Agreed jointly by Ipswich and East Suffolk and West Suffolk Clinical Commissioning Groups GP Practice Woundcare Formulary Version 26 October 2016 Formulary items should be prescribed wherever possible. If a nonformulary item is required, an exception reporting form should be completed (available on IESCCG & WSCCG websites).
1. Saline Irripod 2 x 20ml 2.76 0.23 1 2. Non Adherent dressing N-A Ultra 9.cm x9.cm 40 13.20 0.33 19cm x 9.cm 2 1.7 0.63 3. Soft polymer wound contact dressing Atrauman Urgotul cm x cm 2.60 0.26 7.cm xcm 2.70 0.27 cm x 20cm 30 18.30 0.61 20cm x 30cm 16.90 1.69 cm x cm 30.30 3.03 1cm x 20cm 8.90 8.9 4. Soft silicone wound contact dressing Mepitel One 6cm x 7cm 7.9 1.9 9cm x cm 1.9 3.19 13cm x 1cm 32.2 6.4. Adhesive dressing with absorbent pad Mepore Ultra 7cm x 8cm 60 24.00 0.40 cm x 11cm 36 28.44 0.79 11cm x 1cm 36 41.76 1.16 9cm x 20cm 24 36.00 1.0 4 2 Tap water is preferred for leg ulcers and to irrigate clean wounds To encourage moist wound healing. Use under compression or retention bandages on granulating wounds Lasts up to 7 days; requires a secondary dressing. Suitable for use on fragile/ delicate skin. 7 days Can remain in place for up to 14 days during which time the outer absorbent pad should be changed as needed Low to moderate exudate Suitable for surgical wounds, cuts and abrasions Low-adherent wound contact layer Do not apply under tension Cosmopore E cm x 7.2cm 0.80 0.08 8cm x cm 2 4.2 0.17 8cm x 1cm 2 6.7 0.27 cm x 20cm 2 11.00 0.44 cm x 2cm 2 13.7 0. Primary dressing to cover wounds without the need for additional tape or bandages For use on lightly exuding wounds e.g. post-operative wounds or minor injuries and epithelialising wounds Not suitable for use on leg ulcers
6. Vapour-permeable adhesive film dressing Tegaderm film 6cm x 7cm 0 38.00 0.38 12cm x 12cm.90 1.09 1cm x 20cm 23.70 2.37 7. Hydrogels Intrasite Gel 8g 1 1.78 1.78 1g 1 2.39 2.39 cm x cm 17.80 1.78 Intrasite cm x 20cm 24.00 2.40 Conformable cm x 40cm 43.00 4.30 cm x 6.cm 8.90 1.78 Actiform Cool cm x cm 13.0 2.61 cm x 1cm 3 11.2 3.7 8.Hydrocolloids 8a) Low exudate Duoderm Extra Thin 8b) Low to moderate exudate cm x cm 7.40 0.74 7.cmx7.cm 3.9 0.79 cm x cm 13.00 1.30 1cm x 1cm 28. 2.81 Granuflex cm x cm 27.60 2.76 Granuflex Bordered 6cm x 6cm 8.60 1.72 cm x cm 32.90 3.29 cm x 13cm 38.80 3.88 1cm x 1cm 31.0 6.21-7 -7 Avoid if exudate present risk of maceration Do not use on sensitive skin. Can be left in place up to 7 days Often used as a secondary dressing, or as a prophylactic dressing to prevent friction and shearing damage. Avoid use on ischemic and diabetic feet, infected and heavily exuding wounds Requires a secondary dressing Actiform Cool can be left in place for up to 7 days. For minor burns, abrasions, lacerations and postoperative wounds, stage 1-2 pressure ulcers, lightly exuding leg ulcers 7 days; no secondary dressing required. Allow overlap over wound edge Waterproof dressing For pressure ulcers, leg ulcers, minor burns, skin donor sites, other surgical and traumatic wounds Select a dressing that extends at least 3cm beyond the wound edges. 7 days Waterproof dressing Tegaderm oval (bordered) cm x 12cm 11.4 2.29 13cm x 1cm 21.3 4.27 7 days Shower-proof dressing
