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Wound Care Products Formulary 2019 Hertfordshire Community NHS Trust

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Page 1: Wound Care Products Formulary 2019 Hertfordshire Community ... · WOUND. Wound bed Wound edge Periwound skin. The Triangle of Wound Assessment is a holistic framework that allows

Wound Care Products Formulary 2019Hertfordshire Community NHS Trust

Page 2: Wound Care Products Formulary 2019 Hertfordshire Community ... · WOUND. Wound bed Wound edge Periwound skin. The Triangle of Wound Assessment is a holistic framework that allows
Page 3: Wound Care Products Formulary 2019 Hertfordshire Community ... · WOUND. Wound bed Wound edge Periwound skin. The Triangle of Wound Assessment is a holistic framework that allows

Contents PageWound Care Products Formulary 2019Dressing Selection GuideTriangle of Wound AssessmentBarrier CreamBarrier FilmLow Adherent DressingsIsland DressingsFilm DressingsHydrocolloidsAlginatesHydrofibersFoamsSkin TearsAbsorbent Dressing PadsAnti-microbial DressingsOdour Absorbing DressingsDebridementRetention BandagesCompression BandagesZinc Paste Bandages

PageNegative Pressure Wound TherapyOther Accessory ItemsDressing PacksPressure Ulcer PreventionPressure Ulcer Prevention ChecklistLeg Ulcer Services OnlyPodiatry OnlyHealth VisitorsManagement of Sore & Damaged Nipples

12355677899

101213141617181920

212223242425262728

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Wound Care Products Formulary 2019This 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 samedressings.

• Wound care products must not be added to repeat prescriptions. In exceptional and individual patient casesthis 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

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Dressing selection guide

Skin Tear PathwayTegaderm Absorbent clear acrylic dressing as per Skin Tear Pathway

Skin CareUse appropriate emolients as per

emollient ladder.

When to Swab?Wound breakdown, healing delayed, increase pain, heat, exudate, odour,

bleeding, swelling or redness of surrounding skin. Swab should be obtained at the beginning of any dressing procedure after wound

cleansing.

Moisture LesionsKeep skin healthy, clean & dry

particularly if exudate is excessive. Apply barrier product as required, i.e. Sudocrem/Cavilon as per the

MASD Pathway.

Wounds on feetNecrotic or Sloughy wounds on

feet or heels NEED to be referred to a specialist team, i.e. Podiatry,

Vascular &/or Tissue Viability.

Secondary DressingWhere secondary dressings are

needed consider under bandages: Zetuvit E, Vliwasorb, Kerramax Care. If an adherent secondary dressing is being used consider

Tegaderm plus pad, Hydrocolloid, Foam adhesive or silicone adhesive

This is a guide and should not replace clinical judgement. For further dressing choices refer to the HCT Dressing Formulary. Seek further guidance from Tissue Viability Service (01707252467). Email referrals to [email protected]

Images are copyright of Coloplast

Tiss

ue T

ype

Epithelialising Granulating Sloughy Necrotic Infected Fungating Malodorous

Trea

tmen

t A

im

Promote epithelialisation and wound maturation

Promote Granulation Provide healthy base for

epilelisation

Remove Slough Provide clean base for

granulation tissue

Debride and remove necrosis*See Wounds on Feet box for

specific advice If necrotic wound on the foot of someone with diabetes/PVD see

Wound on Feet box below

Manage infection (systemic antibiotics must be

considered where signs of systemic infection exist)

Manage complex wound e.g. bleeding, exudate, malodour,

size

Dressings

Low

Ex

udat

e

1st Choice: Low Adherent, e.g. Atrauman/Tegaderm Plus

Pad2nd Choice: Hydrocolloid, e.g.

ActivHeal Hydrocolloid

1st Choice: Low Adherent, e.g. Atrauman/Tegaderm Plus

Pad2nd Choice: Hydrocolloid, e.g.

ActivHeal Hydrocolloid

Enzyme Alginogel: e.g. Flaminal Hydro (Consider

using Debrisoft / UCS Wipes)

1st Choice Enzyme Alginogel:e.g Flaminal Hydro

2nd Choice: ActivHeal Hydrocolloid

Kerracontact Ag or Algivon or Surasorb X PHMB

1st Choice: Low Adherent,e.g. Atrauman or Urgotul or

Activheal silicone contact layer

Mod

erat

e Ex

udat

e Foam e.g. Biatain Adhesive/Biatain Silicone (Fragile Skin)/

Activheal Foam

1st Choice Hydrofiber e.g. Aquacel Extra (Aquacel

Ribbon depending on sizeof Cavity)

Hydrofiber e.g Aquacel ExtraAlginate e.g. Activheal

alginateor Enzyme Alginogel: e.g.

