Basingstoke, Southampton and Winchester
District Prescribing Committee and
Portsmouth and South East Hampshire
Area Prescribing Committee
Wound
Formulary
HANDBOOK
February 2013
(Updated July 2014)
Wound Formulary February 2013 version 7.1
Ratified by the Basingstoke, Southampton and Winchester District Prescribing Committee and Portsmouth and South East Hampshire Area Prescribing Committee
Introduction
Dressings are only one component of wound care and, on their own, will not heal wounds. It is assumed that each healthcare professional
will be responsible for ensuring they are up to date with current wound/skin care practice and ensure they are familiar with the products
selected for use.
The purpose of the Hampshire wide Wound Formulary is to provide a list of dressings, bandages, hosiery and topical applications which
based on the evidence available should be selected for approximately 90% of prescribing in this area.
There may be a small number of occasions when, after using the Wound Formulary 1 st and 2nd line, you consider a non-formulary product
may be appropriate.
(In secondary/acute care settings there may be differences due to availability and procurement routes which will be highlighted where
known-please refer to local protocols)
The Wound Formulary is to be a working document with input from all disciplines across nursing, pharmacy and podiatry within acute and
primary care. The Wound Formulary Group continues to meet to provide a forum for the evaluation of new and current products and to
document the evidence available for inclusions to the Wound Formulary for consideration by the District Prescribing Committee.
Product selection has been based on evidence of efficacy (although there is little research evidence available), manufacturers literature,
practical experience of use and cost effectiveness. The recommendations have been developed by collaboration between health
professionals from primary care and secondary care.
In the Wound Formulary we have provided an Exception Reporting form (available electronically) for use when non-formulary products are
used. The information that you provide will be reviewed by the Wound Formulary Group and will be taken into consideration when the
formulary is revised and updated. The Wound Formulary Group requires feedback/comments/rationales on the form. (See last section at
bottom of page)
The group also value any comments you have regarding this edition of the formulary. This is your Wound Formulary and it will only work if
you take ownership of it.
Note the costings in this document are for single dressings/units, based on Drug Tariff prices unless otherwise stated and were accurate at
time of printing.
NB Not all products are available in secondary care. Please refer to local policy.
Version 7.1 Wound Formulary
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Wound Formulary February 2013 version 7.1
Ratified by the Basingstoke, Southampton and Winchester District Prescribing Committee and Portsmouth and South East Hampshire Area Prescribing Committee
General References sources:
BNF Sept 2012: 64, SHIP Guidelines for Antibiotic Prescribing in the Community 2012, Journal of Wound Care Handbook www.woundcarehandbook.com, www.worldwidewounds.com,
www.evidence.nhs.uk, www.nice.org.uk, www.sign.ac.uk, www.tissueviabilityonline.com/, www.ewma.org, www.britishjournalofnursing.com, www.wounds-uk.com/pdf/content_9364.pdf
CONTENTS
1. NON/LOW ADHERENT DRESSINGS
2. ADHESIVE FILM
3. TOPICAL ANTIBACTERIALS
4. ODOUR CONTROL
5. ALGINATES
6. PROTEASE MODULATING MATRIX
7. HYDROGEL
8. FOAM DRESSINGS
9. HYDROCOLLOIDS
10. PASTE BANDAGES
11. BANDAGES
12. SUPPORT HOSIERY
13. ADHESIVE TAPE
14. ABSORBENT DRESSINGS
15. MISCELLANEOUS
Appendix 1 and 2
Appendix 3 Best Practice in Older Person’s Skin Care
Appendix 4
Skin Tears
Superficial Burns/Scalds
Epithelialising Wounds
Granulating Wounds
Over Granulation
Sloughy Wounds
Necrotic Wounds
Critically Colonised or Infected Wounds
Appendix 5 Multilayer Compression Bandage Adaptation Chart
Appendix 6 Critically Colonised/Infected wound Sign Checker and Flow Chart
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Wound Formulary February 2013 version 7.1
Ratified by the Basingstoke, Southampton and Winchester District Prescribing Committee and Portsmouth and South East Hampshire Area Prescribing Committee
Appendix 7 Resource Page
Appendix 8 Exception Reporting Form
Product Type
1. NON/LOW ADHERENT
DRESSINGS
Product
Name
Atrauman®
33
34
Size
Cost/
Item
Comments
5x5cm
7.5x10cm
10x20cm
20x30cm
26p
27p
61p
£1.67
Knitted polyester dressing impregnated with neutral triglycerides. May not
be suitable for patients with sensitivities to coconut or its derivatives.
Consider Tricotex® for patients with coconut allergy.
1. Consider Mepitel® for large skin tears where the skin flap needs
immobilising.
2. Tricotex® is suggested as an alternative for simple non adherent
dressings
NB An Exception reporting form will be needed in both instances.
Choice of dressing for use under topical negative pressure is
determined by local specialist advice
2. ADHESIVE FILM
Vapour permeable film
Softpore®
6x7cm
10x10cm
10x15cm
10x20cm
10x25cm
10x30cm
6p
13p
20p
35p
40p
49p
NOT to be used on post operative wounds or skin tears. Nor on fragile
skin.
Only use on minor superficial wounds where all that is required is
protection from friction.
Hydrofilm®
6x7cm
10x12.5cm
10x15cm
10x25cm
12x25cm
15x20cm
20x30cm
22p
40p
51p
Dry, non-infected wounds; retention of lines; fixation of secondary
dressings.
79p
83p
93p
£1.55
NB: management of IV sites – refer to local guidelines
.
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Wound Formulary February 2013 version 7.1
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Product Type
Product
Name
Size
Cost/
Item
Comments
Management of critically colonised and infected wounds
Appendix 5 for Sign Checker, flow chart and guidance on choice of dressings. All antibacterial dressings should be used for two weeks only. Expert advice
and guidance should be sought if antibacterial dressings are required for a longer period. NB: all antimicrobial dressings to be cut to size of wound. Do not
apply to intact skin.
3. TOPICAL ANTIMICROBIALS
a. Iodine based
Inadine®
5x5cm
33p
Non-adherent dressing impregnated with 10% povidone-iodine. Colour
9.5x9.5cm
49p
change indicates when to change dressing.
Management and prevention of infection in ulcers, minor burns and minor
traumatic skin injuries. Not effective in medium to heavy exudate
®
3. TOPICAL ANTIMICROBIALS
(cont’d)
b.
Cadexomer dressing with iodine. For the treatment of chronic exuding
wounds. Not to be used on dry necrotic tissue.
Apply up to 50g per dressing change, cover with secondary dressing;
change when paste is saturated. Do not exceed 150g Iodoflex® paste
in one week or more than 3 months single course of treatment. BE
AWARE OF CONTRAINDICATIONS FOR USE.
