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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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A5.16  Expand sub section  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
    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
    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
    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
     
       
     ....
    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

    Green

    Medicines which are suitable for initiation and maintenance prescribing by primary and secondary care clinicians. These medicines should be initiated and prescribed within their licensed indications.  

    Amber

    Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate, or initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.

    Some amber medicines require agreement with the local (internal) medicines committee prior to initiation; others may require a framework to support safe transfer and maintenance of care such as a RICaD or ESCA. The Formulary will be annotated to reflect these requirements.   

    Red

    Medicines for initiation and maintenance prescribing by Specialists only  

    Black

    Non-formulary medicines- medicines not recommended for routine primary care prescribing.  

    Grey

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

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