Flaminal Forte

Hydrofiber e.g. Aquacel Extraor Enzyme Alginogel: e.g.

Flaminal Forte

Aquacel Ag+ Extra or Flaminal Forte or Iodoflex or

Kerracontact Ag

Hydrofiber e.g Aquacel Extraor Enzyme Alginogel: e.g. Flaminal Forte (Consider

referral to Tissue Viabillity)

Hig

h Ex

udat

e

Not Applicable

1st Choice Hydrofiber e.g. Aquacel Extra (Aquacel

Ribbon depending on size ofCavity)

2nd Choice: Alginate e.g. ActivHeal Alginate if cavity(Consider Negative Pressure Therapy refer to

Tissue Viability)

Hydrofiber e.g Aquacel Extraor Enzyme Alginogel:

e.g. Flaminal Forte (If need further advice regarding specialist treatment e.g. Maggots refer to Tissue

Viability)

Hydrofiber e.g. Aquacel Extraor Enzyme Alginogel: e.g.

Flaminal Forte

Aquacel Ag+ Extra or Flaminal Forte or

Kerracontact AgRefer to Tissue Viability

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Wound bed

Wound edge

Periwound skin

Triangle of Wound Assessment1

WOUND

Wound bed

Wound edge Periwound skin

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.

To support optimal clinical decision-making all three areas of the wound should be considered.

Patient(age, lifestyle, comorbidities, mobility, etc.)

Wound(3 areas)

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

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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

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BARRIER CREAM Incontinence, slight erythema, mild moisture associated incontinence dermatitis

Product Size NHSSC Box qty Each Comments

Sudocrem 125g 400g

11

Use sparingly, do not apply thickly and do not wipe on pads.

Cavilon cream 28g92g2g (sachets)

ELY571ELY568ELY569

1130

£3.28£6.55£6.40

Apply a pea sized amount at a time to cover the affected area. A little 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 pump1ml applicator3ml applicator

ELY040ELY038ELY039

125 (FP10 5)25 (FP10 5)

£5.79£4.05

£6.55

Prevention and treatment of mod-erate/severe incontinence associ-ated dermatitis (IAD). Prevention of medical adhesive related skin injuries (MARSI) caused by surgical dressings and tapes. Skin protection around stoma/wound sites. Lasts for up to 72 hours.

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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 Polyester tulle impregnated with triglyceride ointment

5 x 57.5 x 1010 x 2020 x 30

EKA000EKA020EKA016EKA036

10 101030

£0.34£0.35£2.19£0.80

Use with secondary dressing such as Zetuvit E, Vliwasorb Pro or Ker-ramax Care. Do not use with Biatain Silicone adhesive.

UrgotulSoft polymer primary wound contact dressing

5 x 510 x 1015 x 1515 x 2010 x 4020 x 30

EKB056EKB057EKB074EKB058EKB082EKB060

40251016105

£1.57£3.13£6.66£8.86£10.53£14.25

For light to moderate exuding wounds.Requires a secondary dressing or absorbent pad. Do not use with Biatain.If adheres consider silicone.Only use if dressing can stay in place for 7 days or alternatives are adhering.

ActivHeal Silicone Wound Contact LayerSoft silicone wound contact layer

5 x 7.510 x 1010 x 2015 x 15

ELA849ELA835ELA836ELA837

10101010

£0.89£2.09£3.97£3.81

Only use if dressing can stay in place for 7 days or alternatives are adhering.Irrigate through primary dressing and change secondary dressing according to need.

ActiliteHoney based contact layer

10 x 1010 x 20

EJE042EJE040

1010

£1.04£1.90

Recurrent or superficial infection as prophylactic.

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ISLAND DRESSINGS Minimal exudate, superficial, closed surgical wounds

Product Size NHSSC Box qty Each Comments

SoftporeLightly absorbent fab-ric island dressing

6 x 710 x 1010 x 1510 x 2010 x 2510 x 3010 x 35

EIJ023EIJ273EIJ014EIJ024EIJ025EIJ026EIJ027

60505030303030

£0.06£0.13£0.20£0.35£0.40£0.49£0.58

Firstline.Minimal exudate.Superficial.Closed surgical wound.Change when strikethrough of exudate visible.

