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Wound Cleansing Solutions |
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Formulary Choice Size Price Treatment Advice |
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Tap water |
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Always warmed but not hot A bucket lined with a black bag is useful to clean leg ulcers |
Irripod
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20ml pods
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£5.50 (25) |
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Irriclens |
240ml can |
£3.12 |
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ABSORBENT PADS LOW ADHERENT
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Indications for use |
Contra- indications
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Formulary Choice Size Price Treatment Advice |
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Interpose (Non- adhesive)
Absorbent perforated plastic film faced dressing |
5x5 cm 10x10 cm 20x 10 cm |
£0.09 £0.15 £0.32 |
Can adhere to wound surface, irrigate off if necessary |
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Mepore (Adhesive border)
Absorbent perforated island dressing |
7x8cm 10x11cm 11x15cm 9x20cm 9x25cm 9x30cm 9x35cm |
£0.09 £0.19 £0.32 £0.39 £0.53 £0.61 £0.67 |
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NON- ADHERENT DRESSINGS |
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Indications for use
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Contra- indications
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Formulary Choice Size Price Treatment Advice |
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N-A Ultra
Silicone coated knitted viscose dressing |
9.5 cm x 9.5 cm
9.5 cm x 19 cm |
£0.33
£0.63 |
Ideal under compression or as primary contact with any wound that requires non adhesion |
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Atrauman
Knitted Polyester Dressing impregnated with Neutral triglycerides |
5 x 5 cm 7.5 x 10 cm 10 x 20 cm |
£0.24 £0.25 £0.56 |
Small holes will not damage granulation tissue on removal Fatty triglycerides give soothing feel to the dressing, without maceration of the surrounding tissue
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Mepitel
Soft silicone wound contact dressing |
5 x 7 cm 8 x 10 cm 12 x 15 cm 20 x 30cm |
£1.44 £2.88 £5.83 £15.28
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Expensive option, try the above options first To be cost effective the dressing is to remain in place for up to two weeks Irrigate holes at each dressing change to keep patent
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SEMI- PERMEABLE ADHESIVE FILM DRESSING
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Allow passage of water vapour and oxygen but not water and micro-organisms Waterproof and impermeable to bacteria Comformable and convenient Allow observation of the wound |
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Indications for use
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Contra- indications
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Formulary Choice Size Price Treatment Advice |
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Opsite Flexigrid
Vapour permeable adhesive film dressing
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6 x 7 cm 12 x 12 cm 15 x 20 cm |
£0.35 £1.00 £2.52 |
Film dressings are useful tools for measuring wound size
This dressing is more cost effective |
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Tegaderm
Vapour permeable adhesive film dressing
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6 x 7 cm 12 x 12 cm 15 x 20 cm |
£0.38 £1.23 £2.34 |
Easy to apply, useful when teaching relatives in the community |
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SEMI PERMEABLE ADHESIVE FILM DRESSING WITH ABSORBANT PAD
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Allow passage of water vapour and oxygen but not water and micro-organisms Provides a moist wound environment
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Indications for use
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Contra- indications
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Formulary Choice Size Price Treatment Advice |
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Opsite Plus
Vapour permeable film dressing with absorbent pad |
5 x 5 cm 8.5 x 9.5 cm 10 x 12 cm 10 x 20 cm 35 x 10 cm |
£0.28 £0.78 £1.06 £1.78 £2.95 |
Useful for slightly exuding superficial wounds eg. Post operative or post biopsy |
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Tegaderm Plus Pad
Vapour permeable film dressing with absorbent pad
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5x7 cm 9x10 cm 9x15 cm 9x20 cm 9x25 cm 9x35 cm |
£0.24 £0.61 £0.90 £1.32 £1.48 £2.50 |
Useful for slightly exuding superficial wounds eg. Post operative or post biopsy |
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HYDROGEL DRESSING |
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Amorphous cohesive material that takes the shape of the wound Rehydrates necrotic tissue and encourages autolytic debridement Requires a secondary dressing
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Indications for use
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Contra- indications
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Formulary Choice Size Price Treatment Advice |
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Purilon Gel
Amorphous cohesive material |
8 gms |
£1.55 |
Change every 1-3 days Daily if wound infected Use a secondary dressing to retain moisture