Medical honey. Useful on sinus wounds. Indicated for infected or critically
colonised wounds. Can be effective if malodour present or as a sloughing
agent.
Iodoflex
5g
10g
17g
£3.96
£7.91
£12.53
Medihoney®
Antibacterial
Medical Honey
20g
50g
£3.96
£9.90
Medihoney® Gel
sheet
5x5cm
10x10cm
£1.75
£4.20
Gel sheet wound dressing comprising antibacterial honey and sodium
alginate, sterile. Honey is released more slowly than other honey products.
Medihoney®
Tulle dressing
10x10cm
£2.98
Strong woven dressing impregnated with antibacterial honey, sterile. For
superficial wounds.
Medihoney®
Antibacterial
Honey Apinate
10x10cm
1.9cmx30cm
£3.40
£4.20
Medihoney®
Antibacterial
Wound Gel
10g
20g
Honey
Version 7.1 Wound Formulary
Non-adherent, non-absorbent, protease modulating matrix, sterile.
£2.69
£4.02
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Wound Formulary February 2013 version 7.1
Ratified by the Basingstoke, Southampton and Winchester District Prescribing Committee and Portsmouth and South East Hampshire Area Prescribing Committee
Product Type
c.
PHMB and silver
Product
Name
Suprasorb X +
PHMB®
Size
Comments
5x5cm
9x9cm
14x20cm
2x21cm
Cost/
Item
£2.46
£4.91
£11.16
£6.95
Acticoat
Absorbent®
5x5cm
10x12.5cm
2x30cm rope
£5.22
£12.54
£12.61
A calcium alginate fibre coated on both surfaces with
nanocrystalline silver. As an antimicrobial absorbent dressing
over partial and full-thickness wounds which are exuding.
Aquacel Ag®
5x5cm
10x10cm
15x15cm
1x45cm ribbon
2x45cm ribbon
£1.93
£4.59
£8.65
£2.97
£4.54
Absorbent, white fibrous dressing composed of Hydrofiber®
(sodium carboxymethylcellulose), impregnated with 1.25 ionic
silver. Forms a coherent soft gel on contact with exudate. Use
as a primary dressing for moderately to highly exuding wounds
where there is infection.
Light to moderately exuding, superficial and deep, critically
colonised and infected wounds. Bio-cellulose dressing
impregnated with broad-spectrum antimicrobial (PHMB
(polyhexamethylene biguanide 0.3%). Can be effective if the
wound is infected and painful.
References:
Robson, V, Dodd, S,Thomas, S. Standardised antibacterial honey
(MedihoneyTM) with standard therapy in wound care: randomised clinical trial.
J Advanced Nursing, March 2009, 65 (3), p.565-75
Gethin, G, Cowman, S. Manuka honey vs. hydrogel: a prospective, open
label, multicentre, randomised controlled trial to compare desloughing efficacy
and healing outcomes in venous ulcers.
J Clinical Nursing, February 2009, 18 (3), p466-74
Stephen-Haynes J. The use of Atrauman non-adherent wound dressing in
tissue viability.
British Journal of Community Nursing, March 2009, 14 (3), S29-34
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Wound Formulary February 2013 version 7.1
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Product Type
d.
e.
Product
Name
Prontosan®
350ml bottle
Cost/
Item
£3.43
(6 ampoules)
£4.58
30ml Gel
£6.35
Anabact®
(0.75%
metronidazole gel)
15g
30g
£4.47
£7.89
The deodorisation of malodorous fungating tumours,
gravitational ulcers and pressure ulcers.
Available on prescription only.
Carboflex®
10x10cm
8x15cm
15x20cm
£3.06
£3.68
£6.97
Sterile non-adhesive dressing with an absorbent wound contact
layer, an activated charcoal central pad and a water-resistant
top layer. For the management of malodorous wounds. Apply
soft material side down. Can be used as primary or secondary
dressing and under compression. Do not cut to size. Evaluate
and eradicate source of malodour such as infection and review
need.
Clinisorb®
10x10cm
10x20cm
15x25cm
Irrigation
Topical antibacterial
4. ODOUR CONTROL
Size
40ml ampoule
NB: charcoal is no
longer effective when it
is wet
Version 7.1 Wound Formulary
£1.84
£2.45
£3.95
Comments
Wound irrigation solution containing Betaine which is a gentle
effective surfactant which penetrates, disturbs and removes
biofilm and wound debris, and PHMB to help control bacterial
levels on the wound.
Cleansing, decontamination and moisturising of acute and
chronic skin wounds, first and second degree burns.
Sterile activated charcoal cloth sandwiched between layers of
nylon/viscose rayon cloth. Apply as a secondary dressing over
an appropriate primary dressing. Exudate will reduce the
dressing’s effectiveness. Can be cut to size. Can be used in the
management of malodorous wounds such fungating wounds,
pressure ulcers, leg ulcers and diabetic foot ulcers. Consider
using Anabact®
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Wound Formulary February 2013 version 7.1
Ratified by the Basingstoke, Southampton and Winchester District Prescribing Committee and Portsmouth and South East Hampshire Area Prescribing Committee
Product Type
Product
Name
Size
Cost/
Item
Comments
Sorbsan® Flat
5x5cm
10x10cm
81p
£1.71
Calcium alginate primary dressing for use in shallow, moist wounds or to help
promote haemostasis in wounds with minor bleeding or where blood is
present in the exudate.
For management of moderately or heavily exuding wounds. May be used to
help manage wounds with minor bleeding.
Secondary dressings are required to support the alginate in situ and maintain
a moist environment.
Is easily removed by irrigation.
Sorbsan®
Packing
2g(30cm)
£3.47
Calcium alginate 2g (30cm length) with sterile probe for packing cavity
wounds.
For exudate management and wound healing of large open or cavity
wounds. May be used to help manage wounds with minor bleeding or where
blood is present in the exudate.
Sorbsan®
Ribbon
40cm
£2.04
Aquacel® Extra
5x5cm
10x10cm
15x15cm
99p
£2.36
£4.44
1x45cm
ribbon
2x45cm
ribbon
£1.76
5. ALGINATES
®
NB: Kaltostat On contact
with a bleeding wound,
promotes haemostasis but
should not be left in place.
Local guidance is to leave for
10 mins and then remove.
®
Kaltostat is non-formulary.
NB: use only where you
can see the base of the
wound as fibres/dressing
can be left in situ’
6. PROTEASE
MODULATING MATRIX –
STERILE
(HYDROFIBER®)
Version 7.1 Wound Formulary
£2.39
Calcium alginate cavity ribbon 1g (40cm length), supplied with a sterile
probe.
Moderately to heavily exuding cavity wounds, including for tunnelling wounds
or sinus wounds. May be used to help manage wounds with minor bleeding
or where blood is present in exudate.
