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Sandwell and West Birmingham Community Dressings and Elasticated Garments Formulary 11th February 2017

Utilising products approved within: Area Prescribing Committee - Birmingham, Sandwell Solihull and Environs Joint Formulary – Wound management products and elasticated garments Compiled by Lesley McDonagh, Tissue Viability Clinical Lead Nurse Patricia Flaherty, Tissue Viability Clinical Specialist Nurse Louise Johnson, Community Matron SWBH

Sara Shakespeare, District Nurse Team Leader

Definition of specialist (agreed by the Wound Network)

An experienced senior nurse, tissue viability specialist nurse, other specialist nurse (for example lymphoedema specialist nurse) or allied health professional who has responsibility for wound care. It is not a requisite that they have an extra qualification but they must have extensive and current experience in wound care management.

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Contents Pages:

3. Low adherence dressing 4. Absorbent dressings 5. Hydrogel dressings

6. Vapour-permeable films and membranes Soft polymer dressings

7. Hydrocolloid dressings 8. Foam dressings Alginate dressings 9. Odour absorbent dressings 10-13. Antimicrobial dressings 14. Surgical absorbents

Physical debridement pads 15. Topical negative pressure therapy Surgical adhesive tapes 16. Bandages Non-extensible bandages Support bandages 17. Adhesive bandages 18. Compression bandages 19. Multi-layer compression bandaging 20. Medicated bandages Larvae 21. Application aids Limb protectors 22. Irrigation fluid Emollients 23. Emollients 24. Barrier products 25. Foot wear 26. Pressure reducing pads Tissue Adhesive 27. Antibiotic Gel Adhesive remover

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BNF Section

APC Version

Rationale (developed by TV Team)

Basic wound contact dressings

A5.1.1 Low adherence dressing Size Price Atrauman

Hartman

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 neutral triglycerides to prevent penetration of granulation tissue. Petroleum free.

5x5cm 7.5x10cm 10x20cm 20x30cm

£0.27 £0.28 £0.63 £1.72

Size Price N/A Ultra Systagenix

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

9.5x9.5cm 9.5x19cm

£0.35 £0.67

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A5.1.2 Absorbent dressings For lightly exuding wounds Size Price Softpore –

Self adhesive 1

st line

(Alternative to Cosmopore Richardson Healthcare

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 epithelialized 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

6x7cm 10x10cm 10x15cm 10x20cm 10x25cm 10x30cm 10x35cm

£0.06 £0.13 £0.20 £0.35 £0.40 £0.49 £0.58

A5.1.2 Absorbent dressings For moderately to heavily exuding wounds Size Price Zetuvit E sterile

Non sterile Hartman Ltd

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

10cmx10cm 10xcm20cm 20x2cm0cm 20cmx40cm 10cmx10cm 10cmx20cm 20cmx20cm 20cmx40cm

£0.21 £0.25 £0.39 £1.10 £0.07 £0.09 £0.14 £0.27

Size Price Zetuvit PLUS Hartman

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

10cmx10cm 10cmx20cm 15cmx20cm 20cmx25cm 20cmx40cm

£0.63 £0.87 £1.00 £1.37 £2.11

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A5.2 Advanced wound dressings A5.2.1 Hydrogel dressings Hydrogel sheet dressings Size Price ActiForm Cool

Activa

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

5x6.5cm 10x10cm 10x15cm

£1.79 £2.63 £3.79

Size Price Aquaform Aspen Medical

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

8g 15g

£1.66 £2.02

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A5.2.2 Vapour-permeable films and membranes Vapour-permeable Adhesive Film Dressing (Semi-permeable Adhesive Dressing) Size Price Hydrofilm -

1st

line Hartman

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

6x7cm 10x12.5cm 10x15cm

£0.22 £0.42 £0.52

A5.2.3 Soft polymer dressings Size Price Kliniderm- foam

silicone border, specialist use

H&R Healthcare

Kliniderm Foam silicone lite border H&R Healthcare

Soft polymer dressing with absorbent pad Type of wound product is suitable for Suitable for low to moderately exuding wounds for patients with fragile skin Available in adhesive and non adhesive Duration dressing remains on wound before changing Up to 7 days Frequency of dressing change 1-7 days Caution/contraindications (when not to use the dressing, patient groups to avoid etc.) Known product or component sensitivity eg Silicone Caution under compression where exudate levels are moderate to high Rationale for inclusion in formulary Silicone adhesive for patients with fragile skin, can be cut to shape and contour around difficult anatomical areas. Different pre cut shapes and sizes available

7.5x7.5cm 10x10cm 12.5x12.5cm 15x15cm 10x20cm 15x20cm 18x18cm (sacral) 12.5x20cm (heel)

