Wound Care Formulary September 2011
Contents Introduction... 2 Low/Non Adherent Dressings... 3 Alginate Dressings... 4 Foam Dressings... 5 Vapour Permeable Films... 8 Hydrogel Dressings... 9 Hydrofibre Dressings... 9 Hydrocolloid Dressings... 10 Odour Absorbing Dressings... 11 Skin Fillers and Protectives... 11 Antimicrobial Dressings... 12 Compression Bandages... 13 Tubular Bandages... 14 Surgical Tapes... 15 Other Dressings and Products... 16 1
Introduction The wound care formulary has been formatted to include the current sizes and costs per unit or individual dressing (correct as of September 2011). The colour coding of Red, Amber and Green give some indication of which products are the more cost effective in a group of similar dressings. GREEN 1 st CHOICE These products are to be used as first line in all cases where clinically appropriate AMBER 2 nd CHOICE To be used in situations where the first line may not be clinically appropriate RED ONLY TO BE USED IN SITUATIONS WHERE FIRST OR SECOND LINE CANNOT BE USED AND THE REASONS FOR THIS CHOICE SHOULD BE DOCUMENTED IN THE PATIENT NOTES To help reduce waste, please ensure that only the required number of individual dressings are ordered or prescribed this may not be a whole pack. It is expected that adherence to the formulary should be at a minimum of 80%. It is recognised that all patients are individual and that on occasion nonformulary items may be clinically indicated in order to provide the care required. Prescribers will not be restricted from prescribing off formulary, however when a non-formulary item is prescribed a Non-Formulary reporting form must be completed and sent to the PCT. This enables monitoring of nonformulary items and tailoring future formulary inclusions appropriately. Prescribing of wound care products will be monitored for compliance with formulary. Please Note All prices are correct as of Drug Tariff September 2011. Please refer to most current editions of the Drug Tariff for the most up-to-date prices. Unless otherwise stated, all prices listed refer to the price of a single dressing or unit of product and not a pack. 2
Low/Non Adherent Dressings Urgotul may only be considered for wounds where adhesion of the primary dressing to the wound or pain is causing particular problems after exploring 1 st line options. N/A Ultra 9.5cm x 9.5cm 0.33 N/A Ultra 19.5cm x 9.5cm 0.63 Atrauman 5cm x 5cm 0.25 Atrauman 7.5cm x 10cm 0.26 Atrauman 10cm x 20cm 0.59 Atrauman 20cm x 30cm 1.63 Premierpore 5cm x 7cm 0.05 Premierpore 10cm x 10cm 0.12 Premierpore 10cm x 15cm 0.18 Premierpore 10cm x 20cm 0.32 Premierpore 10cm x 25cm 0.36 Premierpore 10cm x 30cm 0.45 Premierpore 10 cm x 35cm 0.52 Hydrofilm Plus 5cm x 7.2cm 0.15 Hydrofilm Plus 9cm x 20cm 0.20 Hydrofilm Plus 9cm x 15cm 0.22 Hydrofilm Plus 10cm x 20cm 0.35 Hydrofilm Plus 10cm x 25cm 0.37 Hydrofilm Plus 10cm x 30cm 0.54 Mepitel 5cm x 7cm 1.59 Mepitel 8cm x 10cm 3.19 Urgotul 5cm x 5cm 1.50 Urgotul 10cm x 10cm 3.00 Urgotul 11cm x 11cm 3.02 3