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HYDROGEL SHEET DRESSING |
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Non-Adhesive, high water content hydrogel sheet formed around a supporting blue polyethylene matrix Provides a moist environment at the surface of the wound Permeable to water vapour, gases and small protein molecules, but impermeable to bacteria Rehydrates dry, devitalised tissue and encourages autolysis Absorbs large amounts of exudate, turning “lumpy” and opaque Sheet dressing can be used for burns, scalds and radiation therapy damage Needs to be secured with tape, a secondary dressing or a bandage |
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Indications for use
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Contra- indications
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Formulary Choice Size Price Treatment Advice |
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Actiform Cool
Two sided clear transparent hydrogel formed around a supporting matrix |
5x 6.5 cm 10 x 10 cm 10x15 cm |
£1.59 £2.33 £3.35 |
Change every 1-7 days depending on the condition of the wound Daily changes are necessary if the wound is infected Increased odour may result as bacteria are drawn into the dressing. If this occurs, increase dressing changes until odour subsides Secure with appropriate secondary dressing or bandage Leave top liner in place unless wound highly exuding
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HYDROCOLLOID DRESSING |
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Indications for use
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Contra- indications
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Formulary Choice Size Price Treatment Advice |
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Comfeel Plus
Adhesive sheet dressings |
4 cm x 6 cm 6 cm x 8 cm 10 cm x 10 cm 9 cm x 11 cm 15 cm x 15 cm 18 cm x 20 cm |
£0.83 £1.96 £2.13 £3.40 £4.56 £5.05 |
Dressings should cover wound with at least 2 cm overlap Dressings can remain in place for up to seven days, depending on exudate level Patients can shower with dressing in place
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Comfeel Plus Transparent
Thin Hydrocolloid layer |
5 cm x 7 cm 9 cm x 14cm 15 cm x 20 cm |
£0.59 £2.15 £2.99 |
Dressings should cover wound with at least 2 cm overlap Dressings can remain in place for up to seven days, depending on exudate level Patients can shower with dressing in place |
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PROTEASE MODULATING MATRIX DRESSING |
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Sodium carboxymethylcellulose spun into a fibre As the fibres absorb exudate they form a gel sheet The fibres are absorbent and retain moderate to large amounts of exudate Gel retains its integrity on dressing removal
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Indications for use
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Contra- indications
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Formulary Choice Size Price Treatment Advice |
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Aquacel
Soft sterile non woven pad with hydrocolloid fibres |
5 cm x 5 cm 10 cm x 10 cm 15 cm x 15 cm
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£1.03 £2.44 £4.60
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Dressings can remain in place for up to seven days depending on exudate level |
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Aquacel Ribbon
Soft sterile non woven ribbon with hydrocolloid fibres |
2 cm x 45 cm |
£2.49 |
Loosely pack into cavity, leaving a tail for ease of removal Daily or alternate daily dressing depending on exudate level |
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ALGINATE DRESSINGS
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Dressing consists of sodium and calcium salts In contact with blood or exudate a hydrophilic gel is formed Helps haemostasis in bleeding wounds Formation of the gel encourages autolytic debridement Manufactured from different seaweed varieties Available in flat pad or rope
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Indications for use
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Contra- indications
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Formulary Choice Size Price Treatment Advice |
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Kaltostat
Calcium alginate fibre non woven pads |
5 cm x 5 cm 7.5 cm x 12 cm 10 cm x 20 cm 30 cm x 60 cm |
£0.84 £1.83 £3.63 £25.13 |
Dressing change depending on exudate level Irrigate wounds to remove dressing without discomfort |
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Kaltostat Wound Packing
Calcium alginate fibre non woven rope |
2 gms |
£3.40 |
Loosely pack into cavity, leaving a tail for ease of removal Daily or alternate daily dressing depending on exudate level Irrigate wound well to ensure all dressings removed |
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FOAM DRESSINGS |
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Absorbent dressings that maintain a moist wound environment Depending on dressing can absorb light to heavy exudate levels Low adherent and Comformable Can be used as a primary or secondary dressing Presented in various sizes and shapes to suit areas of the body Adhesive or non- adhesive dressings available |
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Indications for use |
Contra- indications |
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Formulary Choice Size Price Treatment Advice |