4x5cm 5x12.5 7.5x7.5cm 10x10cm 15x15cm

£1.18 £1.68 £2.33 £3.95 £3.20 £5.00 £3.90 £4.59

£0.60 £1.50 £1.00 £1.50 £3.50

5x5cm 10x10cm 10x20cm

£0.95 £1.95 £2.66

Kliniderm non border H&R Healthcare

Soft polymer dressing with absorbent pad Type of wound product is suitable for Suitable for low to moderately exuding wounds for patients with fragile skin Available in adhesive and non adhesive Duration dressing remains on wound before changing Up to 7 days Frequency of dressing change 1-7 days Caution/contraindications (when not to use the dressing, patient groups to avoid etc.) Known product or component sensitivity eg Silicone Caution under compression where exudate levels are moderate to high Rationale for inclusion in formulary Silicone adhesive for patients with fragile skin, can be cut to shape and contour around difficult anatomical areas. Different pre cut shapes and sizes available

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A5.2.4 Hydrocolloid dressings Size Price Duoderm range -

1st line Convatec

Duoderm-extra thin Convatec

Hydrocolloid dressing 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 Protect surrounding 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. skin , reduced risk of blistering. Cost effective

10x10cm 14x14cm 20x20cm 18.5x19.5cm(heel 22.5x20cm (sacral) 11x19cm (oval) 7.5x7.5cm 10x10cm 15x15cm 5x10cm 9x15cm 9x25xm

£2.12 £3.71 £7.38 £5.19 £6.07 £3.22 £0.80 £1.32 £2.85 £0.76 £1.77 £2.82

6.9x7.6cm(mini oval) 10x11cm(oval) 14.3x15.6cm(oval) 19x22.2cm(oval) 13.9x13.9(heel) 14.3x14.3cm

£1.46 £2.39 £4.24 £6.96 £4.22 £3.54

Tegaderm Foam Adhesive 3M

Foam dressing 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

Size Price Aquacel extra

range Convatec

Hydrofibre 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

5x5cm 10x10cm 15x15cm 4x10cm 4x20cm 4x30cm 2x45cm 1x45cm

£1.00 £2.38 £4.78 £1.30 £1.91 £2.87 £2.48 £1.86

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change, Cost effective

A5.2.5 Foam dressings For lightly exuding wounds

Size Price Activheal Foam Trac - Specialist Use Advanced Medical Solutions

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

10x10cm

£1.46

A5.2.6 Alginate dressings

Sorbsan flat 5x5cm 10x10cm 10x20cm SORBSAN PLUS Highly absorbent 7.5x10cm 10x15cm 10x20cm 15x20cm Sorbsan plus border 11.5x14cm 14x19cm 14x24cm 19x24cm Sorbsan ribbon 40cm (includes probe)

£0.81 £1.71 £3.20 £1.76 £3.10 £3.91 £5.49 £3.09 £4.49 £5.47 £6.82 £2.04

Sorbsan (excluding Ag) range – 1st line Aspen

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

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A5.2.8 Odour absorbent dressings Size Price CarboFLEX -

specialist use

Convatec

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

10x10cm 8x15cm(oval) 15x20cm

£3.18 £3.82 £7.23

Size Price Clinisorb - specialist use Clinimed

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

10x10cm 10x20cm 15x25cm(boxes containing 10 each)

£1.89 £2.51 £4.05

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A5.3 Antimicrobial dressings Consider other recommended antimicrobials. Avoid routine or prophylactic use of antimicrobials on non-infected wounds A5.3.1 Honey Size Price Algivon -

specialist use

Advancis Medical

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

5x5cm 10x10cm

£1.98 £3.40

Size Price Activon Tulle- specialist use Advancis Medical

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

5X5cm 10X10cm

£1.80 £2.97

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25g tube Single patient use so can be reused.

£2.05

Activon Tube- specialist use Advancis Medical

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 More cost effective Previous dressing cost: 20g tube £3.96

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A5.3.2 Iodine

Size Price Inadine - 1st line Systagenics

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. No change

5x5cm 9.5x9.5cm

£0.33 £0.49

Size Price Iodoflex- 1st line Smith & Nephew

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 No change

5g 10g 17g

£4.09 £8.17 £12.94

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Size Price Iodosorb- 1st line Smith & Nephew

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 No change

10g ointment 20g ointment 3g powder

£4.51 £9.03 £1.93

A5.3.3

Size Price Kytocel Aspen Medical

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

5x5cm 10x10cm 4x10cm 4x20cm 4x30cm 2.5x45cm

£0.80 £1.92 £1.03 £1.51 £2.27 £1.94

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A5.5.1 Surgical absorbents Cotton

Size Price Sterile Gauze / swabs/ non woven 7.5cm x 7.5com only

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 pack

Size Price Xupad range Richardson Healthcare

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

10x12cm 10x20cm 20x20cm

£0.15 £0.17 £0.28

A5.5.3 Physical debridement pads

Size Price Debrisoft – Specialist Activa

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

Pack of 10

£3.25

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A5.7 Wound care accessories A5.7.3 Surgical adhesive tapes Size Price Clinipore – 1st

line

Clini Supplies

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.

