Wound Care Products Formulary 2019 Hertfordshire Community NHS Trust
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Wound Care Products Formulary 2019 Hertfordshire Community NHS Trust
Contents Page Page Wound Care Products Formulary 2019 1 Negative Pressure Wound Therapy 21 Dressing Selection Guide 2 Other Accessory Items 22 Triangle of Wound Assessment 3 Dressing Packs 23 Barrier Cream 5 Pressure Ulcer Prevention 24 Barrier Film 5 Pressure Ulcer Prevention Checklist 24 Low Adherent Dressings 6 Leg Ulcer Services Only 25 Island Dressings 7 Podiatry Only 26 Film Dressings 7 Health Visitors 27 Hydrocolloids 8 Management of Sore & Damaged Nipples 28 Alginates 9 Hydrofibers 9 Foams 10 Skin Tears 12 Absorbent Dressing Pads 13 Anti-microbial Dressings 14 Odour Absorbing Dressings 16 Debridement 17 Retention Bandages 18 Compression Bandages 19 Zinc Paste Bandages 20
Wound Care Products Formulary 2019
This formulary has been developed to assist any healthcare professional prescribing or requesting dressings
for wound management in Hertfordshire. It aims to aid the decision making process and help choose the
most appropriate product whilst ensuring value for money in the use of NHS resources.
Key messages:
• All the products in the formulary have been selected taking into account available supporting clinical
evidence by a panel of trust wide practitioners who have specialist knowledge and expertise in wound care.
• Advice in the comments column should be followed when selecting products.
• The formulary contains specific sections dedicated for use in podiatry, the leg ulcer service, and health
visiting.
• To avoid waste do not prescribe or request excessive quantities or issue for long term repeats. A maximum
of 14 days’ supply should be sufficient.
• If wound healing does not progress as expected, advice from the Tissue Viability Service should be sought.
• Dressings prescribed on FP10 for individual patients must not be used for any other patient or for car boot
stock
• Adherence to the wound products formulary will be monitored and audited. Clinical justification will be
required for requesting ‘off formulary’. Exception forms must be completed and sent to Tissue Viability.
• Where there may be a number of different health professionals visiting a patient, efforts should be made
to avoid over ordering by ensuring that there are not multiple orders/prescriptions generated for the same
dressings.
• Wound care products must not be added to repeat prescriptions. In exceptional and individual patient cases
this may be necessary and will be agreed with the nurse managing the wound care.
• Prices are subject to change over time and are a guide for comparison of costs of products
1
This is a guide and should not replace clinical judgement. For further dressing
Dressing selection guide
choices refer to the HCT Dressing Formulary. Seek further guidance from
Tissue Viability Service (01707252467). Email referrals to herts.tvn@nhs.net
Epithelialising Granulating Sloughy Necrotic Infected Fungating Malodorous
Tissue Type
Debride and remove necrosis
Manage infection (systemic
Treatment
Promote Granulation Remove Slough *See Wounds on Feet box for Manage complex wound e.g.
Promote epithelialisation and antibiotics must be
Aim
Provide healthy base for Provide clean base for specific advice bleeding, exudate, malodour,
wound maturation If necrotic wound on the foot of considered where signs of
epilelisation granulation tissue size
someone with diabetes/PVD see systemic infection exist)
Wound on Feet box below
Dressings
1st Choice: Low Adherent, 1st Choice: Low Adherent,
1st Choice Enzyme Alginogel: 1st Choice: Low Adherent,
Exudate
e.g. Atrauman/Tegaderm Plus e.g. Atrauman/Tegaderm Plus Enzyme Alginogel: e.g.
e.g Flaminal Hydro Kerracontact Ag or Algivon or e.g. Atrauman or Urgotul or
Low
Pad Pad Flaminal Hydro (Consider
2nd Choice: ActivHeal Surasorb X PHMB Activheal silicone contact
2nd Choice: Hydrocolloid, e.g. 2nd Choice: Hydrocolloid, e.g. using Debrisoft / UCS Wipes)
Hydrocolloid layer
ActivHeal Hydrocolloid ActivHeal Hydrocolloid
Hydrofiber e.g Aquacel Extra
1st Choice Hydrofiber e.g. Hydrofiber e.g Aquacel Extra
Moderate
Exudate
Foam e.g. Biatain Adhesive/ Alginate e.g. Activheal Hydrofiber e.g. Aquacel Extra Aquacel Ag+ Extra or
Aquacel Extra (Aquacel or Enzyme Alginogel: e.g.
Biatain Silicone (Fragile Skin)/ alginate or Enzyme Alginogel: e.g. Flaminal Forte or Iodoflex or
Ribbon depending on size Flaminal Forte (Consider
Activheal Foam or Enzyme Alginogel: e.g. Flaminal Forte Kerracontact Ag
of Cavity) referral to Tissue Viabillity)
Flaminal Forte
1st Choice Hydrofiber e.g.
