating or epithelising wounds
    Inner layer of hydrocolloid adhesive absorbs exudate providing higher absorbency
    Maintains odour control

    Duration dressing remains on wound before changing
    Up to 7 days

    Frequency of dressing change
    3-7 days

    Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
    Not suitable for infected wounds, full thickness burns or wounds with exposed bone, muscle or tendon, wounds at risk of maceration.
    Not for diabetic foot ulcers or ischaemic wounds
    Known product or component sensitivity

    Rationale for inclusion in formulary
    Outer barrier film protects the wound and
    Peri-wound skin from contaminants, body fluids, bacteria and viruses
    Does not contain gelatine or pectin
    Film border prevents creasing of the dressing
    Tegaderm hydrocolloid thin allows for observation of the wound

     
      
    Key
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Unlicensed
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    Link to children's BNF
    click to search medicines.org.uk
    Link to SPCs
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Prescribing in children

    The APC notes that the informed use of unlicensed medicines or of licensed medicines for unlicensed applications (‘off-label’ use) is often necessary in paediatric practice.

    The APC advises GPs to consider specialist prescribing recommendations for Green and Amber medicines that are not subject to ESCAs or RICaDs in combination with the information provided in the BNFC which goes beyond that of marketing authorisations. The BNFC has been designed for rapid reference and the information presented has been carefully selected to aid decisions on prescribing.
      

    Green

    Medicines suitable for routine use within primary care. Initiation and maintenance of prescribing by Specialists, GPs and other qualified clinicians.   

    Amber Initiation

    Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry.  

    Amber Recommended

    Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.  

    Amber SC

    Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry.  

    Red

    Medicines for initiation and maintenance prescribing by Specialists only.  

    Black

    Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use.  

    Grey

    Positive NICE TA and/or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information.  

    netFormulary