For infected/heavily exudating wounds. Do not use on a dry or low exudating
wound. Requires secondary dressing.
Soft, sterile, non-woven pad or ribbon dressing composed of Hydrofiber®
(sodium carboxymethylcellulose). Absorbs wound fluid and transforms into a
soft gel.
Apply in a cavity wound or on shallow wounds. Should overlap the wound
margins.
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Wound Formulary February 2013 version 7.1
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Product Type
7. HYDROGEL
Product
Name
Purilon® gel
Size
8g
15g
Cost/
Item
£1.70
£2.22
IntraSite
Conformable®
10x10cm
10x20cm
10x40cm
£1.76
£2.38
£4.25
ActiFormCool®
10x10cm
20x20cm
5x6.5cm
£2.58
£7.77
£1.76
NB: cut to size and do
not place on intact skin
Version 7.1 Wound Formulary
Comments
Primarily indicated for treatment of necrotic and sloughy wounds, e.g. leg
ulcers, pressure ulcers and non-infected diabetic foot ulcers.
Effective for desloughing and debriding wounds.
For dry ‘sloughy’ or necrotic wounds, lightly exudating wounds, granulating
wounds and cavities. Not suitable for infected or heavily exudating
wounds. Secondary Dressings required. N.B. Can macerate peri-wound
areas if allowed to spill over wound edges under occlusive secondary
dressings. Should be changed every 1-3 days.
IntraSite Conformable® is a hydrogel sheet. It has the added advantage of
being bacteriostatic due to its propylene glycol content. It can be shaped
to fit the wound so reducing the risk of maceration. This dressing also has
the advantage of coming in three sizes.
Consider when pain is a significant factor.
Hydrogel sheet cut to wound size with secondary (blue) backing which can
remain on for low to moderate exuding wounds. For medium to heavy
exuding wounds remove (blue) backing to allow more vapour
transmission.
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Wound Formulary February 2013 version 7.1
Ratified by the Basingstoke, Southampton and Winchester District Prescribing Committee and Portsmouth and South East Hampshire Area Prescribing Committee
Product Type
Product
Name
Size
Cost/
Item
Comments
Allevyn®
Square
7.5x7.5cm
10x10cm
12.5x12.5cm
£1.46
£2.14
£2.62
Biatain®
Square
10x10cm
12.5x12.5cm
18x18cm
£1.71
£2.49
£5.03
Absorbent foam dressing with vapour-permeable film backing and an
adhesive border.
Allevyn®
gentle border
7.5x7.5cm
10x10cm
10x20cm
12.5x12.5cm
£1.46
£2.14
£3.44
£2.61
For fragile skin consider using Allevyn® Gentle Border® or Biatain®
Silicone®
Biatain®
silicone
7.5x7.5cm
10x10cm
12.5x12.5cm
15x15cm
£1.40
£2.06
£2.52
£3.74
Aquacel®
Foam
10x10cm
12.5x12.5cm
17.5x17.5cm
£2.35
£3.07
£5.20
8. FOAM DRESSING
For use on moderately exuding wounds.
Adhesive
Version 7.1 Wound Formulary
Foam dressings should be left in place for up to 7 days. Their mode of
action means exudates will be visible but this does not mean the
dressing requires changing.
Aquacel® Foam is only recommended for use where a Hydrofiber ®
technology is required for exudate management and a robust secondary
dressing required. If the clinician is considering ‘layering’ Aquacel to
achieve this or placing a foam dressing over the top of Aquacel then this
becomes a more cost effective option
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Wound Formulary February 2013 version 7.1
Ratified by the Basingstoke, Southampton and Winchester District Prescribing Committee and Portsmouth and South East Hampshire Area Prescribing Committee
Product Type
Product
Name
Size
Cost/
Item
9. HYDROCOLLOIDS
Comments
To aid debriding, promote granulation,
occlusive barrier.
Sterile, thin hydrocolloid
dressing.
DuoDERM®
Extra Thin
5x10cm
7.5x7.5cm
10x10cm
Absorbent hydrocolloid
dressing with vapourpermeable film backing
and bevelled edge
Comfeel® Plus
Ulcer
4x6cm
10x10cm
15x15cm
Hydrocolloid dressing with
an adhesive foam border.
Granuflex®
Bordered
6x6cm
10x10cm
15x15cm
£1.72
£3.25
£6.21
10. PASTE BANDAGES
Steripaste®
7.5cmx6m
£3.24
For the treatment of dermatological
conditions. Zinc oxide paste cotton bandage.
Ichthopaste®
7.5cmx6m
£3.60
Chronic eczema/dermatitis where occlusion is
indicated. Zinc paste and ichthammol
bandage.
Ensure any residue is removed before
rebandaging. Patch testing required prior to
use. To be applied as per manufacturer’s
instructions and not as a primary dressing or
as a patch.
Version 7.1 Wound Formulary
73p
78p
£1.29
£0.97
£2.37
£5.09
For light to medium exudating wounds ONLY.
Ensure correct size of dressings applied;
overlap the wound by at least two cms N.B.
Odour from the dressing constituents can be
a concern to patients. Not suitable for
infected wounds unless observed frequently.
Not indicated routinely on diabetic foot
wounds- contact local ‘at risk’ foot team for
advice.
NOT first line choice.
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Wound Formulary February 2013 version 7.1
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Product Type
Product
Name
Size
Cost/
Item
11. BANDAGES
a)
SEE APPENDIX 4 (page 30) FOR:
Multilayer Compression Bandage Adaptation Chart
Multi-layer long
stretch bandage
systems and
components
Profore® is the only
complete system available
for 25-30cm and above
30cm should that size be
required. Please see
adaptation chart for
components. (Latex free
option must be ordered)
Comments
Ultra Four® kit
Up to 18cm
18 – 25cm
£6.41
£5.67
Ultra Soft®
Wadding
Bandage
10cm x 3.5m
(unstretched)
39p
Layer One
Ultra Lite®
10cm x 4.5m
(stretched)
85p
Layer Two
Ultra Plus® (light
compression)
10cm x 8.7m
(stretched)
£1.89
Layer Three
Ultra Fast®
Cohesive
Bandage
(moderate
compression)
10cm x 6.3m
(stretched)
£2.59
Layer Four
Mixed aetiology
(reduced compression
Version 7.1 Wound Formulary
Latex–free
Ultra Four® Kit
(reduced
compression)
It is widely recognised that high compression bandaging
should be used in conjunction with assessment of vascular
status. Modified systems should only be used when ABPI
(ankle brachial pressure index) is reduced or patient
concordance is affected or similar.