9. Alginates Algisite M cm x cm 9. 0.91 cm x cm 18.90 1.89 1cm x 20cm 0.70.07 Flaminal Hydro 1g 37.60 7.2 Flaminal Forte 1g 37.60 7.2. Gelling cellulose dressing Durafiber 11. Cavity Dressings cm x cm 9.00 0.90 cm x cm 21.0 2.1 1cm x 1cm 20.2 4.0 Aquacel Ribbon 1cm x 4cm 9.1 1.83 14 2cm x 4cm 12.20 2.44 12. Foam Dressings 12a) Adhesive Allevyn Gentle Border Allevyn Life Allevyn Gentle Border Sacrum 7.cmx7.cm 14.70 1.48 cmxcm 21.80 2.18 cm x 20cm 34.80 3.1.3cmx.3cm 16.70 1.67 12.9cmx12.9cm 24.0 2.4 1.4cmx1.4 cm 29.90 2.99 21cm x 21cm 9.00.90 16.8cmx17.1cm 39. 3.91 14 - Primary dressing; forms a viscous gel on contact with exudate; do not wet the dressing before application Cut or fold to shape of wound to avoid maceration of surrounding skin; can be left in place for up to 7 days Slight to moderate exudate Can be re-capped and reused on the same patient Moderate to heavy exudate Can be re-capped and reused on the same patient For medium and heavily exuding granulating wounds. Can remain in place for up to 7 days; cover with a moisture retentive dressing. Forms a soft cohesive gel on contact with exudate; do not wet dressing before use Do not pack too tightly 7 days except the sacral area where dressings can be left in place for up to days. Tegaderm foam 14cm x 1cm 20.90 4.18 Second line choice 12b) Non-Adhesive Allevyn Gentle cm x cm 12.0 1.2 cm x cm 24.70 2.47 cm x 20cm 39.70 3.97 20cm x 20cm 66.30 6.63-7 days
Allevyn Non- Adhesive Heel.cm x 13.cm 2.20.04-13. Absorbent Dressings - For moderate to heavily exuding wounds Zetuvit E (non-sterile) cm x cm 0 4.07 0.08 cm x 20cm 0 4.0 0.09 20cm x 40cm 30 8. 0.27 Caution: risk of maceration when Allevyn Heel used on exuding wounds Use as secondary dressing Not suitable for application under compression Zetuvit E (sterile) cm x cm 2.2 0.21 cm x 20cm 2 6.00 0.24 20cm x 40cm.70 1.07 cm x 22cm 16.0 1.6 Kerramax care 20cm x 22cm 29.20 2.92 20cm x 30cm 16.6 3.33 14. Cellulose dressing Sorbion Sachet Extra cm x cm 11.2 2.2 20cm x 20cm 3.00 7.00 20cm x cm 18.6 3.73 30cm x 20cm 49.9 9.99 1. Odour absorbent charcoal dressings CliniSorb cm x cm 18.60 1.86 cm x 20cm 24.80 2.48 1cm x 2cm 39.90 3.99 2 14 Use as secondary dressing Not suitable for application under compression Primary or secondary dressing; stackable to increase absorption Primary dressing suitable for moderate to highly exuding wounds; may remain in place for up to 4 days Do not use in conjunction with other dressings unless absolutely necessary. Moderately and lightly exuding wounds (use a separate primary dressing for lightly exuding wounds to prevent adherence) Can be used for up to 7 days Carboflex 8cm x 1cm (oval) 18.70 3.74 cm x cm 31.20 3.12 1cm x 20cm 3.4 7.09 14 Primary or secondary dressing for moderately to heavily exuding malodorous wounds Overlap the wound edge by at least 3cm 16. Anti-Microbials 16a) Povodine Iodine cm x cm 2 8.2 0.33 Inadine 9.cm x9.cm 4.90 0.49 16b) Cadexomer Iodine Low adherent knitted viscose fabric containing povidone iodine Colour change from orange to white as iodine released
Iodoflex paste g 20.0 4.01 16c) Honey Algivon Activon Tulle 17. Dressing S/M or M/L Nurse It gloves 18. Adhesive Tapes For highly exuding wounds Changes colour as iodine is released Duration of treatment should not exceed 3 months cm x cm 9.90 1.98 Alginate dressing cm x cm 17.00 3.40 impregnated with honey cm x cm 9.00 1.80 cm x cm 14.8 2.97 1 0.2 0.2 Micropore 2.cm 1 0.90 0.90 1 Mefix 19. Paste Bandages cm 1 1.81 1.81 cm 1 2.89 2.89 1cm 1 3.94 3.94 Steripaste 7.cm x 6m 1 3.24 3.24 Zipzoc Stocking 17cm x 13cm x 1cm 4 12.2 3.12 Viscopaste PB7 7.cm x 6m 1 3.60 3.60 20. Retention Bandages K-Band stretched 21. Support Bandages 4m x cm 1 0.20 0.20 4m x 7cm 1 0.26 0.26 4m x cm 1 0.26 0.26 K-Lite cm x 4.m 1 0.98 0.98 22. Compression Bandages 22a) Short-Stretch Actico (cohesive) 8cm x 6m 1 3.18 3.18 cm x 6m 1 3.30 3.30 12cm x 6m 1 4.21 4.21 1 Knitted viscose mesh dressing impregnated with honey Dressing retention on nonflexing areas Dressing retention on areas prone to rubbing e.g. elbows, heels Light bandage for securing dressings. When applying on legs, apply from toes to knee to prevent oedema. When applying on oedematous limbs make sure K-soft is applied first to prevent the bandage cutting into the skin.
