WOUND MANAGEMENT FORMULARY - NHS North Somerset

Wound Management Formulary 

June 2012

Contents 

Introduction 3-4 

Page 

Wound Healing Continuum & Appropriate products 5-11 

NSPCT Wound Formulary 

Appendix 1 Criteria for using antimicrobial dressings 

Appendix 2 Using antimicrobial flow chart 

Appendix 3 A-Z Formulary dressings 

Appendix 4 Specialist Formulary 

Formulary Working Group 

12-19 

20 

21 

22 

23 

24 

NSCP and NHS NS Wound Management Formulary Version 2. June 2012 

2

Introduction 

This third edition of the NSPCT Wound Management Formulary is the result of a working 

group consisting of the Tissue Viability Nurse and members from Community Nursing, 

Community Hospital, Podiatry and G.P. Practices in North Somerset. The formulary has been 

designed to be used by all disciplines involved in managing patients with wounds, except for 

nurses working in Nursing Homes. A separate reduced formulary is available for this group 

and can be viewed on the NSCP website. 

The dressing choices offered are found to be effective for the majority of patients with wounds. 

This Formulary should be used in association with the: 

Aseptic Technique Policy (2011) 

Hand Hygiene Policy (2011) 

MRSA for Community Settings Policy (2011) 

NSCP Leg Ulcer Assessment Guidelines (2009) 

NSCP Pressure Ulcer Policy and Guidelines (2012) 

The Bristol, North Somerset, & South Gloucestershire (BNSSG) Joint Formulary 

Aims 

Best practice in wound management. 

To guide practitioners to select appropriate dressing choice 

Standardisation of appropriate products 

Cost effectiveness. 

Wound Management 

Dressings are applied to wounds for many reasons: 

To facilitate rapid and cosmetically acceptable healing 

To reduce pain 

To prevent or combat infection 

To contain exudate 

To remove or contain odour 

To provide maximum comfort for the patient 

Wound healing is a dynamic process and the characteristics of a dressing required by the 

wounds can change as the wound moves through the different phases of the healing process. 

The wound healing continuum, in the first section of this booklet, will aid clinical decisionmaking 

regarding appropriate dressings at each stage of wound healing. 

Using the formulary 

All wounds should be holistically assessed. The underlying pathology that may compromise 

wound healing should be identified and addressed where possible. 

A diagnosis of wound aetiology is essential as treatment pathways differ according to the 

aetiology of the wound. In NSCP additional guidelines are available, with clear treatment 

pathways, for leg ulcers and pressure ulcers, as dressings alone will not heal these wounds. 


3

The dressings in the formulary are suitable for the majority of wounds and for each wound 

stage there are two product choices to accommodate practitioner and patient preference. The 

choice of dressing should be made from the formulary list. A selection of dressings that might 

be needed in specific cases is also available on request to the tissue viability service and listed 

in appendix 4. 

Avoid using layers of dressings as far as possible. Most dressings are designed as wound 

contact layers in their own right. Putting them on top of one another only reduces their 

effectiveness and is wasteful. 

The dressings chosen should promote minimal interference with wounds and frequency of 

changes should normally reflect the maximum wear time. 

Dressings should be ordered on line using the ordering template. No more than a week’s 

supply of dressings should be left in the patient’s home, as the wound requirement will 

change, as it moves through the healing process. 

Hospital formularies are different to those in primary care and wounds should be reassessed, 

in the community, after discharge and care planned as appropriate to the formulary. 

New Products and Review of the Formulary 

The formulary will be completely updated once every 3 years but some changes to the 

dressings available on the template will occur annually. The changes will reflect current best 

practice. 

New products will be trialled and evaluated by the Tissue Viability Nurse and members of the 

Formulary Review Group. 

Topical Negative Pressure 

Topical Negative Pressure therapy is available for use in North Somerset Community 

Partnership if it facilitates hospital discharge, or prevents admission to hospital. There are 

strict criteria to follow for this. All referrals must be made to the Tissue Viability Nurse. 

Maggot Therapy 

Maggot therapy may be suitable for some wounds and is available on prescription. 

Practitioners wishing to use this therapy should have attended an education course prior to 

using this therapy. Please contact the Tissue Viability Nurse if you need further advice. 