Tegaderm Plus PadLightly absorbent Film dressing with pad

5 x 79 x 109 x 159 x 209 x 259 x 35

ELW005ELW006ELW007ELW008ELW009ELW010

502525252525

£0.26£0.65£0.95£1.40£1.57£2.60

For moderate exudate when used as secondary dressing with Aquacel Extra or Activheal AlginateChange when pad full of exudate (or exudate reaches edges of pad).

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 Film dressing

6 x 710 x 12 (Not on FP10 )12 X 12 (FP10 only) 15 x 2010 x 25

ELW211ELW213

ELW217ELW215

10050

1001020

£0.39£0.61

£1.15£2.41

Should not be used on clinically infected, bleeding or highly exuding wounds. Maximum wear time 7 days. For removal, lift corner of the dressing carefully and stretch horizontally away from the wound.

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HYDROCOLLOIDSCan 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.

Product Size (cm) NHSSC Box qty Each Comments

ActivHeal Hydrocolloid (Film Backed)Adhesive hydrocolloid

5 x 7.510 x 1015 x 1515 x 18 sacral

ELM150ELM104ELM105ELM106

101055

£0.78£1.58£3.43£3.98

Dry to low exudate.Superficial. Can debride light necrosis or slough.

ActivHeal Hydrocolloid (Foam Backed)Adhesive hydrocolloid

5 x 7.510 x 1015 x 1515 x 18 sacral

ELM152ELM154ELM156ELM158

101055

£0.97£1.55£2.91£3.36

Firstline.Low exudate.Can be used to debride dry necrosis.

Comfeel PlusAdhesive hydrocolloid

4 x 610 x 1015 x 1520 x 2017 x 17 sacral

ELM064ELM351ELM353ELM164ELM229

10101055

£0.97£2.48£5.31£7.64£5.78

Secondline.Where bevelled edges can help adherence.

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ALGINATESCan 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 5 x 510 x 1010 x 20Rope

ELS139ELS140ELS141ELS142

10 105 5

£0.59£1.15£2.83£2.13

Cover with moisture retentive dressing. Not suitable for dry necrotic wounds. Irrigate to remove if becomes adhered.

HYDROFIBERSFor 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 Hydrofiber

5 x 510 x 1015 x 15

ELY377ELY378ELY379

10105

£1.02£2.42£4.56

Transforms to a soft gel. Micro-contours to the wound bed.

Aquacel RibbonHydrofiber

1 x 452 x 45

ELY368ELY013

55

£1.88£2.50

For tunnelling, undermining and sinuses.

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FOAMSUp 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-Adhesive Non-adhesive foam

5 x 510 x 1010 x 2020 x 2018 x 12 heel

ELA214ELA216ELA246ELA218ELM160

1010101010

£0.75£1.13£2.34£3.92£3.48

Moderate to high exudate. Can be used as a primary or secondary dressing but requires retention with tape (not film) or bandage.Heel dressing not for pressure relief.

Biatain AdhesiveAdhesive foam

7.5 x 7.510 x 1012.5 x 12.515 x 1518 x 1818 x 2823 x 23 sacral19 x 20 heel

ELA658ELA074ELA044ELA635ELA045ELA259ELA050ELA051

101010551055

£1.07£1.79£2.60£3.87£5.25£7.78£4.49£5.25

Moderate exudate. Biatain Adhesive with its unique 3DFit Technology® conforms to the wound bed to fill the gap and reduces exudate pooling for optimal wound healing conditions. Not for pressure relief.

Tegaderm AdhesiveAdhesive foam film

8.8 x 8.8 square10 x 11 oval13.9 x 13.9 circular heel14.3 x 14.3 square6.9 x 6.9 wrap6.9 x 7.6 oval14.3 x 15.6 oval19 x 22 oval

ELA371ELA177ELA180ELA176ELA492ELA493ELA178ELA179

10105101010510

£2.23£2.39£4.25£3.54£1.46£1.71£4.24£6.96

Low to high exudateNot for pressure relief.Trauma free stretch and release technique to remove. Useful shapes for awkward areas.

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FOAMS - continuedUp to 7 days wear time. Change when exudate reaches edge of dressing or dressing domes up.