Alginate Dressings Alginate dressings are highly absorbent and suitable for use on exuding wounds and for promotion of autolysis on wet wounds. ActivHeal Alginate 5cm x 5cm 0.58 ActivHeal Alginate 10cm x 10cm 1.13 ActivHeal Alginate 10cm x 20cm 2.78 ActivHeal Alginate Rope 2cm x 30cm 2.09 Kaltostat 5cm x 5cm 0.91 Kaltostat 7.5cm x 12cm 1.99 Kaltostat 10cm x 20cm 3.84 Kaltostat 15cm x 25cm 6.61 Kaltostat Rope 2g 3.60 4
Foam Dressings FIRST LINE CHOICE ActivHeal Adhesive 7.5cm x 7.5cm 1.18 ActivHeal Adhesive 10cm x 10cm 1.60 ActivHeal Adhesive 12.5cm x 12.5cm 1.68 ActivHeal Adhesive 15cm x 15cm 2.15 ActivHeal Adhesive 20cm x 20cm 4.42 ActivHeal Non-Adhesive 5cm x 5cm 0.73 ActivHeal Non-Adhesive 10cm x 10cm 1.11 ActivHeal Non-Adhesive 20cm x 20cm 3.85 ActivHeal Non-Adhesive 10cm x 17.8cm 2.30 IF SPECIALIST FOAM REQUIRED: FILM Tegaderm Foam Adhesive 14.3cm x 14.3cm 3.44 Tegaderm Foam Adhesive 6.9cm x 7.6cm 1.42 Tegaderm Foam Adhesive 10cm x 11cm 2.33 Tegaderm Foam Adhesive 14.3cm x 15.6cm 4.12 Tegaderm Foam Adhesive 19cm x 22.2cm 6.76 Tegaderm Foam Adhesive Circular (Heel) Tegaderm Foam Adhesive Soft Cloth Border 13.9cm x 13.9cm 4.14 6.9cm x 6.9cm 1.66 5
FOR FRIABLE SKIN ONLY Biatain Silicone 7.5cm x 7.5cm 1.43 Biatain Silicone 10cm x 10cm 2.31 Biatain Silicone 12.5cm x 12.5cm 2.95 Biatain Silicone 15cm x 15cm 4.05 Biatain Silicone 17.5cm x 17.5cm 5.59 FOR HIGHER ABSORBENCY USE ONLY Allevyn Adlhesive 7.5cm x 7.5cm 1.43 Allevyn Adhesive 10cm x 10 cm 2.10 Allevyn Adhesive 12.5 cm x 12.5cm 2.57 Allevyn Adhesive 17.5cm x 17.5cm 5.07 Allevyn Adhesive 22.5cm x 22.5cm 7.38 Allevyn Adhesive 12.5cm x 22.5cm 4.00 Allevyn Adhesive - Sacral 17cm x 17cm 3.80 Allevyn Adhesive - Sacral 22cm x 22cm 5.47 Allevyn Gentle Border 7.5cm x 7.5cm 1.43 Allevyn Gentle Border 10cm x 10 cm 2.10 Allevyn Gentle Border 10cm x 20cm 3.38 Allevyn Gentle Border 12.5cm x 12.5cm 2.57 Allevyn Gentle Border 17.5cm x 17.5cm 5.07 6
Allevyn Gentle Border Heel 23cm x 23.2cm 9.24 Allevyn Gentle Border Lite 5cm x 5cm 0.86 Allevyn Gentle Border Lite 7.5cm x 7.5cm 1.33 Allevyn Gentle Border Lite 10cm x 10cm 2.07 Allevyn Gentle Border Lite 5.5cm x 12cm 1.77 Allevyn Gentle Border Lite 8cm x 15cm 3.29 Allevyn Gentle Border Lite 15cm x 15cm 3.65 Allevyn Gentle Border Sacrum 16.8cm x 17.1cm 3.80 Allevyn Non-Adhesive 5cm x 5cm 1.21 Allevyn Non-Adhesive 10cm x 10cm 2.40 Allevyn Non-Adhesive 20cm x 20cm 6.44 Allevyn Non-Adhesive 10cm x 20cm 3.86 Allevyn Non-Adhesive - Heel Shaped 10.5cm x 13.5cm 4.90 ONLY TO BE USED FOR FEET Biatain Non Adhesive 5cm x 7cm 1.25 Biatain Non Adhesive 10cm x 10cm 2.28 7