22b) Multi-Layer K Two kit 18-2cm 1 7.99 7.99 2-32cm 1 8.72 8.72 18-2cm 1 7.99 7.99 K Two Reduced 2-32cm 1 8.73 8.73 K-Four kit 18cm x 2cm 1 6.74 6.74 K-Soft layer # 1 cm x 3.m 1 0.4 0.4 K-Lite layer # 2 cm x 4.m 1 0.98 0.98 K-Plus layer # 3 cm x 8.7m 1 2.24 2.24 Ko-Flex layer # cm x 6m 4 1 2.97 2.97 23c) High Compression Profore + cm x 3m 1 3.90 3.90 Select latex-free option 24. Elasticated Tubular bandages.0cmx 1m (green) 1 0.8 0.8.0cm x 3m 1 1.62 1.62.0cm x m 1 2.81 2.81 7.cm x 1m 1 0.77 0.77 (blue) Comfifast 7.cm x 3m 1 2.13 2.13 7.cm x m 1 3.74 3.74.7cm x 1m (yellow) 1 1.20 1.20.7cm x 3m 1 3.49 3.49.7cm x m 1 6.04 6.04 2. Barrier film (peri-wound protection) Clinimed LBF Sterile No Sting Barrier Film 26. Swabs Non-woven fabric swab 1ml swab 3.82 0.76 2ml swab.07 1.01 30ml spray 1.96.96 1 Sterile 7.cmx7.cm Non-sterile cm x cm 0.26 0.26 0 0.82 0.82 2 1 To secure dressings and bandages m and 3m lengths are less wasteful than 1m and can accommodate various limb s Consider if blue (7.cm) line will suffice before requesting a yellow (cm) line bandage Do not use Tubigrip or crepe as a retention bandage 1ml swab covers area of at least 1cm x 1cm Reapply at each dressing change May be used on intact or damaged skin For cleaning wounds and providing protection to boney prominences. Do not use as a dressing
2 dressings + 1 pump Secondary Formulary Approved non-formulary items for second line use only FP prescription Item pack unit Hydrocolloid fibrous 6cm x 6cm 9.40 0.94 For exuding or sloughy wounds UrgoClean cm x cm 20.90 2.09 1cm x 20cm 39.30 3.93 2.cmx40cm rope 11.7 2.3 Silver Antimicrobials cm x cm. 0.1 Soft polymer wound contact Atrauman Ag cm x cm 12.40 1.24 dressing cm x 20cm 24.30 2.43 Urgotul Silver cm x 12cm 16 6.00 3.0 Soft polymer wound contact dressing; can be left in place 1cm x 20cm 16 12.32 9.2 for up to 7 days cm X cm 17.60 1.76 Gelling cellulose dressing cm X cm 41.90 4.19 Designed to be left in place for Durafibre Ag 1cm X 1cm 39.40 7.88 up to 7 days 2cm X 4cm 21.00 4.20 20cm x 30cm 97.70 19.4 Cutimed Sorbact swabs Cutimed Sorbact gel Pico 4cm x 6cm 9.67 1.93 7cm x 9cm 1.67 3.13 7.cm x 7.cm 26.0 2.6 7.cm x 1cm 44.80 4.48 cm x 20cm 123.0 - cm x 30cm 123.0 - cm x 40cm 140.00-1cm x 1cm 123.0-1cm x 20cm 123.0-1cm x 30cm 140.00-20cm x 20cm 140.00-2cm x 2cm 140.00 - Primary dressing for contaminated, colonised or infected superficial or deep wounds. Change every 1 3 days depending on the wound condition Cutimed Sorbact swab with an amorphous hydrogel Change every 1 3 days depending on the wound condition Can be used for all types of dry to low exuding wounds that are contaminated, colonised or infected