Product Size NHSSC Box qty Each Comments

Biatain SiliconeBordered silicone adhesive

7.5 x 7.510 x 1012.5 x 12.515 x 1517.5 x 17.515 x 19 sacral25 x 25 sacral18 x 18 heel14 x 19.5 multishape10 x 2010 x 30

ELA425ELA451ELA426ELA427ELA428ELA1014ELA1012ELA1013ELA1015ELA1011ELA1016

10 101055555555

£1.47£2.16£2.65£3.93£5.22£3.99£5.57£5.50£4.36£2.73£5.25

Moderate to high exudate. Second line in case of fragile skin, adhesive skin reaction to other foams, or pain is experienced on removal of dressings. Biatain Silicone with its unique 3DFit Technology® conforms to the wound bed to fill the gap and reduces exudate pooling for optimal wound healing conditions.

Biatain Silicone LiteBordered silicone adhesive

5 x 55 x 12.5

ELA786ELA787

55

£0.91£1.96

Low to moderate exudate.Biatain Silicone Lite with its unique 3DFit Technology® conforms to the wound bed to fill the gap and reduces exudate pooling for optimal wound healing conditions.

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SKIN TEARSFollow skin tear pathway

Product Size (cm) NHSSC Box qty Each Comments

Tegaderm AbsorbentClear acrylic dressing

7.6 x 9.511.1 x 12.714.9 x 15.214.2 x 15.820 x 20.316.8 x 19

EKH023EKH024EKH049EKH022

EKH050

555555

£3.17£4.11£8.66£5.78£13.91£10.37

Transparent, allowing for constant visualisation of the wound. Designed to be left in place for extended (this can be up to 3 weeks) periods of time and early removal may 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.

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ABSORBENT DRESSING PADSPrimary or Secondary layers to absorb exudate. Product Size NHSSC Box qty Each Comments

PremierNon-sterile

10 x 2020 x 40

258

Padding and protection under compression

Zetuvit ENon-sterile absorbent padFP10 only

10 x 1010 x 2020 x 2020 x 40

50505030

£0.07£0.09£0.14£0.27

Padding and protection under compression.Low to moderate exudate as secondary dressing.

Zetuvit ESterile absorbent padFP10 only

10 x 1010 x 2020 x 2020 x 40

25251510

£0.22£0.24£0.40£1.09

Low to moderate exudate as secondary dressing.

Xupad Sterile absorbent pad

10 x 1210 x 2020 x 2020 x 40

EJA092EJA093EJA094EJA095

2525158

£0.15£0.17£0.28£0.40

Low to moderate exudate as secondary dressing.

Vliwasorb ProSuper absorbent pad

12.5 x 12.512.5 X 22.522 x 2222 x 32

EJA218EJA219EJA220EJA221

10101010

£0.89£1.05£1.88£2.37

First line for highly exuding wounds.Can be primary contact layer also.

KerraMax CareSuper absorbent pad

5 x 510 x 1013.5 x 15.510 x 2220 x 2230 x 2020 x 5021 X 23 Multisite

EMA120EME045

EME023EME024EME025EME121EME122

1010

1010555

£1.05£1.30

£1.70£3.00£3.42£4.56£3.25

Secondary dressing for highly exuding wounds. Use where Vliwasorb Pro is inadequate. KerraMax Care can be folded and doubled up.

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ANTI-MICROBIAL DRESSINGSFor 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

Cutimed Sorbact 4 x 6 pad7 x 9 pad10 x 10 pad10 x 20 pad7 x 9 swabRound swab2 x 50 ribbon5 x 200 ribbon

ELY212ELY213ELY215ELY219ELY214ELY309ELY218ELY217

55520502010

£1.68£2.80£5.60£8.74£3.56£3.36£4.11£8.10

Safe to use where the primary goal is to reduce bacterial burden.Binds microbes irreversibly using Sorbact® technologySafe to use for longer periods than 2 weeks, will not harm intact skin.Do not use in combination with creams or ointments as the binding effect is impaired.

Flaminal HydroHydrogel containing antimicrobial enzymes

15g50g

ELG021ELG025

51

£7.79£25.78

Can be used on all wound types, i.e. arterial and venous leg ulcers, all wound conditions and all patient types, including diabetics

Flaminal ForteHydrogel containing antimicrobial enzyme

15g50g

ELG022ELG023

51

£7.79£25.78

Can be used on all wound types, i.e. arterial and venous leg ulcers, all wound conditions and all patient types, including diabetics

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ANTI-MICROBIAL DRESSINGS - CONTINUEDProduct Size NHSSC Box qty Each Comments

Iodoflex0.9% Cadexomer iodine past

5g10g17g

EKB007EKB008EKB009

532

£4.19£8.37£13.25

Non-adherent: can be removed with saline. 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 againSuitable for biofilm

Suprasorb X + PHMBBio cellulose dressing impregnanted with broad sprectrum PHMB

5 x 59 x 914 x 202 x 21 rope

ELY243ELY244ELY246ELY245

6666

£2.08£4.33£8.59£6.67

Can remain in situ for 5- 7days. Does not affect healthy cells. Suitable for light to moderately exuding, superficial and deep wounds.Do not use in silver sensitivity.