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Biatain Soft-Hold Dressing Non adhesive foam dressing |
10x10cm 15x15cm 10x20 cm |
£2.30 £3.82 £3.49 |
Soft adherent layer enabling easier application Helps to ease pain on removal
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Biatain Range Adhesive
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6cm diameter 12x12cm 18x18cm Sacral 23 x 23cm Heel 19 cm x 20cm |
£1.50 £2.25 £4.50 £3.85 £4.49 |
Adhesive border made of hydrocolloid based material |
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Mepilex Border
Absorbent soft silicone dressing |
7.5 x 7.5 cm 10 x 10cm 15 x 15 cm 15 x 20 cm |
£1.38 £2.49 £4.07 £5.11 |
To be considered only if use of the above dressings not appropriate
Used for wounds with compromised or fragile surrounding skin |
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3M Foam Adhesive (now Tegaderm) |
8.8x8.8 10x10 20x20 10x20 10x60 |
£2.13 £2.09 £5.65 £3.54 £11.96 |
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VACUTEX CAPILLARY DRESSING
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Three layered polyester filaments and polycotton fibres Creates a pulling action of interstitial fluid from the wound bed Encourages autolytic debridement
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Indications for use |
Contra- indications
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Highly exuding wounds Colonised wounds Fistulas or sinuses |
Arterial bleeds Vascular fungating wounds Heavily bleeding wounds
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Formulary Choice Size Price Treatment Advice |
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Vacutex
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10 x 10 cm 10 x 15 cm 10 x 20 cm 15 x 20 cm |
£1.66 £2.23 £2.68 £3.14 |
Line wound with NA Ultra prior to application Cut dressing to size of wound bed Create layers of dressing to fill cavity Seal with a film or occlusive dressing
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ANTIMICROBIAL DRESSINGS- Iodine Based |
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The use of topical antibiotics is not justified for the routine treatment of colonised or infected wounds An alternative to reduce wound bioburden are the antimicrobial range of iodine dressings Iodine dressings are potent antimicrobials with broad spectrum and little resistance The application of these antimicrobials in a slow release delivery system provides a continuous antimicrobial effect Iodine is available as povidone-iodine dressings, solutions, powders and sprays, or Cadexomer polysaccharide starch
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Indications for use
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Contra- indications
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Chronic exuding wounds Infected or heavily colonised wounds Malodorous wounds |
Known sensitivity History of thyroid disease Pregnant/ breast feeding Care with very large wounds Caution with renal impairment Patients receiving lithium No more than 150g of iodoflex /iodosorb per week Max duration up to three months in any single course of treatment
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Formulary Choice Size Price Treatment Advice |
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Inadine
Knitted viscose dressing impregnated with providone- iodine ointment 10% |
5 cm x 5 cm 9.5 cm x 9.5cm
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£0.30 £0.45 |
Wound contact layer for abrasions and superficial burns
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Iodoflex
Cadexomer iodine 0.9% in a paste form |
5 gms 10gms 17gms |
£3.65 £7.32 £11.58 |
Renew when saturated Daily if wound very wet Resembles mashed potato when needing renewal |
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Iodosorb Ointment
Cadexomer iodine 0.9% in ointment |
10gms |
£4.04 |
Apply to work surface to depth of approx 3 mm Resembles mashed potato when needing renewal |
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ANTIMICROBIAL DRESSINGS- Silver Based |
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The use of topical antibiotics is not justified for the routine treatment of colonised or infected wounds An alternative to reduce wound bioburden are the antimicrobial range of silver dressings Silver acts as a heavy metal by impairing the bacterial electron transport and some DNA functions Silver sulphadiazine is a safe, broad spectrum agent for topical use Effective against common pathogenic organisms |
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Indications for use |
Contra- indications |
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Chronic exuding wounds Infected or heavily colonised wounds Malodorous wounds
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Use with care for patients with renal, hepatic insufficiency Use with care in pregnancy, lactation, children and neonates Prolonged use or use over a large surface area will warrant review of systemic response to silver Appropriate use of silver dressings to be reviewed after maximum duration of one month Use of dressing should not exclude frequent reassessment of wounds including arterial and diabetic aetiologies Known sensitivity to silver |
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Formulary Choice Size Price Treatment Advice |
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Atrauman Ag
Non adherent tulle dressing impregnated with silver |
5 x 5cm 10 x 10 cm 10 x 20 cm |
£0.46 £1.12 £2.19
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Useful as a non adherent silver application Cover with secondary dressing |