Aquacel Extra (Aquacel Hydrofiber e.g Aquacel Extra
Ribbon depending on size of or Enzyme Alginogel:
High Exudate
Cavity) e.g. Flaminal Forte (If need Hydrofiber e.g. Aquacel Extra Aquacel Ag+ Extra
Not Applicable 2nd Choice: Alginate further advice regarding or Enzyme Alginogel: e.g. or Flaminal Forte or Refer to Tissue Viability
e.g. ActivHeal Alginate if specialist treatment e.g. Flaminal Forte Kerracontact Ag
cavity(Consider Negative Maggots refer to Tissue
Pressure Therapy refer to Viability)
Tissue Viability)
Skin Tear Pathway When to Swab? Moisture Lesions Wounds on feet Secondary Dressing
Tegaderm Absorbent clear acrylic Wound breakdown, healing delayed, Keep skin healthy, clean & dry Necrotic or Sloughy wounds on Where secondary dressings are
dressing as per Skin Tear Pathway increase pain, heat, exudate, odour, particularly if exudate is excessive. feet or heels NEED to be referred needed consider under bandages:
bleeding, swelling or redness of Apply barrier product as required, to a specialist team, i.e. Podiatry, Zetuvit E, Vliwasorb, Kerramax
Skin Care surrounding skin. Swab should be i.e. Sudocrem/Cavilon as per the Vascular &/or Tissue Viability. Care. If an adherent secondary
Use appropriate emolients as per obtained at the beginning of any MASD Pathway. dressing is being used consider
emollient ladder. dressing procedure after wound Tegaderm plus pad, Hydrocolloid,
cleansing. Foam adhesive or silicone adhesive
Images are copyright of Coloplast 2
Triangle of Wound Assessment 1
The Triangle of Wound Assessment is a holistic framework that allows practitioners to assess
and manage all areas of the wound, including the periwound skin.
Patient
(age, lifestyle,
Wound Wound Periwound comorbidities,
edge bed skin Wound bed mobility, etc.)
Wound
WOUND (3 areas)
To support optimal clinical decision-
making all three areas of the wound Wound edge Periwound skin
should be considered. Other factors
(e.g. socio-economic
factors)
1. Dowsett C et al. Taking wound assessment beyond the edge. Wounds International 2015;6(1):19-23
3
It offers a simple framework that supports clinical decision-making
and better patient outcomes
Three simple steps of wound assessment
By systematically taking the user through each of the wound areas, the Triangle of
Wound Assessment guides the HCP through the different wound management steps.
Wound assessment
Management goals
Treatment
4
BARRIER CREAM
Incontinence, slight erythema, mild moisture associated incontinence dermatitis
Product Size NHSSC Box qty Each Comments
Sudocrem 125g 1 Use sparingly, do not apply thickly
Practice Nurses - District Nurses - Nursing Homes
400g 1 and do not wipe on pads.
Cavilon cream 28g ELY571 1 £3.28 Apply a pea sized amount at a time
92g ELY568 1 £6.55 to cover the affected area. A little
2g (sachets) ELY569 30 £6.40 goes a long way! Apply daily or
twice daily.
BARRIER FILM
Broken skin, severe incontinence associated dermatitis
Product Size NHSSC Box qty Each Comments
Cavilon film 28ml pump ELY040 1 £5.79 Prevention and treatment of mod-
1ml applicator ELY038 25 £4.05 erate/severe incontinence associ-
3ml applicator ELY039 (FP10 5) ated dermatitis (IAD). Prevention
25 of medical adhesive related skin
(FP10 5) £6.55 injuries (MARSI) caused by surgical
dressings and tapes. Skin protection
around stoma/wound sites. Lasts for
up to 72 hours.
5
LOW ADHERENT DRESSINGS
Used to protect trauma to granulating or healing wounds. First line dressing for leg ulcers. Can remain in place for up to 7 days
Product Size (cm) NHSSC Box qty Each Comments
Atrauman 5x5 EKA000 10 £0.34 Use with secondary dressing such
Practice Nurses - District Nurses - Nursing Homes
Polyester tulle 7.5 x 10 EKA020 10 £0.35 as Zetuvit E, Vliwasorb Pro or Ker-
impregnated with 10 x 20 EKA016 10 £2.19 ramax Care. Do not use with Biatain
triglyceride ointment 20 x 30 EKA036 30 £0.80 Silicone adhesive.
Urgotul 5x5 EKB056 40 £1.57 For light to moderate exuding
Soft polymer primary 10 x 10 EKB057 25 £3.13 wounds.
wound contact 15 x 15 EKB074 10 £6.66 Requires a secondary dressing or
dressing 15 x 20 EKB058 16 £8.86 absorbent pad. Do not use with
10 x 40 EKB082 10 £10.53 Biatain.
20 x 30 EKB060 5 £14.25 If adheres consider silicone.
Only use if dressing can stay in
place for 7 days or alternatives are
adhering.
ActivHeal Silicone 5 x 7.5 ELA849 10 £0.89 Only use if dressing can stay in
Wound Contact Layer 10 x 10 ELA835 10 £2.09 place for 7 days or alternatives are
Soft silicone wound 10 x 20 ELA836 10 £3.97 adhering.
contact layer 15 x 15 ELA837 10 £3.81 Irrigate through primary dressing
and change secondary dressing
according to need.
Actilite 10 x 10 EJE042 10 £1.04 Recurrent or superficial infection as
Honey based contact 10 x 20 EJE040 10 £1.90 prophylactic.
layer
6
ISLAND DRESSINGS
Minimal exudate, superficial, closed surgical wounds
Product Size NHSSC Box qty Each Comments
Softpore 6x7 EIJ023 60 £0.06 Firstline.
Practice Nurses - District Nurses - Nursing Homes
Lightly absorbent fab- 10 x 10 EIJ273 50 £0.13 Minimal exudate.
ric island dressing 10 x 15 EIJ014 50 £0.20 Superficial.
10 x 20 EIJ024 30 £0.35 Closed surgical wound.
10 x 25 EIJ025 30 £0.40 Change when strikethrough of
10 x 30 EIJ026 30 £0.49 exudate visible.
10 x 35 EIJ027 30 £0.58
Tegaderm Plus Pad 5x7 ELW005 50 £0.26 For moderate exudate when used
Lightly absorbent Film 9 x 10 ELW006 25 £0.65 as secondary dressing with Aquacel
dressing with pad 9 x 15 ELW007 25 £0.95 Extra or Activheal Alginate
9 x 20 ELW008 25 £1.40 Change when pad full of exudate (or
9 x 25 ELW009 25 £1.57 exudate reaches edges of pad).