KerraContact Ag3+

Silver with Ag Oxysalt technology

5 x 510 x 12.515 x 1520 x 40

ELY597ELY598ELY599ELY600

5555

£3.20£7.75£13.59£41.48

Can be cut to shape and can overlap.Review after 7 days, use no longer than 4 weeks.Do not use in silver sensitivity.Suitable for biofilm. Suitable for overgranulation.

Aquacel Ag+ ExtraHydrofiber dressing

5 x 510 x 1015 x 1520 x 30

ELY514ELY515ELY516ELY517

101055

£1.96£4.67£8.81£21.86

Ag+ Technology combines silver and anti-biofilm agents.For use in wet, infected wounds or where biofilm is suspected.Do not use in silver sensitivity.

Aquacel Ag+ RibbonHydrofiber ribbon-dressing

2 x 45 ribbon1 x 45 ribbon

ELY113ELY369

1010

£4.70£3.08

For use in infected cavities and sinuses where wound is wet or biofilm is suspected.Do not use in silver sensitivity.

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ANTI-MICROBIAL DRESSINGS - HONEYReduces 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

Algivon 5 x 510 x 10

ELS549ELS550

1010

£2.01£3.54

An alginate based honey dressing 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 5 x 510 x 10

CR3761CR3658

66

£1.80£2.97

Dry to moderately wet wounds

Actilite 10 x 1010 x20

CR3849CR3852

66

£0.98£1.90

Drier superficial wounds as prophylactic

ODOUR ABSORBING DRESSINGS

Product Size (cm) NHSSC Box qty Each Comments

ClinisorbActivated charcoal non-absorbent dressing

10 x 1010 x 2015 x 25

ELV051ELV053ELV055

101010

£1.94£2.58£4.15

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DEBRIDEMENTProduct Size NHSSC Box qty Each Comments

UCS wipesSterile pre-moistened wound debridement cloth

Foil pack DT500 10 £3.25 Pre-moistened with an anallergic solution to soften necrotic tissue and slough.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 padLolly

ELZ354ELZ728

55

£6.55£5.84

For removal of debris, biofilm and 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.

BioBagLarvae therapy

2.5 x 44 x 55 x 66 x 1210 x 10

11111

Under guidance from specialist services such as vascular, TVNs, leg ulcer, podiatry

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RETENTION & WADDING BANDAGES

Product Size NHSSC Box qty Each Comments

Easifix KPolyamide bandage4m stretchedFP10 only

2.5cm x 4m5cm x 4m7cm x 4m10cm x 4m15cm x 4m

2020202020

£0.10£0.11£0.16£0.19£0.33

Used as retention bandage. Apply lightly. Do not use under compression or with swollen limbs.

K-Band 5cm x 4m7cm x 4m10cm x 4m15cm x 4m

EDB034EDB035EDB039EDB040

20202020

£2.25£2.66£3.04£4.94

K-SoftNon retention bandageWool bandage

10cm x 3.5m EPA028 10 £0.46 To be used under retention bandage. 1st layer in multi-layer bandage system.

K-LiteType 2 support bandage

10cm x 4.5m ECA100 10 £1.02 2nd layer in multi-layer bandaging system. Retention bandage where swelling is present, apply at 50% stretch

ActifastTubular retention bandage

1m1m, 3m, 5m1m, 3m, 5m1m, 3m, 5m

1m1m, 5m

EPG079EPG080/1/2EPG084/5/6EPG087/8/9

EPG090EPG091/2

1111

11

£0.64£0.66/£1.85/£3.20£0.88/£2.44/£4.62£1.38/£3.98/£7.11

£2.09£3.84/£16.90

Can be used under K-Soft layer when bandaging.