Aquacel Ag
Protease Modulating Matrix containing 1.2% ionic silver
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5 x5 cm 10 x 10 cm 15 x15 cm 2g ribbon
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£1.74 £4.00 £7.82 £4.17 |
Not suitable for dry wounds or those covered with hard black necrosis
For deeper cavities or sinuses ribbon packing is generally preferred |
Contreet Foam Non Adhesive Range
Silver Foam dressing |
5 cm round 10x 10 cm 15 x 15 cm 20 x 20 cm
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£3.01 £7.18 £14.42 £20.34 |
Used in wounds with moderate to high exudates levels May cause transient discolouration of wound bed
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TYPE 1: LIGHTWEIGHT CONFORMING STRETCH BANDAGES |
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These bandages have a simple dressing retention function High degree of elasticity but with little power
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Indications for use
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Contra- indications
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To retain a dressing close to the wound Does not inhibit movement Does not restrict blood flow |
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Formulary Choice Size Price Treatment Advice |
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K- Band Knitted polyamide and cellulose contour bandage |
5 cm 7 cm All x 4 metres 10 cm 15 cm
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£0.18 £0.23 £0.25 £0.44 |
10 cm size should be minimal size used for the lower limb For fragile skin consider wool padding layer first |
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Easy Fix Polyamide and cellulose contour bandage |
5 cms |
£0.33 |
To use for bandaging toes in conjunction with lymphoedema bandaging |
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TYPE 2: LIGHT SUPPORT BANDAGES |
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Used to prevent oedema Gives support to mild sprains and strains Limited extensibility Used as a crepe bandage
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Indications for use
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Contra- indications
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For support without exerting undue pressure To prevent formation of oedema
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Formulary Choice Size Price Treatment Advice |
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K- Lite Knitted elastomer and Viscose bandage |
5 cm 7 cm All x 4 .5metres 10 cm 15 cm
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£0.49 £0.68 £0.89 £1.29 |
Acts as the second layer in the 4 layer bandage system |
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SUB-COMPRESSION WADDING BANDAGE |
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Soft Absorbent bandage
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Indications for use
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Contra- indications
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To protect vulnerable areas such as tissues and tendons Essential to apply prior to compression bandaging To provide padding to shape the leg prior to bandage application Absorbs exudate from highly exuding wounds
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Some patients may have sensitivity to the bandage and will need a cotton liner prior to application
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Formulary Choice Size Price Treatment Advice |
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Lantor (hospital use)
K-Soft |
5 cm All x 3 .5metres 10 cm 15 cm
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(Hospital only)
£0.40 (Community only) |
Acts as the First layer in the 4 layer bandage system
Useful under crepe bandage to protect frail limbs Eg the elderly |
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TYPE 3: COMPRESSION BANDAGES |
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Provides high compression used in the management of venous insufficiency and ulcerations Inappropriate application can lead to hazardous levels of pressure Full assessment of the patient including doppler studies essential prior to the application of the bandages Different classes of type 3 bandages (3a, 3b, 3c, )are designed to provide differing levels of pressure to the limb ALL COMPRESSION BANDAGES SHOULD HAVE WADDING LAYER APPLIED FIRST (See sub-compression wadding advice page)AND CAREFUL OBSERVATION OF EXTREMITIES AFTER APPLICATION OF BANDAGES
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Indications for use |
Contra- indications |
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Gross oedema Venous ulceration Post -thrombotic venous insufficiency
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Arterial insufficiency Inadequate training of bandaging technique Caution with diabetic patients
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Formulary Choice Size Price Treatment Advice |
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3a Light compression bandage (14-17 mmHg at ankle)
K- Plus
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10 cm x 8.7 cm stretched 15 cm
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£2.17 (Hospital only) |
Always apply toe to knee 50 % overlap Used as 3rd layer of 4 layer bandage system, but applied in a figure of eight |
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3b Moderate compression bandage (18-24 mmHg at ankle)
Coban cohesive bandage (Hospital) Ko-Flex Cohesive Bandage (community) |