1.25x5m 2.5x5m 2.5x10m

£0.35 £0.59 £0.73

5cmx5m 10cmx5m

£1.81 £2.90

Mefix – 2nd line

Molnlyke

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.

A5.6 Complex adjunct therapies A5.6.1 Topical negative pressure therapy

Tissue Viability Nurse recommendation only, request from Consultants

Topical Negative Pressure Therapy Dependent on Trust contract. Specialist use V.A.C. therapy - KCI

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

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A5.8 Bandages A5.8.1 Non-extensible bandages

Size Price Knit-Band Clini Supplies

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.

A5.8.2 Light-weight conforming bandages 5cmx4m (hand) 7cmx4m 10cmx4m (limb) 15cmx4m (large limb)

£0.10 £0.15 £0.17 £0.30

Red (small limb) 3.5cmx1m Green (medium limb) 5cmx1m 5cmx3m 5cmx1m Blue (large limb) 7.5cmx1m 7.5cmx3m 7.5cmx5m Yellow (child's trunk or very large limbs) 10.75cmx1m 10.75cmx3m 10.75cmx5m Beige (adults trunk) 17.5cmx1m

£0.56 £0.58 £1.62 £2.81 £0.77 £2.13 £3.74 £1.20 £3.49 £6.04 £1.83

CliniFast Clini Supplies

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

A5.8.4 Support bandages

Size Price K lite Urgo Ltd

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

Light support bandage. Class 2 10cmx4.5m (stretched)

£1.00

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A5.8.5 Adhesive bandages

Size Price Ko-flex Urgo Ltd

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 pro

A5.8.6 Cohesive bandages Compression bandage class 3b cohesive 10cmx6m (stretched)

£3.01

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A5.8.7 Compression bandages High compression bandages

Size Price Actico Activa

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.

4cmx6m 6cmx6m 8cmx6m 10cmx6m 12cmx6m

£2.39 £2.80 £3.22 £3.34 £4.26

Size Price Comprilan - specialist recommendation BSN Medical

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

6cmx5m 8cmx5m 10cmx5m 12cmx5m

£2.67 £3.14 £3.37 £4.11

Size Price Cellona - specialist use Activa

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.

Sub-compression wadding bandage 5cmx2.75cm 7.5cmx2.75m 10cmx2.75m 15cmx2.75m

£0.31 £0.38 £0.47 £0.60

Size Price K-Soft Urgo

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.

Sub bandage wadding 10cmx3.5m (unstretched)

£0.45

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A5.8.8 Multi-layer compression bandaging

Size Price K-Four range Urgo

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

Four layer systems Up to 18cm 18-25cm 25-30cm Above 30cm

£7.14 £6.83 £6.83 £9.41

Size Price Coban 3M

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)

Two layer systems Coban 2

£8.24

Size Price Coban Lite 3M

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)

Coban 2 Lite (reduced compression)

£8.24

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A5.8.9 Medicated bandages

Size Price Viscopaste- specialist use Smith & Nephew

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.

7.5x6m £3.65

Size Price Ichthopaste- specialist use Smith & Nephew

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 Zinc and ichthammol bandage. For treatment of dermatitis and chronic eczema when venous insufficiency is present.

7.5x6m £3.68

Size Larvae

Tissue Viability Nurse recommendation only 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

Price £199.50 £229.50 £249.50 £279.50 £299.50 £150.00 £160.00 £102.50

LarvE (free range or in BioFOAM dressing) - specialist use only Biomond

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. 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

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kit pack. Additional 100 or 200 larvae available.

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

Size Price Seal-Tight Woundcare Protector Autonomed

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. 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.) N/A Rationale for inclusion in formulary Multiple sizing for leg including extra large limb No adjustments required

All sizes Short Long

£10.50

Small Medium Large X-Large Measuring guide should be used

EasY-Slide (application aid for open toe stockings ) Credenhill

Compression hosiery garments applicator for open toe Type of wound product is suitable for Application of open toe compression garments 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.) N/A Rationale for inclusion in formulary Applicator for open toe hosiery

Small Medium Measuring guide should be used

Magnide (application aid for closed toe stockings) Credenhill

Application aid for closed toe stockings Type of wound product is suitable for Application of closed toe compression garments Duration dressing remains on wound before changing N/A Frequency of dressing change

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N/A Caution/contraindications (when not to use the dressing, patient groups to avoid etc.) N/A Rationale for inclusion in formulary Effective applicator for closed toe hosiery

Size Price Irripod CD Medical

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

Wound Irrigation 25x20ml

£5.84

Size Price Emulsifying Ointment

Emollient ointment containing emulsifying wax, white soft paraffin and liquid paraffin Type of wound product is suitable for For treatment of dry skin conditions Duration dressing remains on wound before changing Reapply daily Frequency of dressing change 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. Dermatologu approved.