Red line (3.5cm) for small limb Green line (5cm) for medium limb Blue line (7.5cm) for large limb Yellow line (10.75cm) for trunk (child) Beige line (17.5cm) for trunk (adult) Purple line (20cm) for large adult

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COMPRESSION BANDAGESProduct Ankle size NHSSC Box qty Each Comments

K-Four KitFull compression

less than 18cm 18-25cm 25-30cm greater than 30cm

EVN154EVN008EVN155EVN156

1111

£8.29£8.14£8.05£11.06

Multi-layer system providing full compression for venous leg ulcersContains latex

K-Two KitFull compression

18-25cm 25-32cm

ECAECA

11

£8.24£9.00

Multi-layer system providing full compression for venous leg ulcers. Contains latex but latex free version available.

K-FourReduced compression

greater than 18cm EVN145 1 £5.26 Multi-layer system providing reduced compression for mixed aetiology leg ulcers. Contains latex.

UrgoK2Reduced compression

18-25cm 25-32cm

ECAECA

11

£8.24£9.01

Multi-layer system providing reduced compression for mixed aetiology leg ulcers. Contains latex but latex free version available.

COMPRESSION BANDAGES - SEPARATE COMPONENTSProduct Ankle size NHSSC Box qty Each Comments

K-Plus Ko-Flex Coban Tensopress

10cm x 8.7m 10cm x 6m 10cm x 6m 10cm x 3m

ECA162ECD018ECD020EBA077

101011

£2.31£3.07£2.93£3.51

Light compression (Type 3A). Cohesive compression. Alternative to Ko-Flex, can be easier to apply. Type 3C high compression.Contains latex.

Actico Short stretch cohesive full compression bandage

10cm x 6m EBA016 1 £3.41 High working pressures and low resting pressures. Ultra low sensitivity latex.

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ZINC PASTE BANDAGESProduct Size NHSSC Box qty Each Comments

Ichthopaste Zinc Paste and Ichthamol BP

7.5cm x 6m EFA051 1 £5.75 For highly exuding wounds. Patch test first!

Viscopaste PB7 Zinc paste bandage

7.5cm x 6m EFA011 1 £5.20 For chronic leg ulcers and skin conditions.

Zipzoc Stocking Zinc Oxide 20%

one size EFA018 1 £5.21 For chronic leg ulcers and skin conditions. Tubular paste bandage

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NEGATIVE PRESSURE WOUND THERAPYProduct Size (cm) NHSSC Box qty Each Comments

Renasys - F Foam kit

Small

MediumLarge

ELZ509

ELZ510ELZ511

1

11

£23.45

£27.24£32.32

‘Soft port dressing, 10x8x3cm foam, transparent film As above with 20x13x3cm foam As above with 25x15x3cm foam

Renasys - G Gauze kit

Small

Medium

Large

ELZ512

ELZ513

ELZ514

1

1

1

£19.98

£25.06

£31.80

Soft port dressing, 7.5x7.5cm non-adh gauze, transparent film, 15x17cm antimicrobial gauze, 1 saline bullet, 1 skin-prep wipe As above with 7.5x20cm non-adh gauze and 20x30cm antimicrobial gauze As above with 7.5x20cm non-adh gauze and 11.4x3.7cm antimicrobial gauze roll

Renasys Go Cannister kit

300ml750ml

ELZ515ELZ516

55

£20.30£27.98

PICO 7 Disposable

10 x 20 10 x 30 10 x 40 15 x 15 15 x 20 15 x 30 20 x 2025 x 2515 x 20 (multisite) 20 x 25 (multisite)

ELZ899ELZ900ELZ902ELZ901ELZ903ELZ904ELZ905ELZ906ELZ907ELZ908

2222222222

£128.09£127.45£146.86£127.45£ 127.45£146.86£146.86£146.86£126.88£145.48

Disposable and portable negative pressure therapy system. Designed to kick-start healing. Exudate levels must be moderate, when in excess of 300mls use Renasys system.

Each box contains 2 dressings for one week of therapy.

Renasys Accessories Stand alone soft port kitY ConnectorAdhesive gel patchGauze wound filler

ELZ517ELZ518ELZ440ELZ426

11105

£9.83£3.34£3.47£7.10

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OTHER ACCESSORY ITEMSProduct Size (cm) NHSSC Box qty Each Comments

Clini swab Sterile non-woven gauze

7.5 x 7.5 25 To reduce fibre intrusion into wound. Suitable for patient use in clinic to cleanse wounds with sterile saline.

Soft swab Non sterile gauze

10 x 10 ENI194 100 Suitable for cleansing chronic 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 Sterile saline

20ml MRB742 25 £4.80 Suitable for general use where aseptic wound cleansing is necessary.