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Wound Formulary February 2013 version 7.1
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Product Type
11. BANDAGES
(cont’d)
b) Short stretch
compression
Product Name
Size
Cost/
Item
Actico® (not latex
free)
4cmx6m
6cmx6m
8cmx6m
10cmx6m
12cmx6m
£2.33
£2.73
£3.14
£3.26
£4.16
Comprilan®
10cmx5m
£3.27
To be considered as the
second line short stretch
bandage system if Actico®
is either unaccepted or
ineffective eg. Slippage
Version 7.1 Wound Formulary
Coban® 2 layer
compression
system
Multi-layer
compression
bandage kit
£8.08
Comments
Short stretch compression
Cohesive short stretch bandage. Consider in patients that
have ability to flex ankle/toes, have chronic oedema, can’t
tolerate long stretch, have diabetes. Can be taught to be
applied by patients for self care. Bandage of choice for
lymphoedema management. Cohesive short stretch
bandages for single use and adapted according to ankle
circumference.
NB: 10cm is preferred width for routine below knee leg ulcer
bandaging
.
Reusable system (washable). High cotton content.
LATEX FREE – second line choice.
Bandages of choice for lymphoedema/chronic oedema
management
Two-layer compression system that delivers sustained,
therapeutic compression to be used as a kit comprising of
latex-free foam padding layer and a latex-free, cohesive,
compression bandage. Apply the two layers which bond to
form a single-layer bandage. Can be worn for up to 7 days.
Recommended in patients with an ABPI <0.8.
The Coban 2® Layer Lite Compression System designed to
be comfortable for patients less tolerant of compression
therapy and/or reduced ABPI(ankle brachial pressure index)
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Wound Formulary February 2013 version 7.1
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Product Type
Product
Size
Cost/
Comments
Name
Item
ALL healthcare professionals must ensure their competencies for applying compression bandaging are up to date
Arterial screening (i.e. Doppler ultrasound) must be undertaken before compression hosiery or bandaging is commenced. Note that arterial screening
must be repeated periodically if compression therapy is ongoing. Ref: Local Leg Ulcer Guidelines/Standard Operating Procedures
K-lite®
10cmx4.5m
15cmx4.5m
98p
£1.43
Crepe bandage
10cm
15cm
£1.75
£2.53
CliniFast®
3.5cmx1m
5cmx1m
7.5cmx1m
10.75cmx1m
17.5cmx1m
56p
58p
77p
£1.20
£1.83
Red line
Green line
Blue line
Yellow line
Beige line
Comfifast®
3.5cmx1m
5cmx1m
7.5cmx1m
10.75cmx1m
17.5cmx1m
56p
58p
77p
£1.20
£1.83
Red line
Green line
Blue line
Yellow line
Beige line
11. BANDAGES
(cont’d)
c) Light weight
conforming
bandages
WARNING – can act as a tourniquet.
Light retention bandage. Not advised for leg bandaging due to
high stretch capability. Consider crepe bandage toe to knee to
support leg if arterial or pre-assessment.
Elasticated viscose stockinette. Also available in 3m and 5m
lengths for green, blue and yellow line, which may be more cost
effective.
Version 7.1 Wound Formulary
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Wound Formulary February 2013 version 7.1
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Product Type
Product
Name
12. SUPPORT HOSIERY
Class 1
Light (mild) Support
Compression at ankle 1417mmHg
Activa®
Size
Cost/
Item
Below knee
Thigh length
£7.21
£7.89
Class 2
Medium (moderate)
Support Compression at
ankle 18 – 24 mmHg
Below knee
Thigh length
£10.54
£11.73
Class 3
Strong Support
Compression at ankle 2535mmHg
Below knee
Thigh length
Kit
Accessories
Waterproof Protector
Activa®
Leg Ulcer Hosiery Kit
Activa ® Liner Pack
Acti-Glide®
Compression hosiery
application system
LimbO®
Version 7.1 Wound Formulary
1 Stocking and 2
liners
3 Liners
Standard and
short leg
£11.95
£13.90
£22.12
Comment
The make of hosiery selected depends on comfort, cosmetic
appearance and ease of application.
Activa® (Activa Health Care) are deemed the preferred products
by the Formulary Group.
For recurring leg ulceration and gross varices.
Available as small, medium, large, extra large and extra extra
large. Useful for active ulceration to apply full compression for
patients who can’t tolerate bandaging. Assessing and
measuring as per single hosiery products.
£16.26/£16.58 Liner pack available in all sizes, open and closed toe.
£14.12
Supply of single unit only.
£10.56
Available as slim, normal and large build.
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Wound Formulary February 2013 version 7.1
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Product Type
Product
Name
Size
12. SUPPORT HOSIERY
(cont’d)
Class 2
23-32 mmHg
Class 3
34-46mmHg
Comment
These products increase the venous and lymphatic return by aiding
the absorption of excess limb fluid. They can help in the
management of recurring ulcers and when conventional hosiery not
containing oedema of limbs. They have a higher ‘Stiffness Index’
(aids stimulation to lymph to encourage fluid return) and can last up
to 6 months before replacing if undamaged.
Hosiery for Chronic
oedema/lymphoedema
Class 1
18-21mmHg
Cost/
Item
ActiLymph®
Available
below and
above knee
with a wide or
regular
silicone band
to prevent
slippage at
thigh
1 stocking per
prescription
item.
Variety of
colours, sizes,
open and
closed toe.
Provide light compression for early mild oedema with little leg
distortion. Suitable for chronic oedema, lymphoedema, lipoedema,
prophylaxis, maintenance therapy, palliative use.
Provide medium compression for moderate to severe chronic
oedema and lymphoedema, where resistant oedema occurs and
some shape distortion.
Provides strong compression and should be used for maintenance
of severe chronic oedema and lymphoedema, where resistant
oedema persists, history of recurring ulceration or where lymphatic
damage is considerable and when use of lower classes has proved
ineffective.
References:
MORRIS, A. (2004) Cellulitis and Erysipelas. Clinical Evidence 12: 2271-7
Available online:
www.clinicalevidence.com/ceweb/conditions/skd/1708/1708.jsp
MOFFAT, C. (2003) Lymphoedema:an underestimated health problem.
Quality Journal of Medicine. 96: 731-8
Activa Healthcare Website and Information
www.activahealthcare.co.uk/actilymph/
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Product Type
Product
Name
Size
Cost/
Item
Clinipore®
2.5cmx5m
5cmx5m
59p
99p
Hypafix®
5cmx5m
10cmx5m
£1.38
£2.32
To be used only when Clinipore® is deemed unsuitable.
14. ABSORBENT
DRESSINGS
Zetuvit E® Sterile
10x10cm
10x20cm
20x20cm
20x40cm
21p
24p
38p
£1.06
Absorbent and protective. Used as a secondary dressing.
NB community nurses can obtain Surgipads® from central stores.