9 x 35 ELW010 25 £2.60
FILM DRESSINGS
For lightly exuding wounds only. Can be used as a secondary dressing with Activheal alginate or Aquacel Extra.
Product Size NHSSC Box qty Each Comments
Tegaderm 6x7 ELW211 100 £0.39 Should not be used on clinically
Film dressing 10 x 12 (Not on ELW213 50 £0.61 infected, bleeding or highly exuding
FP10 ) wounds. Maximum wear time 7
12 X 12 (FP10 only) ELW217 100 £1.15 days. For removal, lift corner of
15 x 20 ELW215 10 £2.41 the dressing carefully and stretch
10 x 25 20 horizontally away from the wound.
7HYDROCOLLOIDS
Can stay in place for up to 7 days. Warm between hands before applying to improves adherence. Should extend at least 2cm beyond the edge of
the wound. Can also be used as a secondary dressing over Aquacel Extra/Activheal alginate. Can be used as a protectant for peri-ulcer tissue with
Negative Pressure Wound Therapy.
Not for use on diabetic or arterial foot/leg ulcers unless directed by podiatry, TVN or leg ulcer service.
Practice Nurses - District Nurses - Nursing Homes
Product Size (cm) NHSSC Box qty Each Comments
ActivHeal 5 x 7.5 ELM150 10 £0.78 Dry to low exudate.
Hydrocolloid (Film 10 x 10 ELM104 10 £1.58 Superficial.
Backed) 15 x 15 ELM105 5 £3.43 Can debride light necrosis or slough.
Adhesive hydrocolloid 15 x 18 sacral ELM106 5 £3.98
ActivHeal 5 x 7.5 ELM152 10 £0.97 Firstline.
Hydrocolloid (Foam 10 x 10 ELM154 10 £1.55 Low exudate.
Backed) 15 x 15 ELM156 5 £2.91 Can be used to debride dry necrosis.
Adhesive hydrocolloid 15 x 18 sacral ELM158 5 £3.36
Comfeel Plus 4x6 ELM064 10 £0.97 Secondline.
Adhesive hydrocolloid 10 x 10 ELM351 10 £2.48 Where bevelled edges can help
15 x 15 ELM353 10 £5.31 adherence.
20 x 20 ELM164 5 £7.64
17 x 17 sacral ELM229 5 £5.78
8ALGINATES
Can stay in place for up to 7 days. Can debride wet slough. Useful haemostatic dressing. For moderate to heavily exuding wounds.
Product Size NHSSC Box qty Each Comments
ActivHeal Alginate 5x5 ELS139 10 £0.59 Cover with moisture retentive
Practice Nurses - District Nurses - Nursing Homes
10 x 10 ELS140 10 £1.15 dressing.
10 x 20 ELS141 5 £2.83 Not suitable for dry necrotic
Rope ELS142 5 £2.13 wounds.
Irrigate to remove if becomes
adhered.
HYDROFIBERS
For moderate to heavily exuding wounds. Can stay in place for up to 7 days. Can debride wet slough.
Product Size NHSSC Box qty Each Comments
Aquacel Extra 5x5 ELY377 10 £1.02 Transforms to a soft gel.
Hydrofiber 10 x 10 ELY378 10 £2.42 Micro-contours to the wound bed.
15 x 15 ELY379 5 £4.56
Aquacel Ribbon 1 x 45 ELY368 5 £1.88 For tunnelling, undermining and
Hydrofiber 2 x 45 ELY013 5 £2.50 sinuses.
9FOAMS
Up to 7 days wear time. Change when exudate reaches edge of dressing or dressing domes up.
Product Size (cm) NHSSC Box qty Each Comments
ActivHeal Foam Non- 5x5 ELA214 10 £0.75 Moderate to high exudate.
Practice Nurses - District Nurses - Nursing Homes
Adhesive 10 x 10 ELA216 10 £1.13 Can be used as a primary or
Non-adhesive foam 10 x 20 ELA246 10 £2.34 secondary dressing but requires
20 x 20 ELA218 10 £3.92 retention with tape (not film) or
18 x 12 heel ELM160 10 £3.48 bandage.
Heel dressing not for pressure relief.
Biatain Adhesive 7.5 x 7.5 ELA658 10 £1.07 Moderate exudate.
Adhesive foam 10 x 10 ELA074 10 £1.79 Biatain Adhesive with its unique
12.5 x 12.5 ELA044 10 £2.60 3DFit Technology® conforms to
15 x 15 ELA635 5 £3.87 the wound bed to fill the gap and
18 x 18 ELA045 5 £5.25 reduces exudate pooling for optimal
18 x 28 ELA259 10 £7.78 wound healing conditions.
23 x 23 sacral ELA050 5 £4.49 Not for pressure relief.
19 x 20 heel ELA051 5 £5.25
Tegaderm Adhesive 8.8 x 8.8 square ELA371 10 £2.23 Low to high exudate
Adhesive foam film 10 x 11 oval ELA177 10 £2.39 Not for pressure relief.
13.9 x 13.9 circular heel ELA180 5 £4.25 Trauma free stretch and release
14.3 x 14.3 square ELA176 10 £3.54 technique to remove. Useful shapes
6.9 x 6.9 wrap ELA492 10 £1.46 for awkward areas.
6.9 x 7.6 oval ELA493 10 £1.71
14.3 x 15.6 oval ELA178 5 £4.24
19 x 22 oval ELA179 10 £6.96
10FOAMS - continued
Up to 7 days wear time. Change when exudate reaches edge of dressing or dressing domes up.