Dressing Samples 

Manufacturers’ sales representatives often offer NSCP staff ‘samples’ of dressings. Samples 

should not be used to treat NHS patients and all offers should be declined 


4

Wound Healing Continuum and Appropriate Products 

Description of 

Wound 

Exudate Management Aims Product Choice 

Black Wound 

Black tissue is 

Necrotic tissue 

which is 

dehydrated. 

No – Low 

Exudate 

Facilitate removal of necrotic tissue 

by rehydrating the wound; this is 

essential if the wound is to heal. 

Use Purilon Gel with a low adherent 

dressing such as Atrauman and 

gauze or a film 

Actiform Cool is a sheet hydrogel 

dressing. The dressing is applied 

directly to the wound without the 

film backing removed. 

Hydrogel : 

Purilon Gel 

Actiform Cool 

Film : 

C-View 

Hydogel dressings may need 

changing daily or alternate days, as 

they are not effective if the wound 

becomes dry. 

Moist wound care is 

only appropriate for 

wounds with an 

adequate blood 

supply. Black 

wounds with an 

inadequate blood 

supply e.g. necrotic 

digits must be kept 

dry. 

Please contact the 

Tissue Viability 

Service if unsure if 

a wound is suitable 

for debridement. 

Hydocolloid dressings will debride 

providing minimal exudate is 

present. It promotes autolytic 

debridement by forming a gel on 

contact with exudate. 

Honey dressings debride and are 

also antibacterial. They are a good 

choice on malodorous wounds. 

Using foams, on this type of wound 

is generally not appropriate. The 

foam will reabsorb the gel and 

moisture that is required for 

autolysis. The wound will also need 

frequent dressing changes, which is 

not cost effective. 

Hydrocolloid : 

Tegaderm 

Hydrocolloid 

Honey Product: 

Activon tube 

Algivon 

Actilite 


5


Wound 

Black – Yellow 

Wound 

Necrotic tissue and 

yellow slough 


Low 

Exudate 

Promote removal of necrotic and 

sloughy tissue by autolysis. Provide 

moist environment. 

A hydrogel is required on black 

areas on a low exuding wound. 

If the wound is exudating a small 

amount, a hydrocolloid may be 

beneficial as it will form a gel in 

contact with the wound and will aid 

autolysis. 

Hydrogel : 

Purilon Gel 

Actiform Cool 

Hydrocolloid: 

Tegaderm 

Hydrocolloid 

Mod – 

High 

Honey dressings debride and are 

also antibacterial. Honey is a good 

choice on malodorous wounds. 

If the wound is wet, the exudate will 

need to be managed by using a 

more absorbent dressing. 

The formulary choices are, an 

alginate or a cellulose fibre gelling 

dressing. 

A hydrofibre ribbon should be used 

on wounds that require packing as 

the product has a knitted thread 

inserted to ensure no fibres are 

shed from the dressing. 

As these products absorb the 

exudate they gel, which aids 

autolysis. 

Foams should only be used if they 

manage exudate sufficiently to 

significantly decrease dressing 

changes. 

Careful consideration should be 

given to the choice of secondary 

dressing. If the wound needs 

daily or frequent changes, an 

absorbent dressing pad should 

be used. 

Honey product 

Activon tube 

Algivon 

Actilite 

Cellulose fibre 

gelling dressing: 

Durafiber 

Alginate: 

Sorbsan plus 

Hydofibre 

Aquacel Ribbon 

Foam : 

Biatain 

Allevyn 

Adhesive 

Tegaderm 

Foam 

Secondary Dressing: 

Dressing Pad 

Kerramax 


6


Wound 

Yellow Wound 

Slough is usually 

yellow or white 

Exclude possibility 

of pus and 

spreading infection 


Low 

Exudate 

Mod – 

High 

Facilitate removal of sloughy tissue 

to promote healing. Provide a moist 

environment for autolysis to occur. 

Depending on the level of exudate 

either a gel or a hydrocolloid may 

be appropriate. 

If using a gel cover with a low 

adherent dressing and gauze. 

Honey dressings will debride and 

are antibacterial. They are a good 

choice on malodorous wounds 

Actilite is a honey coated low 

adherent dressing and suitable on 

superficial wounds and under 

compression 

If the wound is wet, the exudate will 

need to be managed using an 

alginate, hydrofibre or cellulose fibre 

gelling dressing. As these products 

absorb exudate they gel, which aids 

autolysis. 