Vapour Permeable Films Hydrofilm 6cm x 7cm 0.21 Hydrofilm 10cm x 12.5cm 0.40 Hydrofilm 15cm x 20cm 0.92 IV 3000 (I-Hand) 5cm x 6cm 0.40 IV 3000 (non winged 6cm x 7cm 0.53 peripheral) IV 3000 (ported peripheral) 7cm x 9cm 0.70 IV 3000 (PICC line) 9cm x 12cm 1.37 IV 3000 (Central line) 10cm x 12cm 1.34 Tegaderm Film Dressing 12cm x 12cm 1.09 8
Hydrogel Dressings ActivHeal Hydrogel 15g 1.39 Purilon gel Podiatry use 8g 1.67 only ActiFormCool 10cm x 10cm 2.54 ActiFormCool 5cm x 6.5cm 1.73 ActiFormCool 10cm x 15cm 3.65 Hydrofibre Dressings ActivHeal Aquafiber Rope 2cm x 42cm 1.78 ActivHeal Aquafiber 5cm x 5cm 0.74 ActivHeal Aquafiber 10cm x 10cm 1.77 ActivHeal Aquafiber 15cm x 15cm 3.34 Aquacel 5cm x 5cm 1.12 Aquacel 10cm x 10cm 2.66 Aquacel 15cm x 15cm 5.00 Aquacel 4cm x 10cm 1.40 Aquacel 4cm x 20cm 2.07 Aquacel 4cm x 30cm 3.11 Aquacel Ribbon 2cm x 45cm 2.64 9
Hydrocolloid Dressings Hydrocolloid dressings form a gel in the presence of exudiates to facilitate rehydration in light to moderately exudiating wounds. They also promote autolytic debridement of dry, sloughy or necrotic wounds and promote granulation. If there are problems with adhesion or rucking of the dressing, a film backed alternative (Tegaderm) can be considered as a second line. ActivHeal Hydrocolloid 10cm x 10cm 1.55 ActivHeal Hydrocolloid 15cm x 15cm 3.37 ActivHeal Hydrocolloid - 15cm x 18cm 3.91 Sacral ActivHeal Hydrocolloid 5cm x 7.5cm 0.76 ActivHeal Hydrocolloid Foam 10cm x 10cm 1.52 Backed ActivHeal Hydrocolloid Foam 15cm x 15cm 2.86 Backed ActivHeal Hydrocolloid Foam 15cm x 18cm 3.30 Backed - Sacral ActivHeal Hydrocolloid Foam 5cm x 7.5cm 0.96 Backed Tegaderm Hydrocolloid 10cm x 12cm 2.26 Tegaderm Hydrocolloid 13cm x 15cm 4.22 Tegaderm Hydrocolloid - Sacral 17.1 x 16.1 4.71 10
Odour Absorbing Dressings Clinisorb 10cm x 10cm 1.81 Clinisorb 10cm x 20cm 2.37 Clinisorb 15cm x 25cm 3.81 Skin Fillers and Protectives Sorbaderm Barrier Cream 92g 7.19 Sorbaderm No Sting Barrier Film Spray Sorbaderm No Sting Barrier Film Sfoam Applicators (Sterile) 28ml 5.99 1m x 5 4.45 11
Antimicrobial Dressings Topical antimicrobial dressings will reduce the level of bacteria within a wound but will not treat a spreading tissue infection. Spreading infection must always be treated with systemic antibiotics. The action of antimicrobial dressings can interfere with wound healing and should always be used for the shortest possible time. Do not use topical antimicrobial agents to reduce the risk of surgical site infections in surgical wounds that are healing by primary intention (NICE 2004). Flamazine Tube 50g 3.85 Inadine 9.5cm x 9.5cm 0.48 Inadine 5cm x 5cm 0.32 Anabact 15g 4.47 Anabact 30g 7.89 Iodosorb Ointment - Tube 20g 8.58 Iodosorb Ointment - Tube 10g 4.29 Flaminal Forte - Licenced for 15g 7.26 resealing Flaminal Hydro - Licenced for 15g 7.26 resealing Iodoflex Paste 17g 12.29 Iodoflex Paste 10g 7.76 Iodoflex Paste 5g 3.88 12