Product Size NHSSC Box qty Each Comments
Biatain Silicone 7.5 x 7.5 ELA425 10 £1.47 Moderate to high exudate.
Practice Nurses - District Nurses - Nursing Homes
Bordered silicone 10 x 10 ELA451 10 £2.16 Second line in case of fragile skin,
adhesive 12.5 x 12.5 ELA426 10 £2.65 adhesive skin reaction to other
15 x 15 ELA427 5 £3.93 foams, or pain is experienced on
17.5 x 17.5 ELA428 5 £5.22 removal of dressings.
15 x 19 sacral ELA1014 5 £3.99 Biatain Silicone with its unique 3DFit
25 x 25 sacral ELA1012 5 £5.57 Technology® conforms to the wound
18 x 18 heel ELA1013 5 £5.50 bed to fill the gap and reduces
14 x 19.5 multishape ELA1015 5 £4.36 exudate pooling for optimal wound
10 x 20 ELA1011 5 £2.73 healing conditions.
10 x 30 ELA1016 5 £5.25
Biatain Silicone Lite 5x5 ELA786 5 £0.91 Low to moderate exudate.
Bordered silicone 5 x 12.5 ELA787 5 £1.96 Biatain Silicone Lite with its unique
adhesive 3DFit Technology® conforms to
the wound bed to fill the gap and
reduces exudate pooling for optimal
wound healing conditions.
11SKIN TEARS
Follow skin tear pathway
Product Size (cm) NHSSC Box qty Each Comments
Tegaderm Absorbent 7.6 x 9.5 EKH023 5 £3.17 Transparent, allowing for constant
Practice Nurses - District Nurses - Nursing Homes
Clear acrylic dressing 11.1 x 12.7 EKH024 5 £4.11 visualisation of the wound. Designed
14.9 x 15.2 EKH049 5 £8.66 to be left in place for extended
14.2 x 15.8 EKH022 5 £5.78 (this can be up to 3 weeks) periods
20 x 20.3 5 £13.91 of time and early removal may
16.8 x 19 EKH050 5 £10.37 interfere with wound healing. Only
change when edges have rolled
compromising the viral and bacterial
barrier or wound fluid is leaking into
the border. Monitoring of the wound
is still required.
12ABSORBENT DRESSING PADS
Primary or Secondary layers to absorb exudate.
Product Size NHSSC Box qty Each Comments
Premier 10 x 20 25 Padding and protection under
Practice Nurses - District Nurses - Nursing Homes
Non-sterile 20 x 40 8 compression
Zetuvit E 10 x 10 50 £0.07 Padding and protection under
Non-sterile absorbent 10 x 20 50 £0.09 compression.
pad 20 x 20 50 £0.14 Low to moderate exudate as
FP10 only 20 x 40 30 £0.27 secondary dressing.
Zetuvit E 10 x 10 25 £0.22 Low to moderate exudate as
Sterile absorbent pad 10 x 20 25 £0.24 secondary dressing.
FP10 only 20 x 20 15 £0.40
20 x 40 10 £1.09
Xupad 10 x 12 EJA092 25 £0.15 Low to moderate exudate as
Sterile absorbent pad 10 x 20 EJA093 25 £0.17 secondary dressing.
20 x 20 EJA094 15 £0.28
20 x 40 EJA095 8 £0.40
Vliwasorb Pro 12.5 x 12.5 EJA218 10 £0.89 First line for highly exuding wounds.
Super absorbent pad 12.5 X 22.5 EJA219 10 £1.05 Can be primary contact layer also.
22 x 22 EJA220 10 £1.88
22 x 32 EJA221 10 £2.37
KerraMax Care 5x5 EMA120 10 £1.05 Secondary dressing for highly
Super absorbent pad 10 x 10 EME045 10 £1.30 exuding wounds. Use where
13.5 x 15.5 Vliwasorb Pro is inadequate.
10 x 22 EME023 10 £1.70 KerraMax Care can be folded and
20 x 22 EME024 10 £3.00 doubled up.
30 x 20 EME025 5 £3.42
20 x 50 EME121 5 £4.56
21 X 23 Multisite EME122 5 £3.25
13ANTI-MICROBIAL DRESSINGS
For use with clinically infected wounds. Where biofilm is suspected it is recommended to use a 2 week rotational antimicrobial regime with weekly
review. Change dressing a minimum of 2-3 days. Debriding mechanically with Debrisoft prior to dressing application may also be useful for biofilm.
For example: 2 weeks Iodoflex or KerraContact Ag, 2 Weeks Suprasorb X + PHMB, 2 weeks Cutimed.
Product Size (cm) NHSSC Box qty Each Comments
Practice Nurses - District Nurses - Nursing Homes
Cutimed Sorbact 4 x 6 pad ELY212 5 £1.68 Safe to use where the primary goal
7 x 9 pad ELY213 5 £2.80 is to reduce bacterial burden.
10 x 10 pad ELY215 5 £5.60 Binds microbes irreversibly using
10 x 20 pad ELY219 20 £8.74 Sorbact® technology
7 x 9 swab ELY214 5 £3.56 Safe to use for longer periods than
Round swab ELY309 0 £3.36 2 weeks,
2 x 50 ribbon ELY218 20 £4.11 will not harm intact skin.
5 x 200 ribbon ELY217 10 £8.10 Do not use in combination with
creams or ointments as the binding
effect is impaired.