Super Absorbent
Dressing
Drymax Extra®
10x10cm
10x20cm
20x20cm
20x30cm
£1.84
£2.43
£4.28
£2.89
For use under compression
13. ADHESIVE TAPES
Non-woven synthetic
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Comment
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Product Type
Product
Name
Size
Cost/
Item
Comments
Leukostrip®
6.4x76mm
£6
Available on FP10, cheaper than Steri-strip®.
Polyfield® Nitrile
Patient Pack
52p
Sterile dressing pack containing powder-free nitrile gloves, laminate
sheet, 7 non-woven swabs, towel, apron and disposable bag.
Nurse It® dressing
packs
52p
Pair of powder-free latex vinyl gloves, 7 non-woven swabs, 1
compartment tray, disposable forceps, laminated paper sterile field,
large apron, paper towel and white polythene disposable bag.
26p
Use for general purpose swabbing and cleansing.
15. MISCELLANEOUS
Sterile Skin Closures
Dressing Packs
Non-woven Fabric Swab
sterile
(5 pack)
7.5x7.5cm
Sodium Chloride
Irripod®
20ml x 25
£5.56
Gauze and Cotton Tissue
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Gamgee®
Drug Tariff
Normal Saline – is the irrigation solution of choice. All irrigation
solutions should be applied at body temperature. Tap water only to
be used according to local policy for leg washing and all chronic and
acute wounds will be cleansed with a sterile, single use solution, if
required.
500g
£5.22
Gamgee® - For use to absorb large amounts of exudate. Not to be
used as primary dressing. If used in leg management always pad
OUTSIDE the bandage to maintain adequate pressures (if
compression) to the leg. Can be cut to size if required.
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Product Type
Product
Name
Size
Cost/
Item
Please refer to local formulary/dermatological guidance for detailed product
list and advice. Table of all the products can be found in MIMS and includes
the potential sensitisers. http://www.mims.co.uk/Tables/882437/EmollientsPotential-Skin-Sensitisers-Ingredients/
15. MISCELLANEOUS
(cont’d)
Skin Protectant
Comments
Cavilon® Barrier
Film
5x1ml
5x3ml
£4.88
£7.83
Permitabs®
30
£11.45
Potassium permanganate
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To protect surrounding skin in high exudate wounds to prevent
maceration. For use over excoriated skin and around stomas. Use in
moist areas where it is difficult to get dressing adhesion.
When used appropriately Cavilon® reduces wound trauma.
Adjunct therapy only. Short-term treatment for wet weepy, infected or
eczematous legs.
One tablet dissolved in 4 litres of water.
Indicated for short term use only. Maximum of 2 weeks in
conjunction with assessment to ascertain cause of infection or
weeping and treat underlying cause.
Warn patients about staining. If treating feet suggest using white
soft paraffin around the toe nails to reduce staining.
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APPENDIX 1
PROTOCOL FOR TAKING SWAB FROM A SUSPECTED INFECTED
OR NON-HEALING WOUND
Bacteriological swabs should only be taken when there is clinical evidence
of infection in a wound (see appendix 5) For example
1. Spreading cellulites and/or
2. New or increased pain not accounted for by underlying arterial
disease or
3. Patient is systemically unwell with fever, raised pulse, raised
respiration or raised white blood cell count
APPENDIX 2
ASEPTIC NON TOUCH TECHNIQUE
Refer to organisational policy
Clean the ulcer with recommended sterile solution to remove debris, pus
or other foreign material. Gently pass the swab over the area in a zig zag
motion ensuring it is turning in a circular motion so the entire swab is
covered. Swab from the centre to the outside of the wound and ensure
that if there is any exudate present it is thoroughly absorbed by the swab.
Send the swab to the pathology department as soon as possible including
the following information:
1. Patient name, date of birth and NHS number
2. Location of the patient
3. Site where the swab was taken from
4. Clinical indicators for taking the swab
5. Any antibiotics the patient may be on
6. The clinical investigation required
7. Wound history and other treatment tried
8. Any relevant co-morbidities or current diseases
Record the taking of the swab in the patient’s notes. It is the practitioner’s
responsibility, as the patient’s advocate, to access the results and liaise
with the medical staff to act on the swab result if indicated.
Infection is not implied by the mere presence of organism. The
microbiology result must be taken into account along with the clinical
indicators for infection
Ref: Patten,H. (2010) Identifying wound infection: Taking a swab. Wound
essentials.64-66
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APPENDIX 3
Best Practice in Older Person’s Skin Care
(Best Practice Statement: Care of the Older Person’s Skin. London: Wounds UK, 2012. Download from www.wounds-uk.com)
Aim: To maintain the Integrity of the Skin
As a person ages, changes in the skin occur, increasing skin vulnerability to a variety of damage. Older skin is less able to regenerate & protect, increasing the risk of skin
breakdown
Dry & vulnerable skin
Older skin is thinner and dryer making it vulnerable to splitting and bacterial invasion and the dryness is often a cause of itching. Emollients applied twice daily are seen as
the first line of treatment and will help rehydrate and maintain skin integrity. Traditional soaps dry the skin out, increasing the problem.
Emollient therapy is recommended as best practice for care of older person’s skin and should be used as an alternative to soap. Adequate quantities should be used
according to the patient’s need (refer to BNF for types of preparations and quantities)
Total emollient therapy (Lawton, 2009)
Soap substitutes
Soap is an irritant and can make the skin itchy. Soap substitutes cleanse effectively but do not leave the skin feeling
dry. Products containing SLS (eg. Aqueous cream) should not be used as a soap substitute
Add to bath water to help moisturise the skin. Bath additives leave a layer of oil after bathing*Warning: bath oils can
Bath oils*
make the bath slippery. Risk assess patient and environment for suitability
Moisturisers
Moisturisers are ‘leave on’ emollients. They are available as:
Ointments: they have the highest oil content and are greasy. They can be messy to apply, leave the skin looking
shiny and stain clothes. They are suitable for very dry skin and may be best applied at night. Ointments usually
work by occlusion
Creams: they are quickly absorbed and more cosmetically acceptable. Creams are good for daytime use and work
by occlusion or ‘active’ humectant effect, but are much less effective than ointments
Lotions: the lightest and least greasy emollients (contain less oil). They are not suitable for dry skin conditions
Damage related to moisture from maceration & incontinence
Excess fluid on the skin from wounds, sweating, urine and/or faecal incontinence and peri-stomal exudate are likely to increase the damage to the skin causing maceration.
Excessive moisture due to urine/faecal incontinence can lead to skin damage presenting as a moisture lesion. A protective skin barrier is required as prevention.