Compression Bandages K-Four#1 (K-Soft Long) 10cm x 4.5m 0.54 K-Four#1 (K-Soft) 10cm x 3.5m 0.43 K-Four#2 (K-Lite) 10cm x 4.5m 0.97 K-Four#3 (K-Plus) 10cm x 8.7m 2.17 K-Four multi-layer Less than 18cm 6.85 compression bandage kit K-Four multi-layer 18-25cm 6.55 compression bandage kit K-Four multi-layer 25-30cm 6.55 compression bandage kit K-Four multi-layer Greater than 30cm 9.02 compression bandage kit Coban 2 Lite - multi-layer one size 8.08 compression bandage kit Coban 2 - multi-layer one size 8.08 compression bandage kit Advasoft sub compression 10cm x 3.5cm 0.37 bandage wadding Actico 10cm x 6m 3.21 Flexiban Only for use with Actico 10cm x 3.5m 0.48 13
Tubular Bandages Comfifast 3.5cm x 1m (Red) 0.56 Comfifast 5cm x 1m (Green) 0.58 Comfifast 5cm x 3m (Green) 1.62 Comfifast 5cm x 5m (Green) 2.81 Comfifast 7.5cm x 1m (Blue) 0.77 Comfifast 7.5cm x 3m (Blue) 2.13 Comfifast 7.5cm x 5m (Blue) 3.74 Comfifast 10.75cm x 1m (Yellow) 1.20 Comfifast 10.75cm x 3m (Yellow) 3.49 Comfifast 10.75cm x 5m (Yellow) 6.04 Comfifast 17.5cmx1m (Beige) 1.83 Ribbed cotton & viscose stockinette arm/leg (child); arm (adult) Ribbed cotton & viscose stockinette arm (OS adult); leg (adult) Ribbed cotton & viscose stockinette leg (OS adult) Ribbed cotton & viscose stockinette trunk (child) Ribbed cotton & viscose stockinette trunk (adult) Ribbed cotton & viscose stockinette trunk (OS adult) 5cm x 5m 2.45 7.5cm x 5m 3.22 10cm x 5m 4.27 15cm x 5m 6.15 20cm x 5m 7.11 25cm x 5m 8.50 14
Surgical Tapes Mediplast 1.25cm x 5m 0.30 Scanpor 1.25cm x 10m 0.53 Mediplast 2.5cm x 5m 0.50 Clinipore 2.5cm x 10m 0.73 Clinipore 5cm x 5m 0.99 15
Other Dressings and Products Zetuvite E is suitable for moderate to heavily exudiating wounds but requires a primary dressing along with secondary retention. Zetuvit is not suitable for use under compression as its absorbency is impaired. Icthopaste & Steripaste 7.5cm x 6m 3.53 Irripod 25 x 20ml 5.56 Woundcare Dressing Pack 0.44 Zetuvit E Non Sterile 10cm x 10cm 0.06 Zetuvit E Non Sterile 10cm x 20cm 0.08 Zetuvit E Non Sterile 20cm x 20cm 0.14 Zetuvit E Non Sterile 20cm x 40cm 0.26 Zetuvit E Sterile 10cm x 10cm 0.20 Zetuvit E Sterile 10cm x 20cm 0.23 Zetuvit E Sterile 20cm x 20cm 0.37 Zetuvit E Sterile 20cm x 40cm 1.04 Non-Woven Fabric Swab, Sterile. Specification 28. (These swabs are an alternative to gauze swabs) Non-Woven Fabric Swab, Non Sterile. Specification 28. (These swabs are an alternative to gauze swabs) Gauze Swab Type 13 Light BP 1988, Sterile Gauze Swab Type 13 Light BP 1988, Non Sterile 7.5cm sq x 5 pads 0.25 10cm sq x 100 pads 0.79 7.5cm sq x 5 pads 0.39 10cm sq x 100 pads 1.37 16
Produced by the North Lancashire Medicines Management Team 17