10 cm x 6m stretched |
£2.76
£3.16
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Adheres to themselves but not the skin Fourth layer of 4 layer bandage system Used for sports injuries Do not apply with excessive tension Apply in spiral with 50 % overlap
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SURGICAL TAPES |
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Adhesive tapes are useful to retain dressings Permeable and non- woven
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Indications for use
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Contra- indications
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To secure non adhesive dressings
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Can cause irritation and allergic reactions Are occlusive and may cause maceration Creates a tourniquet if applied under tension |
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Formulary Choice Size Price Treatment Advice |
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Scanpor
Surgical synthetic adhesive tape |
1.25 cm 2.5 cm All x 5metres 5 cm
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£0.40 £0.64 £1.11 |
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Mefix
Permeable apertured non- woven surgical synthetic adhesive tape |
2.5 cm 5 cm All x 5metres 10 cm 15 cm 20 cm 30 cm
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£0.90 £1.58
£2.53 £3.45 £4.42 £6.34 |
Used when a wider tape coverage is required |
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SHORT STRETCH BANDAGES |
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Indications for use
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Contra- indications
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Oedema in limbs Venous Leg Ulceration Lymphoedema management
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Inappropriate application can lead to uneven application, or hazardous levels of pressure
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Formulary Choice Size Price Treatment Advice |
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Comprilan |
6 cm 8 cm 10 cm 12 cm
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£2.49 £2.90 £3.12 £3.80 |
To be applied over a wool padding layer Can be applied using various techniques eg putter, or in a spiral toe to knee at full stretch |
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Actico
Cohesive short Stretch
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10cm 12 cm
(Various other sizes available for use by Lymphodema specialist)
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£3.21 £3.76 |
To be applied over a wool padding layer Can be applied using various techniques eg putter, or in a spiral toe to knee at full stretch |
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TUBULAR BANDAGES |
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Available in different forms Some are elasticated, whilst others are gauze and stockinette Sizes vary to suit body area
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Indications for use |
Contra- indications
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To support muscle sprains, strains and joints To provide a skin coverage after dressings or creams applied To retain dressings in awkward parts of the body eg digits or trunks
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Caution with elasticated versions with arterial incompetence Always apply elasticated versions from toe to knee on the lower limb |
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Formulary Choice Size Price Treatment Advice |
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Elastic tubular bandage
Comfi grip
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Sizes B-G depending on body area and size 0.5 and 1m lengths |
Current prices unavailable. |
To provide support to sprains and strains Ensure arterial sufficiency before application |
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Tubular viscose stockinette
Comfi fast
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Colour coded red - beige depending on body area and size 1m, 3m and 5m lengths |
Current prices unavailable. |
Useful in the wet wrapping treatment of atopic eczema |
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Larval Therapy
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Sterile larvae from the greenbottle Lucilia Sericata Secrete proteolytic enzymes which soften necrotic tissue enabling the larvae to ingest the dead tissue Reduce the bacterial load in the wound Available in a “tea-bag” for superficial areas, although not as effective as the free range applications
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Indications for use |
Contra- indications
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All soft necrotic /sloughy wounds Osteomyelitis Abscesses Necrotising fasciitis
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Hard Dry necrotic tissue Fistula or wounds connecting to vital organs Wounds with exposed blood vessels
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Formulary Choice Size Price Treatment Advice |
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LarvE
Contact TVN's to order |
Made to fit wound size |
Approx £50 per application
On FP10 for community use |
Always remove hydrogels prior to application Protect surrounding skin from enzymes Use a foot bag for toes/ foot wounds Therapy less effective if patient is receiving Metronidazole
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VACUUM ASSISTED CLOSURE (V.A.C.)