Soap Substitutes 500g

£2.10

Emollients Based on Chapter 13 - APC approved

Size Price Liquid paraffin / white soft paraffin 50:50 Ennogen

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 Duration dressing remains on wound before changing NA Frequency of dressing change 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

500g £6.09

Size Price Flexitol Heel Balm Podiatry requests Dermatonics

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 Duration dressing remains on wound before changing Reapply daily Frequency of dressing change 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

75ml 200ml

£4.00 £9.50

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Size Price Zerocream Thornton & Ross

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 Duration dressing remains on wound before changing NA Frequency of dressing change 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

50g 500g

£1.17 £4.08

Size Price Zeroderm ointment Thornton & Ross

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 Duration dressing remains on wound before changing NA Frequency of dressing change 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.

500g 125g

£4.10 £2.41

Size Price Zeroguent Thornton & Ross

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 Duration dressing remains on wound before changing NA Frequency of dressing change 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

100g 500g (tube)

£2.33 £6.99

Size Price Zerobase Thornton & Ross

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 Duration dressing remains on wound before changing NA Frequency of dressing change 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

50g (tube) 500g (pump)

£1.04 £5.26

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Size Price ZeroAQS cream Thornton & Ross

Emollient cream that occludes and moisturises the skin. Type of wound product is suitable for For external application for use a s an emollient and as a skin cleanser/soap substitute in the management for dry skin conditions. Duration dressing remains on wound before changing NA Frequency of dressing change 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)

500g £3.29

Barrier Preparations

Size Price Metanium ointment

Barrier cream Type of wound product is suitable for: For relief of the symptoms of nappy rash Frequency of change 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

30g £2.06

Size Price Cavilon Durable Barrier Cream – 1st line 3M

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 Duration dressing remains on wound before changing Reapply Twice daily Frequency of dressing change 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

2g sachets x 20 28g (tube) 92g (tube)

£7.47 £3.98 £8.12

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Size Price Cavilon No Sting Barrier Film Pump Spray and applicators – 1st line 3M

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 Duration dressing remains on wound before changing Up to 72 hours Frequency of dressing change 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

1ml foam applicators x 5 28ml pump spray

£5.00 £8.03

Size Price Kerraped Crawford Healthcare

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 there own footwear 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 correct size is selected Rationale for inclusion in formulary Only footwear available for patients with neuropathic ulcers or bulky bandages

Multi-use Boot Uk shoe size 2-5.5 6-7.5 8-10 10.5-13

£56.49

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Size Price Kerra Pro Crawford Healthcare

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

Pressure reducing pads Sheet 10cmx10cmx0.3cm 10cmx10cmx1.2cm Strip 50cmx2.5cmx0.3cm 30cmx5cmx0.3cm Sacrum/ankle –one size Heel-one size

£4.20 £12.64 £5.26 £6.32 £16.69 £14.83

Size Price Liquiband Optima Advance Medical Solutions

Tissue Adhesive Type of wound product is suitable for Closure of minor skin wounds from surgical incisions and simple traumatic lacerations Duration dressing remains on wound before changing Single application should be sufficient to close the wound. If this does not maintain the wound edges, refer to a medic for consideration of other wound closure Frequency of dressing change As necessary Caution/contraindications (when not to use the dressing, patient groups to avoid etc.) May cause skin sensitivities Do not use on any wound with evidence of active infection, gangrene or wounds of pressure aetiology Do not use on mucosal surfaces or on skin that may be regularly exposed to bodily fluids or with dense natural hair Do not use on patients with a known sensitivity to formaldehyde or cyanoacrylate Rationale for inclusion in formulary Necessary for closure of minor wounds

Skin tissue adhesive 0.5g

£5.50

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Size Price Anabact (metronidazole gel- specialist use Cambridge Healthcare Supplies

Pale yellow, clear gel containing 0.75% metronidazole Type of wound product is suitable for Malodourous fungating wounds Requires a secondary dressing Duration dressing remains on wound before changing Apply 1-2 times daily following cleansing Frequency of dressing change 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

Antibiotic Gels – Infection 15g 30g

Size Price Appeel Adhesive Remover Clinimed

Adhesive remover 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 Duration dressing remains on wound before changing Use at each dressing change Frequency of dressing change N/A 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

Sachet:5ml Wipes(x30)

£1.13 £15.29

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