Flaminal Hydro 15g ELG021 5 £7.79 Can be used on all wound types,
Hydrogel containing 50g ELG025 1 £25.78 i.e. arterial and venous leg ulcers,
antimicrobial enzymes all wound conditions and all patient
types, including diabetics
Flaminal Forte 15g ELG022 5 £7.79 Can be used on all wound types,
Hydrogel containing 50g ELG023 1 £25.78 i.e. arterial and venous leg ulcers,
antimicrobial enzyme all wound conditions and all patient
types, including diabetics
14ANTI-MICROBIAL DRESSINGS - CONTINUED
Product Size NHSSC Box qty Each Comments
Iodoflex 5g EKB007 5 £4.19 Non-adherent: can be removed with
0.9% Cadexomer 10g EKB008 3 £8.37 saline.
Practice Nurses - District Nurses - Nursing Homes
iodine past 17g EKB009 2 £13.25 Do not use in thyroid disease, iodine
sensitivity or with pregnant/lactating
women.
Read the product leaflet for amount
to use – Iodoflex can be used on
patients for 3 months, with a 1 week
break and then treatment can
commence again
Suitable for biofilm
Suprasorb X + PHMB 5x5 ELY243 6 £2.08 Can remain in situ for 5- 7days. Does
Bio cellulose dressing 9x9 ELY244 6 £4.33 not affect healthy cells. Suitable
impregnanted with 14 x 20 ELY246 6 £8.59 for light to moderately exuding,
broad sprectrum 2 x 21 rope ELY245 6 £6.67 superficial and deep wounds.
PHMB Do not use in silver sensitivity.
KerraContact Ag3+ 5x5 ELY597 5 £3.20 Can be cut to shape and can
Silver with Ag Oxysalt 10 x 12.5 ELY598 5 £7.75 overlap.
technology 15 x 15 ELY599 5 £13.59 Review after 7 days, use no longer
20 x 40 ELY600 5 £41.48 than 4 weeks.
Do not use in silver sensitivity.
Suitable for biofilm.
Suitable for overgranulation.
Aquacel Ag+ Extra 5x5 ELY514 10 £1.96 Ag+ Technology combines silver and
Hydrofiber dressing 10 x 10 ELY515 10 £4.67 anti-biofilm agents.
15 x 15 ELY516 5 £8.81 For use in wet, infected wounds or
20 x 30 ELY517 5 £21.86 where biofilm is suspected.
Do not use in silver sensitivity.
Aquacel Ag+ Ribbon 2 x 45 ribbon ELY113 10 £4.70 For use in infected cavities and
Hydrofiber ribbon- 1 x 45 ribbon ELY369 10 £3.08 sinuses where wound is wet or
dressing biofilm is suspected.
Do not use in silver sensitivity.
15ANTI-MICROBIAL DRESSINGS - HONEY
Reduces bacterial burden, debrides slough and eliminates odour. Adequate pain assessment is required, can increase exudate levels. Safe to use in
Diabetic patients. Suitable for biofilm.
Product Size (cm) NHSSC Box qty Each Comments
Practice Nurses - District Nurses - Nursing Homes
Algivon 5x5 ELS549 10 £2.01 An alginate based honey dressing
10 x 10 ELS550 10 £3.54 for wetter wounds
Algivon Plus Ribbon 2.5 x 20 ribbon ELS551 10 £3.43 An alginate based honey dressing
for wetter wounds
Activon Gel 25g tube CR3830 6 £2.05 For drier wounds. Can be used
to debride necrosis where risk of
infection exists
Activon Tulle 5x5 CR3761 6 £1.80 Dry to moderately wet wounds
10 x 10 CR3658 6 £2.97
Actilite 10 x 10 CR3849 6 £0.98 Drier superficial wounds as
10 x20 CR3852 6 £1.90 prophylactic
ODOUR ABSORBING DRESSINGS
Product Size (cm) NHSSC Box qty Each Comments
Clinisorb 10 x 10 ELV051 10 £1.94
Activated charcoal 10 x 20 ELV053 10 £2.58
non-absorbent 15 x 25 ELV055 10 £4.15
dressing
16DEBRIDEMENT
Product Size NHSSC Box qty Each Comments
UCS wipes Foil pack DT500 10 £3.25 Pre-moistened with an anallergic
Sterile pre-moistened solution to soften necrotic tissue and
Practice Nurses - District Nurses - Nursing Homes
wound debridement slough.
cloth The weave of the gauze traps all
debris and biofilm in its fibres.
The solution aids cleaning and
hydration of the surrounding skin
and removal of hyperkeratosis
Debrisoft 10 x 10 pad ELZ354 5 £6.55 For removal of debris, biofilm and
Lolly ELZ728 5 £5.84 superficial slough on wounds.
Follow instructions: use slightly
damp (no more than 30 mls of
water) and apply a circular motion
to the wound bed.
Do not immerse in water.
BioBag 2.5 x 4 1 Under guidance from specialist
Larvae therapy 4x5 1 services such as vascular, TVNs, leg
5x6 1 ulcer, podiatry
6 x 12 1
10 x 10 1
17RETENTION & WADDING BANDAGES
Product Size NHSSC Box qty Each Comments
Easifix K 2.5cm x 4m 20 £0.10 Used as retention bandage. Apply
Polyamide bandage 5cm x 4m 20 £0.11 lightly.
Practice Nurses - District Nurses - Nursing Homes
4m stretched 7cm x 4m 20 £0.16 Do not use under compression or
FP10 only 10cm x 4m 20 £0.19 with swollen limbs.
15cm x 4m 20 £0.33
K-Band 5cm x 4m EDB034 20 £2.25
7cm x 4m EDB035 20 £2.66
10cm x 4m EDB039 20 £3.04
15cm x 4m EDB040 20 £4.94
K-Soft 10cm x 3.5m EPA028 10 £0.46 To be used under retention
Non retention bandage. 1st layer in multi-layer
bandage bandage system.
