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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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A5.03.03  Expand sub section  Silver
A5.03.03  Expand sub section  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  Expand sub section  With charcoal
A5.03.03  Expand sub section  Soft polymer dressings
A5.03.03  Expand sub section  Hydrocolloid dressings to top
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  Expand sub section  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  Expand sub section  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

 
   
 ....
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.  

The term 'Specialist' refers to Consultants, General Practitioners and Independant Prescribers with a Specialist Interest.  

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