Clinipore Permeable Non woven Synthetic Adhesive Tape

1.25cm x 5m 2.5cm x 5m 5cm x 5m

EHU019EHU020EHU021

111

£0.35£0.59£1.00

Hypafix Permeable apertured Non Woven synthetic Adhesive tape

5cm x 10m 10cm x 10m 15cm x 10m 20cm x 10m 30cm x 10m

EHR111EHR113EHR115EHR117EHR032

11111

£2.47£4.76£7.05£9.35£13.52

AdvancisWound Probe CR4223

CR42361050

£1.08£1.08

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DRESSING 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

Clear polythene bag Plastic backed sheets Vinyl disposable gloves Disposable Apron

MVB029CTC007FTG050/FTG051/FTG052BTB272

200100100100

£0.02£0.05£0.02£0.03

Non-sterile packs that need to be made up

Nurse It FP10 only Dressing Pack

s/m or m/l gloves 10 £0.55 As above but includes Plastic tray & disposable forceps

Softdrape Not FP10 Dressing Pack

SmallMediumLarge

EJA045EJA046EJA047

202020

0.42p eachAs above but with plastic tray (no forceps)

Wound Care EssentialsNon-sterile glovesBox of 200£6.60FTE1071

Sterile Dressing Packs £0.42 each*Use only for immunocompromised patients, sites where invasive devices are entering the body and closed incisional surgical wounds of less than 48 hours.

Disposable plastic bagsRoll of 250£2.45MVB028

GauzePack of 100£0.39ENI195

Dental BibsPack of 500£12.77 ILE1834Gallipot Sterile 6Pack of 200 £1.20 EVX053

ApronsPack of 100£3.19BTB093

** Contact your local company reps for disposable rulers.*** Pre-pack kits £ 0.164 (less than 17p) vs 42p

Tissue Viability ServiceeMail: [email protected]

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PRESSURE ULCER PREVENTION

Product Size (cm) NHSSC Box qty Each Comments

KerraPro Sacrum/ankle 10 x 10 x 0.3 10 x 10 x 1.2 Heel Strip 30 x 5 x 0.3 Strip 50 x 5 x 0.3

FES9910FES9912FES9913FES9911FES9914FES9915

155255

£16.97£4.27£12.85£15.07£6.43£5.35

Helps to protect the skin in at-risk patients as part of a pressure ulcer prevention programme.

Devon ProtectorFoam positioning device

Foot & Heel Pad

FER12940FER12941

1 pair1 pair

£4.99£7.99

To reduce the risk of pressure ulcers whilst maintaining proper circulation and providing long lasting cushioning and protection.

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 EPosition ‘You’ Risk & Records Pain Look Equipment

Does your patient or their carer need help or advice to change the pa-tient’s position?

What are you going to do right now to make a difference?

Have you considered all risk

factors:• Continence?

• Nutrition?• Waterlow?

Are the records accurate and up to

date?

Have you checked all pressure areas for redness and

pain?

Have you looked at your patient’s skin from top to toe?

What equipment is needed?

Is it set up properly and working?Does it need upgrading?

THINK PRESSURE DAMAGE - THINK PURPLE

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LEG ULCER SERVICES ONLYProduct Size (cm) NHSSC Box qty Each Comments

Polymem Non-Adherent Soft polymer foam dressing

8 x 8 10 x 10 13 x 13

ELA301ELA303ELA305

666

£1.59£2.47£4.12

Cleansing surfactants aid debridement of necrosis and slough

Polymem Max More absorbent soft polymer foam dressing

11 x 11 ELA659 6 £2.99 Cleansing surfactants aid debridement of necrosis and slough

Biatain Ibu Non-Adhesive

5 x 7 10 x 12 15 x 15 20 x 20 10 x 22.5

ELA408ELA320ELA322ELA403ELA304

55555

£1.75£3.37£5.30£9.02£5.30

Foam dressing impregnated with Ibuprofen for moderate to highly exuding painful wounds.

Biatain Ibu Soft-Hold With partially adherent hydrocolloid adhesive layer

10 x 12 15 x 1510 x 22.5

ELA332ELA331ELA302

555

£3.37£5.30£5.30

Foam dressing impregnated with Ibuprofen for moderate to highly exuding painful wounds.

Coban 2 2-layer bandage kit

One size ECA136 1 £8.24 Foam contact layer against skin may prevent slippage with challenging leg shape. Latex free.