Product choice for an individual patient involves consideration of patient preference, consistency required, ingredients including potential allergens, suitable packaging and
cost. The products of choice are therefore ones which are effective, the patient finds acceptable and is prepared to use on a regular basis. Refer to local
formulary/dermatological guidance for more detailed product list and advice. Table of all the products can be found in MIMS and includes the potential sensitisers.
http://www.mims.co.uk/Tables/882437/Emollients-Potential-Skin-Sensitisers-Ingredients/
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Appendix 4 Product Selection Tools
Skin Tears
Description
Superficial or traumatic wound, where skin rips, common in the elderly and the dehydrated. Sterile dressing s for low exudating
wounds.
Aims
Cover and protect
Promote atraumatic removal
Promote healing
Minimise scarring
Treatment
Primary
dressing
Section1
Wound
contact layer
Example
®
Atrauman
Application
Secondary dressing
Redressing advice
Straighten skin using forceps drawing edges
together.
Do not apply to bleeding wound.
.
Gauze pad or dressing
pad secured with a
bandage/tubular
bandage.
Dressing can remain in place for up to 7 days.
Secondary dressing can be changed
independently on strike through of dressing.
Other factors to consider
Underlying conditions
Nutrition
Oedema adjacent to wound
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Place of wound – if lower leg, undertake full assessment including ABPI where appropriate
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Superficial Burns/Scalds
NB: monitor intensively initially and seek advice if burn progresses
Description
Weeping, blisters
Aims
For scalds – monitor initially as effects can continue for a few days after event
To cover and protect
Promote atraumatic removal
Minimise scarring
Treatment
Primary
dressing
Section1
Wound contact
layer
Example
Application
®
Atrauman
Apply directly to
wound.
Secondary
dressing
Gauze or dressing
pad for protection.
Redressing advice
Dressing can remain in place for up to seven days. Secondary
dressing can be changed independently on strike through of dressing.
Other factors to consider
Nutrition
Place of wound
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Effect on daily functioning (washing)
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Epithelialising Wounds
Description
The wound is pink in colour, the tissue is fragile with evidence of healing bed and/or margins
Aim
To cover and protect
To support wound closure
Maintain moist environment
Treatment
Primary
dressing
Section1
Wound contact
layer
Example
Application
Section 2
Films
Hydrofilm
Section 9
Hydrocolloid
Duoderm
Extra Thin
®
Apply directly to
wound.
®
Remove cover 1, apply
to dry wound, then
remove layer 2.
Dressing should have
2cm plus overlap of
the wound margin.
Atrauman
®
Secondary
dressing
Gauze or dressing
pad, secured with a
bandage/tubular
bandage or film.
Not required.
Not required.
Redressing advice
Secondary dressing can be
changed independently on strike
through of dressing.
Up to 7 days.
To remove film stretch film
parallel to skin.
Change when transparency
reaches the edge of dressing.
Can remain in place for 7 days.
Other factors to consider
Reduction of pressure to the wound area
Treatment of oedema adjacent to the wound
Nutritional factors
Effect on daily functioning, bathing (Duoderm® is waterproof)
Continence of patient
Treatment of pain
Hydrocolloids may cause hypergranulation (use with caution in patients with diabetes)
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Granulating Wounds
Description
Wound could be red in colour and has a granular ‘bubbly’ appearance
Aim
To maintain moist environment
To promote wound healing
To support wound to epithelializing stage
Treatment
Primary
dressing
Section1
Wound
contact
layer
Example
Application
Secondary dressing
Redressing advice
Apply directly to wound.
Gauze or dressing pad
secured with a
bandage/tubular bandage.
Allevyn
®
Biatain
Apply with pink side facing up.
Apply in diamond shape for
improved conformity in body
areas.
Not required if adhesive.
Secure with bandage/tubular
bandage if non adhesive.
Atrauman can remain in place for up to
7 days.
Secondary dressing can be changed
independently, on strike through of
dressing.
Up to 7 days.
Section 8
Foam – if
exuding
Section 6
®
Hydrofiber
Aquacel
®
Extra
Directly on to wound with
overlap margin
Gauze or dressing pad
secured with a
bandage/tubular bandage.
®
Atrauman
®
®
Up to 7 days.
Other factors to consider
Reduction of pressure to the wound area
Nutritional factors
Continence of patient
Treatment of pain
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Treatment of oedema adjacent to the wound
Manual repositioning
Effect on daily functioning, bathing
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Over-Granulation
Description
•
•
•
Characterised by proud-flesh occurring after the wound bed has filled with granulation tissue
An excessive laying down of new blood vessels creating a bulge of highly vascular tissue
Prevents epithelialisation
Cause
•
•
•
Infection has disturbed the equilibrium of the inflammatory phase. May be excessively wet.
Result of wound dressing. Low oxygen environment of e.g. hydrocolloids can stimulate over-granulation
Over-granulation can be an indication of malignancy and should be ruled out
Treatment
•
•
•
•
•
•
•
Many treatments are not research based but expert opinion
Change dressing to a higher moisture vapour transmission rate e.g. foam
Treat infection
®
If dry - Haelan tape–moderately potent steroid
®
Stoma sites if wet- Kendall AMD foam under pressure
Hydrocortisone 1% cream or ointment - use sparingly, once a day for 7 days then alternate days for 7 applications
Pressure- creating an ischaemic response, risk of trauma
Treatment
Primary
dressing
Example
Application
Secondary dressing
Redressing advice
Mild topical steroid such as
hydrocortisone
1 finger tip unit
Simple foam dressing such as
®
Biatain
Review in 3-4 days
Cover wound
Simple foam such as Biatain
Simple foam as above
®
Haelan tape
Section 3
®
Inadine if bleeding or
infection suspected with
delayed healing
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Cover wound
®
Review in 24 hours
Review in 3-4 days
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Sloughy Wounds
Description
Presence of yellow or soft brown/grey devitalised tissue. Can be wet or dry.
Aim
To rehydrate in order to support process of automatic debridement
Management of exudate (NB: do not use a hydrogel on wet wounds)
®
Removal or loosening of devitalised tissue – consider Medihoney which is licensed for this
Other factor to consider
Reduction of pressure to the wound area
Nutritional factors
Continence of patient
Treatment of oedema adjacent to the wound
Manual repositioning
Effect on daily functioning, bathing
Treatment of pain
Treatment
Exudate
High to
Moderate
Low to
moderate
Primary
dressing
Section 5
Alginates
Example
Section 6
®
Hydrofiber
Aquacel Extra
Section 9
Hydrocolloid
Comfeel Plus
ulcer dressing or
®
Duoderm Extra
Thin.
®
®
Purilon /Intrasite
Conformable
®
ActiformCool gel
sheet
Section 7
Hydrogels
Sorbsan Flat
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®
®
®
Application
Secondary dressing
Protect outer
tissue with
®
Cavilon .
Allevyn adhesive,
gauze or dressing pad
secured with a bandage
or tubular bandage.