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Application of localised negative pressure to the wound to encourage granulation Removal of interstitial fluid allows tissue decompression and enhanced blood flow Removes infectious materials Creates a negative environment and blood pulled into area along with beneficial white blood cells and growth factors.
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Indications for use |
Contra- indications
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Acute and traumatic wounds Arterial insufficiency ulcers Flaps Dehisced incisions Meshed grafts |
Fistulas to organs or body cavities Necrotic tissue Untreated osteomyelitus Malignancy in the wound Exposed arteries or veins N.B. Care with bleeding and anticoagulated patients
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Formulary Choice Size Price Treatment Advice |
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Refer to TVN's and VAC Policy to order
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Hire and dressing unit
Approx £50 per day |
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CAVILON BARRIER FILM
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No Sting transparent protective barrier film Forms a waterproof barrier Non alcohol base Non petroleum based so ensures incontinence aids do not clog
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Indications for use |
Contra- indications
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Skin exposed to bodily wastes, fluids, adhesive dressings and tapes Superficial skin break, stoma and peg sites Incontinence dermatitis
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Formulary Choice Size Price Treatment Advice |
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Cavilon
No sting Barrier film |
Foam applicator 1&3 mls
Spray bottle 28ml |
£4.98 £7.99 £6.67
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Treats skin breakdown Clean skin prior to application Apply uniform coating Reapply 48-72 hrs or more often if needed No need to remove film in between use |
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Cavilon
Durable Barrier Cream |
2gm sachet 28gm tube 92gm tube
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£7.58 £4.00 £8.15 |
Prevents skin breakdown Barrier against bodily fluids Apply sparingly in pea sized amounts |
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METRONIDAZOLE GEL- Odour Absorbing Products
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Contains antibiotic metronidazole Effective against anaerobic bacteria
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Indications for use |
Contra- indications
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Malodorous fungating tumours Malodorous wounds
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Those with a hypersensitivity to metronidazole Pregnant or lactating mothers Overuse will induce resistance |
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Formulary Choice Size Price Treatment Advice |
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Anabact 0.75% |
15g |
£4.47 |
Apply one or twice daily to the wound Consider oral metronidazole if odour is not controlled
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PARAFFIN TULLE DRESSING
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Yellow or soft white paraffin impregnated into open weave cotton Requires a secondary dressing
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Indications for use |
Contra- indications
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Clean superficial wounds
Not recommended as first line treatment only under specialist area prescription eg burns and plastic referral |
Change daily to prevent drying out and wound adhesion Granulation tissue can be incorporated into open weave and removed with dressing Heavily exuding wounds
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Formulary Choice Size Price Treatment Advice |
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Jelonet |
10 x 10cm |
£0.27 |
Use several layers to prevent dressing drying out and adhering to wound bed
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Sterile Dressing Packs
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Indications for use |
Contra- indications
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Awaiting update for clinical indications |
Awaiting update for contra-indications
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Formulary Choice Size Price Treatment Advice |
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Poly-field Soft Vinyl Patient Pack Sterile Pack containing: 1 Pair Powder Free sterile soft vinyl gloves 1 Polythene Sheet 7 Non Woven Swabs 1 Towel 1 White Polythene Disposable Bag 1 Apron
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Available in Small, Medium and Large… 50x45cm 10x10cm 43x38cm |
£0.52 |
Please specify on Prescription what size is required (size is in reference to glove size). |
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