Wool bandage
K-Lite 10cm x 4.5m ECA100 10 £1.02 2nd layer in multi-layer bandaging
Type 2 support system.
bandage Retention bandage where swelling is
present, apply at 50% stretch
Actifast Can be used under K-Soft layer
Tubular retention when bandaging.
bandage
1m EPG079 1 £0.64 Red line (3.5cm) for small limb
1m, 3m, 5m EPG080/1/2 1 £0.66/£1.85/£3.20 Green line (5cm) for medium limb
1m, 3m, 5m EPG084/5/6 1 £0.88/£2.44/£4.62 Blue line (7.5cm) for large limb
1m, 3m, 5m EPG087/8/9 1 £1.38/£3.98/£7.11 Yellow line (10.75cm) for trunk
(child)
1m EPG090 1 £2.09 Beige line (17.5cm) for trunk (adult)
1m, 5m EPG091/2 1 £3.84/£16.90 Purple line (20cm) for large adult
18COMPRESSION BANDAGES
Product Ankle size NHSSC Box qty Each Comments
K-Four Kit less than 18cm EVN154 1 £8.29 Multi-layer system providing full
Full compression 18-25cm EVN008 1 £8.14 compression for venous leg ulcers
Practice Nurses - District Nurses - Nursing Homes
25-30cm EVN155 1 £8.05 Contains latex
greater than 30cm EVN156 1 £11.06
K-Two Kit 18-25cm ECA 1 £8.24 Multi-layer system providing full
Full compression 25-32cm ECA 1 £9.00 compression for venous leg ulcers.
Contains latex but latex free version
available.
K-Four greater than 18cm EVN145 1 £5.26 Multi-layer system providing reduced
Reduced compression compression for mixed aetiology leg
ulcers. Contains latex.
UrgoK2 18-25cm ECA 1 £8.24 Multi-layer system providing reduced
Reduced compression 25-32cm ECA 1 £9.01 compression for mixed aetiology leg
ulcers. Contains latex but latex free
version available.
COMPRESSION BANDAGES - SEPARATE COMPONENTS
Product Ankle size NHSSC Box qty Each Comments
K-Plus 10cm x 8.7m ECA162 10 £2.31 Light compression (Type 3A).
Ko-Flex 10cm x 6m ECD018 10 £3.07 Cohesive compression. Alternative
Coban 10cm x 6m ECD020 1 £2.93 to Ko-Flex, can be easier to apply.
Tensopress 10cm x 3m EBA077 1 £3.51 Type 3C high compression.
Contains latex.
Actico 10cm x 6m EBA016 1 £3.41 High working pressures and
Short stretch cohesive low resting pressures. Ultra low
full compression sensitivity latex.
bandage
19ZINC PASTE BANDAGES
Product Size NHSSC Box qty Each Comments
Ichthopaste 7.5cm x 6m EFA051 1 £5.75 For highly exuding wounds. Patch
Zinc Paste and test first!
Practice Nurses - District Nurses - Nursing Homes
Ichthamol BP
Viscopaste 7.5cm x 6m EFA011 1 £5.20 For chronic leg ulcers and skin
PB7 Zinc paste conditions.
bandage
Zipzoc one size EFA018 1 £5.21 For chronic leg ulcers and skin
Stocking Zinc Oxide conditions.
20% Tubular paste bandage
20NEGATIVE PRESSURE WOUND THERAPY
Product Size (cm) NHSSC Box qty Each Comments
Renasys - F Small ELZ509 1 £23.45 ‘Soft port dressing, 10x8x3cm foam,
Foam kit transparent film
Practice Nurses - District Nurses - Nursing Homes
Medium ELZ510 1 £27.24 As above with 20x13x3cm foam
Large ELZ511 1 £32.32 As above with 25x15x3cm foam
Renasys - G Small ELZ512 1 £19.98 Soft port dressing, 7.5x7.5cm
Gauze kit non-adh gauze, transparent film,
15x17cm antimicrobial gauze, 1
saline bullet, 1 skin-prep wipe
Medium ELZ513 1 £25.06 As above with 7.5x20cm non-adh
gauze and 20x30cm antimicrobial
gauze
Large ELZ514 1 £31.80 As above with 7.5x20cm non-adh
gauze and 11.4x3.7cm antimicrobial
gauze roll
Renasys Go 300ml ELZ515 5 £20.30
Cannister kit 750ml ELZ516 5 £27.98
PICO 7 10 x 20 ELZ899 2 £128.09 Disposable and portable negative
Disposable 10 x 30 ELZ900 2 £127.45 pressure therapy system. Designed
10 x 40 ELZ902 2 £146.86 to kick-start healing. Exudate levels
15 x 15 ELZ901 2 £127.45 must be moderate, when in excess
15 x 20 ELZ903 2 £ 127.45 of 300mls use Renasys system.
15 x 30 ELZ904 2 £146.86
20 x 20 ELZ905 2 £146.86 Each box contains 2 dressings for
25 x 25 ELZ906 2 £146.86 one week of therapy.
15 x 20 (multisite) ELZ907 2 £126.88
20 x 25 (multisite) ELZ908 2 £145.48
Renasys Accessories Stand alone soft port kit ELZ517 1 £9.83
Y Connector ELZ518 1 £3.34
Adhesive gel patch ELZ440 10 £3.47
Gauze wound filler ELZ426 5 £7.10
21OTHER ACCESSORY ITEMS
Product Size (cm) NHSSC Box qty Each Comments
Clini swab 7.5 x 7.5 25 To reduce fibre intrusion into wound.