Coban 2 Lite 2-layer bandage kit

One size ECA203 1 £8.24 Provides a reduced compression version. Latex free.

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PODIATRY 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 5 x 7 ELY360 5 £1.20 Silicone contact layer

Mepitel 5 x 7 EKH002 5 £1.47 Silicone contact layer

Covidien Foam(Kendall)

5 x 5 7.5 x 7.5 10 x 10

ELA705ELA706ELA700

100500

£0.69£1.13£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 5 x 5 EKB039 10 £0.57 Silver contact layer

Acticoat 10 x 10 ELY071 12 £8.91 Silver contact layer

Inadine 5 x 510 x 10

EKB501EKB095

2510

£0.41£0.59

Iodine based contact layer

Iodosorb 10g EKB012 4 £5.38 Cadexomer Iodine Ointment

Polymem 8 x 810 x 10

ELA301ELA303

1515

£1.80£2.76

Cleansing surfactants aid debridement of necrosis and slough

PolymemSilver 10.8 x 10.8 ELA989 15 £6.99 As above with silver antimicrobial

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HEALTH VISITORS - Management of sore & damaged nipples

Product Comments

JelonetParaffin gauze dressing10x10cm

Cracked nipple with minimal exudate:Gauze square soaked in yellow soft paraffin gauze. HV can prescribe on FP10Change at each feed, apply folded to the damaged area. Re-view response to treatment after 5 days and if no improvement discontinue use. Long term use may predispose to thrush.Mother needs to remember to remove before feeds

It should be folded to prevent the dressing drying out and shaped to the damaged area of the nipple. Helps stop the wound sticking to bra/breast pads. Mothers report helps to relieve pain.Mother needs to remember to remove before feeds

HydrosorbHydrogel dressing5x7cm10x10cm20x20cm

Open & established wounds (granulating):A possible option in the treatment of nipples with open sores or cracks. Applied between feeds. The dressing contains water/glycerine donating moisture to the wound. When applied to the skin they feel cool and may decrease pain. Secondary dressing is required as they are almost all non-adhesive.

Absorbs wound fluid and milk. Good moisture for dry wounds. Some dressings are designed for breastfeeding use e.g. NovagelMother needs to remember to remove before breastfeeds

Activheal Alginate 5x5cmAlginate dressing

Open sores with cracks and or deep fissures with moderate to high exudate:Used for moderate to high amounts of wound exudate. Made from seaweed, reacts with serum and wound exudate to pro-duce a gel that fits well to the contours of wounds. Secondary dressing is required.

Highly absorbent and moulds easily to the shape of the wound. It can be layered into fissures. Advise mother to rinse wound before feeds to remove all alginate fibres.Mother needs to remember to remove before breastfeeds

Mepitel film 5x7cmVapour-permeable films and membranes dressings

Shallow wounds with light exudates: Suitable for light exuding wounds. This transparent film dress-ing provides, comfort, protection and a moist wound healing environment. Typical applications include skin tear or abrasions. The dressing is supplied between two layers of plastic film. The size of the film should overlap the wound margin by approxi-mately two centimetres.

NICE ( February 2018 ) identify that these products can be more effective than gauze dressings Mother needs to remember to remove before breastfeeds

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Management of sore & damaged nipplesMother presents with sore nipplesMother presents with damaged nipples

1. Observe feed2. Assess tongue function 3. Support with positioning and attachment

Is a follow up appointment required?Have telephone details of support services been shared?

1. Record outcome of consultation on system 1

2. Complete feeding plan

YesNo

1. Record outcome of consultation on system1

2. Complete feeding plan

3. Is a follow up appointment required? If so arrange through remote booking

Topical application Wound management

Consider if topical treatment is required using evidence of guideline • Breast milk• Cream• Emollient

Consider if a dressing is required:

• Paranet Jelonet Paraffin gauze dressing• Hydrogel dressing• Activheal Alginate • Mepitel Permeable film

1. Record outcome of consultation on System & identify treatment

2. Complete feeding plan 3. Arrange follow up Appointment

1. Observe feed2. Assess baby’s tongue function

Is treatment required?

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Pharmacy TeamHertfordshire Community NHS TrustHoward Court14 Tewin RoadWelwyn Garden CityAL7 1BWTelephone: 01707 388000Email: [email protected]

Tissue Viability ServiceBRE Building 14Bucknalls LaneWatfordWD25 9XXTelephone: 01707 252467Email: [email protected]

Printed: February 2019Design: January 2019