®
Allevyn adhesive,
gauze or absorbent
dressing secured with a
bandage or tubular
bandage.
Not required.
Apply directly to
the wound.
Dressing should
have 2cm plus
overlap of the
wound.
As for necrotic
®
Gauze and Hydrofilm
with foam if require
®
Redressing advice
Change when strike through of secondary dressing occurs.
Removal can be aided by moistening with saline, if stuck to
wound bed reassess dressing being used.
Suitable for exuding or wet slough. Change when strike
through of secondary dressing occurs. Removal can be
aided by moistening and gently flushing with saline, if stuck
to wound bed reassess dressing being used.
If exudate a concern then consider a foam
Change when transparency reaches the edge of dressing.
Can remain in place for 7 days.
For dry, low exuding or resistant slough removal.
Consider if wound painful.
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Necrotic Wounds
Description
The presence of black or yellowish brown tissue
Aim
To ‘break down’ or soften devitalised tissue
To rehydrate tissue
To support remove of devitalised tissue
To promote autolysis
NB: if intact with no breakdown, keep area dry. Once debridement has begun and areas of exudate seen, proceed to debriding with hydrogels eg. Heel and toe
wounds. All heel wounds require a vascular assessment (Doppler) in order to ascertain underlying cause of wound.
Treatment
Primary dressing
Example
Section 7
Hydrogels
Purilon
®
Intrasite
®
Conformable
Application
Apply gel onto
devitalised tissue.
Consider protecting
healthy surrounding
®
tissue with Cavilon .
Mould and shape to
wound bed.
Secondary
dressing
Section 9
Foams;
®
Allevyn /
®
Biatain
Redressing advice
Gel can remain in contact for up to 3 days. Gel
can be removed by irrigation with normal saline.
Secondary dressing can be changed
independently when strike though takes place.
Other factors to consider
Reduction of pressure to the wound area
Nutritional factors
Continence of patient
Treatment of pain
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Treatment of oedema adjacent to the wound
Manual repositioning
Effect on daily functioning, bathing
Wounds can look larger when debrided
Increase in exudates may lead to maceration
Wounds often malodorous
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Critically colonised or infected Wounds
Management of lower leg wounds on patients with diabetes requires referral to your local specialist team.
Management of foot ulcers on patients with or without diabetes requires referral to your local specialist team.
Description
See sign checker and flow chart for identification
Aim To reduce critical colonisation or infection to reduce wound bio-burden and infection. It is expected that all nursing staff will familiarise themselves with the
products suggested and their appropriate use.
This guide is intended for first line treatment/product consideration. It is not considered as an exhaustive list or to be applicable for all patients. All healthcare
professionals are expected to use their clinical judgement when assessing patients and wounds.
Prior to applying the dressing, it is recommended that all infected or non healing wounds where it is considered that the bio-burden is contributing to the non
healing are soaked/irrigated with Prontosan® irrigation solution in order to attempt to reduce/minimise that burden.
Treatment
Wound
characteristics
Low exudate
First line
Second line
Notes
Inadine®
Medihoney® Tulle
Choice of dressing will depend on type of wound but apinate not considered suitable
Moderate exudate
Iodoflex®
Medihoney gel
High exudate
Iodoflex®
NB:
maximum
use see
section 3
Acticoat absorbent®
®
®
®
Consider Suprasorb X +PHMB if Iodine and honey are not tolerated because of pain. Cover
®
Suprasorb X PHMB with a hydrofilm if exudate results in dressing drying out. Exudate levels
may require a foam as a secondary dressing
NB: Acticoat could dry out a wound if exudate levels reduce so monitor and step down as
appropriate.
Aquacel Ag®
®
®
Zetuvit sterile, Drymax may be needed as a secondary dressing to manage high levels of
exudate
Other factors to consider
Antimicrobial dressings should be used initially for two weeks only; if after reassessment the need for further antimicrobial use is indicated, this should be actioned and
documented in the patient’s notes together with the rationale.
Note: inflammation around wound edges is an expected part of the inflammatory process of wound healing in acute wounds and may be evident for up to three days, or
longer in a patient with diabetes or patient’s poor immune response, e.g. the elderly.
Patients who are immuno-compromised and/or with diabetes may not show the classic signs of infection or have a delayed inflammatory response.
Diabetics and patients who are immunocompromised may not show the classic signs of infection.
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Appendix 5
Ankle size
Multilayer Compression Bandage Adaptation Chart for ankle/limb size and latex free options
Bandage regime
Individual
Component
Individual
Component
Individual
Component
Individual
Component
Approx.
Pressure
Value at
ankle
All bandages applied 50% overlap from base of toes to knee 50% Compression stretch
commences at 1st turn at ankle
(note different application techniques for some bandages)
Under 18cms
‘Ultra Four’
Ultra Soft no. 1
(spiral)
x2
Ultra Lite no.2
(spiral)
x1
Ultra Plus no.3 x 1
(figure of 8)
14-17mmHg approx
Ultra Fast no.4 x 1
(spiral)
18-25mmHg approx
40mm
Hgs at ankle
Ultra Soft no.1
(spiral)
x1
Ultra Lite no.2
(spiral)
x1
Ultra Plus no.3 x 1
(figure of 8)
14-17mmHg approx
Ultra Fast no.4 x 1
(spiral)
18-25mmHg approx
40mm
Hgs
at ankle
Profore #1
(spiral)
(Latex Free)
x1
Profore Plus
(spiral)
(Latex Free)
x1
Profore #4
(spiral)
(Latex Free)
x
40mm
Hgs
at ankle
Profore #1
(spiral)
(Latex Free)
x1
Profore #3
(figure of 8)
(Latex Free)
x1
Profore Plus
(spiral)
(Latex Free)
x1
Profore #4
(spiral)
(Latex Free)
Ultra Soft no. 1
(spiral)
x1
Ultra Lite no. 2
(spiral)
x1
Ultra Fast no.4 x 1
(spiral)
x
Kit available
18 – 25 cms
25 – 30 cms
Over 30 cms
‘Ultra Four’
Kit available
Profore (Latex
Free)
25-30cms
No kit available
Profore
(Latex Free)
>30 cms
No kit available
Mixed
‘Ultra Four’ Kit
aetiology
(Reduced
(reduced
Compression
compression) Kit available
x1
x1
40mm
Hgs
at ankle
18-24
mmHgs on a
18-25 ankle
size
Notes:
Extra padding layers (#no 1’s) may need to be ordered to pad, protect and shape leg so to achieve safe graduated compression (leg shape)
Standard Profore is NOT latex free, so be sure to order latex free version (no kits available so order components individually)
Make sure patient has suitable footwear before opting for multi-layer systems
Consider if patient requiring frequent changes within a week, that multi-layer may not be time, or cost effective
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Appendix 6
Critically colonised or infected Wounds SIGN CHECKER
Sign Checker
Systemic Infected
redness >2cm & pain
Locally Infected
Critically Colonized
Colonized
Local redness <2cm or
small flare & pain
No change (at ≥2 weeks) &
no cellulitis
Expected progress
(expected inflamm.)