Sterile non-woven Suitable for patient use in clinic to
Practice Nurses - District Nurses - Nursing Homes
gauze cleanse wounds with sterile saline.
Soft swab 10 x 10 ENI194 100 Suitable for cleansing chronic
Non sterile gauze wounds. Wet with tap water.
Tap water 1st line for cleaning chronic wounds.
Consider shower or designated bowl
in patients own home. Suitable for
general use if wound cleansing is
necessary for wounds such as leg
ulcers & contaminated pressure
ulcers.
Clinipod 20ml MRB742 25 £4.80 Suitable for general use where
Sterile saline aseptic wound cleansing is
necessary.
Clinipore 1.25cm x 5m EHU019 1 £0.35
Permeable Non woven 2.5cm x 5m EHU020 1 £0.59
Synthetic Adhesive 5cm x 5m EHU021 1 £1.00
Tape
Hypafix 5cm x 10m EHR111 1 £2.47
Permeable apertured 10cm x 10m EHR113 1 £4.76
Non Woven synthetic 15cm x 10m EHR115 1 £7.05
Adhesive tape 20cm x 10m EHR117 1 £9.35
30cm x 10m EHR032 1 £13.52
Advancis
Wound Probe CR4223 10 £1.08
CR4236 50 £1.08
22DRESSING PACKS
For chronic wounds dressing packs can be made up using individual components as below.
The use of sterile dressing packs is expensive and often unnecessary.
Product Size NHSSC Box qty Each Comments
Practice Nurses - District Nurses - Nursing Homes
Clear polythene bag MVB029 200 £0.02 Non-sterile packs that need to be
Plastic backed sheets CTC007 100 £0.05 made up
Vinyl disposable gloves FTG050/FTG051/FTG052 100 £0.02
Disposable Apron BTB272 100 £0.03
Nurse It s/m or m/l gloves 10 £0.55 As above but includes Plastic tray &
FP10 only Dressing disposable forceps
Pack
Softdrape Small EJA045 20 As above but with plastic tray (no
Not FP10 Dressing Medium EJA046 20 0.42p each forceps)
Pack Large EJA047 20
Wound Care Essentials
Non-sterile Aprons Disposable
gloves Pack of 100 plastic bags
Box of 200 £3.19 Roll of 250
£6.60 BTB093 £2.45
FTE1071 MVB028
Gauze Dental Bibs Sterile Dressing
Pack of 100 Pack of 500 Packs £0.42 each
£0.39 £12.77 ILE1834 *Use only for
immunocompromised
ENI195 Gallipot Sterile 6 patients, sites where
Pack of 200 invasive devices are
£1.20 EVX053 entering the body
and closed incisional
surgical wounds of less
** Contact your local company reps for disposable rulers. Tissue Viability Service than 48 hours.
*** Pre-pack kits £ 0.164 (less than 17p) vs 42p eMail: hct.tvn@nhs.net
23PRESSURE ULCER PREVENTION
Product Size (cm) NHSSC Box qty Each Comments
KerraPro Sacrum/ankle FES9910 1 £16.97 Helps to protect the skin in at-risk
10 x 10 x 0.3 FES9912 5 £4.27 patients as part of a pressure ulcer
Practice Nurses - District Nurses - Nursing Homes
10 x 10 x 1.2 FES9913 5 £12.85 prevention programme.
Heel FES9911 2 £15.07
Strip 30 x 5 x 0.3 FES9914 5 £6.43
Strip 50 x 5 x 0.3 FES9915 5 £5.35
Devon Protector Foot & Heel FER12940 1 pair £4.99 To reduce the risk of pressure ulcers
Foam positioning Pad FER12941 1 pair £7.99 whilst maintaining proper circulation
device and providing long lasting cushioning
and protection.
THINK PRESSURE DAMAGE - THINK PURPLE
PRESSURE ULCER PREVENTION CHECKLIST
EVERY staff member checks EVERY patient EVERY time they go in to undertake any care for EVERY point on this checklist, and TAKES AC-
TION at the time of checking. Easy to remember PURPLE
P U R P L E
Position ‘You’ Risk & Records Pain Look Equipment
Have you
considered all risk
What equipment is
factors:
Does your patient needed?
• Continence? Have you checked
or their carer need What are you going Have you looked at Is it set up properly
• Nutrition? all pressure areas
help or advice to to do right now to your patient’s skin and working?
• Waterlow? for redness and
change the pa- make a difference? from top to toe? Does it need
pain?
tient’s position? upgrading?
Are the records
accurate and up to
date?
24LEG ULCER SERVICES ONLY
Product Size (cm) NHSSC Box qty Each Comments
Polymem 8x8 ELA301 6 £1.59 Cleansing surfactants aid
Non-Adherent 10 x 10 ELA303 6 £2.47 debridement of necrosis and slough
Soft polymer foam 13 x 13 ELA305 6 £4.12
dressing
Polymem Max 11 x 11 ELA659 6 £2.99 Cleansing surfactants aid
More absorbent soft debridement of necrosis and slough
polymer foam dressing
LEG ULCER SERVICES ONLY
Biatain Ibu 5x7 ELA408 5 £1.75 Foam dressing impregnated with
Non-Adhesive 10 x 12 ELA320 5 £3.37 Ibuprofen for moderate to highly
15 x 15 ELA322 5 £5.30 exuding painful wounds.
20 x 20 ELA403 5 £9.02
10 x 22.5 ELA304 5 £5.30
Biatain Ibu Soft-Hold 10 x 12 ELA332 5 £3.37 Foam dressing impregnated with
With partially adherent 15 x 15 ELA331 5 £5.30 Ibuprofen for moderate to highly
hydrocolloid adhesive 10 x 22.5 ELA302 5 £5.30 exuding painful wounds.
layer
Coban 2 One size ECA136 1 £8.24 Foam contact layer against skin may
2-layer bandage kit prevent slippage with challenging
leg shape. Latex free.