Thick slough not responding
Necrosis/thick slough
but debriding
Continuing wetness
Wet/moist as stage of
healing
Purulence
Exudate as stage of
healing
Wide heat/swelling
Local heat/swelling
Rapid onset new site
necrosis
New necrosis on wound
bed
Extension
Extension
Blistering or satellites
wetness
Purulence
wetness
Purulence
Haemorrhagic
patches/spots
necrotic tissue
CRP
WBC
Blue green exudate
necrotic tissue
Fast returning slough
Light mobile slough
CRP
WBC
Pyrexia/Rigor
Confusion (elderly)
Malodour
Bacteraemia
Discoloured granulation
Normal granulation
Lymphangitis/adenitis
Friable granulation
Epithelial tissue
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Complete Sign C hecker
r
Management of lower leg wounds on patients with diabetes requires referral to your local specialist team.
Locally infected
Systemic or active
Infection
Select appropriate
antimicrobial dressing
Refer to Tissue Viability if required
Colonised (progressing
normally)
Critically colonised
Monitor closely
Select appropriate antimicrobial
dressing.
Use sign checker
regularly to monitor
progression
Monitor closely
Take a swab
Seek medical opinion
Start broad spectrum
antibiotics while
awaiting culture results
If systemic
signs only:
Look outside
wound for
source of
infection
Select topical antimicrobial
Good clinical outcome
Good clinical
outcome
No improvement after
10 - 14 days
Continue with
antimicrobial
for 2 weeks
No improvement
after 10 - 14 days
Take a swab
No improvement
after 10 - 14 days
If wound
unchanged or
deteriorating
discuss with
TVN
Good clinical
outcome
Discontinue
antimicrobial
after 2
weeks and
monitor
If wound
deteriorates or
any signs of
systemic
infection
Check swab sensitivities
Complete antibiotics
Reassess wound
after 2 weeks
Change antibiotics if required
Refer to Tissue Viability
Reassess antimicrobial dressing after 2 weeks
Version 7.1 Wound Formulary
32
Wound Formulary February 2013 version 7.1
Ratified by the Basingstoke, Southampton and Winchester District Prescribing Committee and Portsmouth and South East
Hampshire Area Prescribing Committee
APPENDIX 7
Resources
There are a variety of resources available to the clinician in addition to this document.
 All woundcare/products companies will have information via their own websites or found by search
engine, eg. Google.
 Information via electronic versions of BNF, MIMS, Woundcare Handbook
(www.woundcarehandbook.com)
NAME
TITLE
Denise
Woodd
Julie Gove
LU Nurse Specialist
TRUST
TV Nurse Specialist
(Southampton)
TV Nurse Specialist
(Portsmouth)
Locality Lead
Pharmacist
(Southampton)
Advanced Clinical
Nurse Specialist
(Winchester/Andover)
Advanced Clinical
Nurse Specialist (New
Forest& Romsey)
Advanced Clinical
Nurse Specialist
Advanced Clinical
Nurse Specialist
Solent NHS Trust
Kirsten
Lawrence
CCG Lead
NHS Hampshire
Fran
Spratt
Tina
Chambers
Janet
Brember
Catherine
Langhorn
Barbara
Topley
Tissue Viability
Lead
Michael
BennettMarsden
Lucy
McIldowie
Sue
Lawton
Lisa Rice
Caryn
Carr
Jane
Barker
Guy
Alexander
Southampton City CCG
Southern Health NHS Foundation Trust
Team e mail hamp-
pct.tissueviabilityspecialistteam@nhs.
net
PHONE
NUMBERS
E MAIL
02380 6080 42
07789 505045
02380 713416
07785 351566
023 8029 6960
07899 987 464
[email protected]
Fax no 02380 538751
[email protected]
Fax No. 02380 713410
[email protected]
Fax No. 023 92 344 933
[email protected]
.
02380 673988
07747 792895
[email protected]
Fax No. 02380 673977
07789867790
[email protected]
Fax No. 02380 673977
07740852241
02380 673988
07887 985101
[email protected]
Fax No. 02380 673977
[email protected]
Fax No. 02380 673977
07776223615
[email protected]
Pharmacist – lead for
dressings
University Hospital Southampton NHS
Foundation Trust
Hampshire Hospitals Foundation Trust
01962 825595
[email protected]
NHS Portsmouth
02392 684588
Prescribing Support
Pharmacist
NHS Portsmouth
02392 684568
Tissue Viability
Lead
Portsmouth Hospital NHS Trust
[email protected]
Fax No. 02392 831656
[email protected]
Fax No. 02392 831656
[email protected]
Phone/Fax No. 02392 286985
Wound Formulary
Pharmacy lead
Portsmouth Hospital NHS Trust
Clinical Nurse
Specialist
Formulary Pharmacist
[email protected]
(leave message)
Version 7.1 Wound Formulary
33
Switchboard 02392 286000
Bleep 0078
Switchboard 02392 286000
Bleep: 1393
[email protected]
Phone/Fax No. 02392 286117
Wound Formulary February 2013 version 7.1
Ratified by the Basingstoke, Southampton and Winchester District Prescribing Committee and Portsmouth and South East
Hampshire Area Prescribing Committee
APPENDIX 8 Generic Exception Reporting Form (add organisational logo)
WOUND CARE FORMULARY Exception Reporting Form
Mandatory requirement when using wound and skin care products not on
formulary. (no patient ID to be seen)
This will aid the Formulary Group to ensure the most appropriate products are included in the Formulary
and highlight products for evaluation.
Your Name, Base, Designation and Contact Details:-
Name, type and size of non-formulary product used:-
Who was the product initiated/suggested by:- (e.g. GP/hospital
ward/community/practice/specialist nurse/company representative):-
Name & base of WISH/ANTS Link Nurse/HCP/nurse specialist you discussed this with:-
Why has this non-formulary product been chosen: - (+ Description of the wound if a
dressing)
What products have already been tried and what were the results:-
OUTCOMES AND COMMENTS
STATE outcome of using non-formulary product (please include frequency of use,
increase/reduce visits, how long the product was used for, amount used and whether appropriate and
successful)
Any other comments:- ie. Would you use this again, pt experience, other factors eg. Pain, ease of use,
availability, has a formal evaluation been done and fed back etc
Please send/fax a copy of this form (no patient data) to your local nurse specialist or prescribing advisor
(see resource page in formulary for fax nos under email addresses) and keep a copy for reference .
Version 7.1 Wound Formulary
34