Coban 2 Lite One size ECA203 1 £8.24 Provides a reduced compression
2-layer bandage kit version. Latex free.
25PODIATRY ONLY
Ulcers on the foot have additional factors which can prevent them from healing. Some dressings will behave differently when walked on. Hydrocol-
loids and adhesive dressings are not recommended to be used for ulcers on the diabetic foot. Signs of infection are not always typical in a person
with diabetes or peripheral vascular disease. Consider referring any diabetic foot ulcers to Podiatry and/or consider contacting Podiatry for advice
on wound care for foot ulceration.
Product Size (cm) NHSSC Box qty Each Comments
Normasol 25ml MRB358 25 £0.13
Adaptic Touch 5x7 ELY360 5 £1.20 Silicone contact layer
Mepitel 5x7 EKH002 5 £1.47 Silicone contact layer
Covidien Foam 5x5 ELA705 100 £0.69
PODIATRY ONLY
(Kendall) 7.5 x 7.5 ELA706 50 £1.13
10 x 10 ELA700 0 £1.02
Mepilex XT 10 x 11 ELA722 5 £3.13 Silicone foam
Mepilex Ag 10 x 10 ELA339 5 £6.55 Silicone foam with silver
Atrauman Ag 5x5 EKB039 10 £0.57 Silver contact layer
Acticoat 10 x 10 ELY071 12 £8.91 Silver contact layer
Inadine 5x5 EKB501 25 £0.41 Iodine based contact layer
10 x 10 EKB095 10 £0.59
Iodosorb 10g EKB012 4 £5.38 Cadexomer Iodine Ointment
Polymem 8x8 ELA301 15 £1.80 Cleansing surfactants aid
10 x 10 ELA303 15 £2.76 debridement of necrosis and slough
PolymemSilver 10.8 x 10.8 ELA989 15 £6.99 As above with silver antimicrobial
26HEALTH VISITORS - Management of sore & damaged nipples
Product Comments
Jelonet Cracked nipple with minimal exudate: It should be folded to prevent the dressing drying out and
Paraffin gauze Gauze square soaked in yellow soft paraffin gauze. shaped to the damaged area of the nipple. Helps stop the
dressing HV can prescribe on FP10 wound sticking to bra/breast pads. Mothers report helps to
10x10cm Change at each feed, apply folded to the damaged area. Re- relieve pain.
view response to treatment after 5 days and if no improvement Mother needs to remember to remove before feeds
discontinue use. Long term use may predispose to thrush.
Mother needs to remember to remove before feeds
Hydrosorb Open & established wounds (granulating): Absorbs wound fluid and milk. Good moisture for dry wounds.
Hydrogel A possible option in the treatment of nipples with open sores Some dressings are designed for breastfeeding use e.g.
dressing or cracks. Applied between feeds. The dressing contains water/ Novagel
HEALTH VISITORS
5x7cm glycerine donating moisture to the wound. When applied to the Mother needs to remember to remove before breastfeeds
10x10cm skin they feel cool and may decrease pain. Secondary dressing
20x20cm is required as they are almost all non-adhesive.
Activheal Open sores with cracks and or deep fissures with moderate Highly absorbent and moulds easily to the shape of the wound.
Alginate to high exudate: It can be layered into fissures. Advise mother to rinse wound
5x5cm Used for moderate to high amounts of wound exudate. Made before feeds to remove all alginate fibres.
Alginate from seaweed, reacts with serum and wound exudate to pro- Mother needs to remember to remove before breastfeeds
dressing duce a gel that fits well to the contours of wounds. Secondary
dressing is required.
Mepitel film Shallow wounds with light exudates: NICE ( February 2018 ) identify that these products can be
5x7cm Suitable for light exuding wounds. This transparent film dress- more effective than gauze dressings
Vapour- ing provides, comfort, protection and a moist wound healing Mother needs to remember to remove before breastfeeds
permeable environment. Typical applications include skin tear or abrasions.
films and The dressing is supplied between two layers of plastic film. The
membranes size of the film should overlap the wound margin by approxi-
dressings mately two centimetres.
27Management of sore & damaged nipples
Mother presents with damaged nipples Mother presents with sore nipples
1. Observe feed 1. Observe feed
2. Assess baby’s tongue function 2. Assess tongue function
3. Support with positioning and attachment
Is treatment required?
No Yes Is a follow up appointment required?
Have telephone details of support services
been shared?
1. Record outcome Topical application Wound management
of consultation on
system1 1. Record outcome of consultation on
2. Complete feeding system 1
plan Consider if a dressing is
Consider if topical 2. Complete feeding plan
3. Is a follow up required:
appointment treatment is required
using evidence of • Paranet Jelonet Paraffin
required? If so
guideline gauze dressing
arrange through
• Breast milk • Hydrogel dressing
remote booking
• Cream • Activheal Alginate
• Emollient • Mepitel Permeable film
1. Record outcome of consultation on System &
identify treatment
2. Complete feeding plan
3. Arrange follow up Appointment
28Pharmacy Team Tissue Viability Service
Hertfordshire Community NHS Trust BRE Building 14
Howard Court Bucknalls Lane
14 Tewin Road Watford
Welwyn Garden City WD25 9XX
AL7 1BW Telephone: 01707 252467
Telephone: 01707 388000 Email: herts.tvn@nhs.net
Email: Hct.pharmacy.enquiries@nhs.net
Printed: February 2019
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