Hydrogel: 

Purilon Gel 

Actiform cool 

Hydrocolloid: 

Tegaderm 

Hydrocolloid 

Honey product 

Activon Tube 

Algivon 

Actilite 



Durafiber 

Alginate: 

Sorbsan Plus 

Cavity wounds should be packed 

lightly with a hydrofibre ribbon which 

is chosen because it does not shed 

fibres. 




changes. Silicone coated foams can 

be used if the skin surrounding the 

wound is delicate and there are 

concerns about damage on removal 

of dressing. 






be used. 

Hydofibre 


Foam: 

Biatain 

Allevyn 

Adhesive 

Tegaderm 

Foam 

Silicone Coated 

Foam: 

Siltec 

Allevyn Gentle 

Border 

Secondary Dressing: 

Dressing Pad 

Kerramax 


7


Wound 

Yellow – Red 

Wound 

Slough and 

granulation tissue 

present 


Low 

Exudate 

Mod – 

High 

Promote moist environment to 

enhance healing and slough 

removal. 

Depending on the level of exudate 

either a gel or a hydrocolloid may 

be appropriate. 

If using a gel cover with a low 

adherent dressing and gauze 

Light silicone coated foams should 

be considered, for patient comfort if 

the surrounding skin is fragile or to 

increase wear time of the dressing 

Actilite is a honey coated low 

adherent dressing and suitable on 

superficial wounds and under 

compression 

Manage exudate to enhance 

healing by using an alginate or 

cellulose fibre gelling dressing. 

These products gel as they absorb 

the exudate which aids autolysis. 


lightly with a hydrofibre ribbon which 

is chosen because it does not shed 

fibres. 






be used. 




changes 

Hydrogel: 

Purilon Gel 

Actiform Cool 

Hydrocolloid: 

Tegaderm 

Hydrocolloid 


Foam 

Siltec Lite 


Border Lite 

Honey product: 

Actilite 



Durafiber 

Alginate: 

Sorbsan Plus 

Hydofibre: 


Foam: 

Biatain 

Allevyn 

Adhesive 

Tegaderm 

Foam 


Foam 

Cutimed Siltec 


Border 

SecondaryDressing: 

Dressing Pad 

Kerramax 


8


Wound 

Exudate Management Aims 

Product Choices 

Red 

Granulating 

Wound 

Low 

Moist environment to promote 

active healing. 

Leave undisturbed for as long as 

exudate management allows. 

If problems with dressing adhering 

to the wound bed, first consider 

light silicone coated foam 

dressings 

Hydrocolloid: 

Tegaderm 

Hydrocolloid 

Low adherent 

Dressing 

Atrauman 

Adaptic Touch 

Telfa 

Beware of dark red 

tissue that bleeds 

easily, this can 

indicate high 

bacterial burden or 

infection if 

accompanied by 

other signs. 

Pink 

Epithelialising 

Wound 

Mod – 

High 

Telfa has been chosen for podiatry 

patients but can be considered for 

sutured wounds and a wound that 

is superficial with minimal exudate. 

Maintain moist environment and 

manage exudate. 

Manage exudate to enhance 

healing by using an alginate or 

cellulose fibre gelling dressing. 

These products gel as they absorb 

the exudate this aids autolysis 


lightly with a hydrofibre ribbon 

which is chosen because it does 

not shed fibres. 


Foam 

Siltec Lite 


Border Lite 



Durafiber 

Hydofibre 

Aquacel 

Ribbon 

Foam: 

Biatain 

Allevyn 

Adhesive 

Tegaderm 

Foam 

The aim of treatment at this stage 

of healing is to promote minimum 

disturbance of the wound and 

foams and silicone coated foams 

are usually the most appropriate at 

this stage of healing 


Foam 

Siltec/Siltec 

Lite 


Border 

Secondary 

Dressing: 

Dressing Pad 

Kerramax 


9

Signs of critical 

colonisation 

Exudate Management Aims & Use of 

Antimicrobial Products 

Product Choice 

Wound bed 

deterioration : 

High bacterial burden 

Increase in slough 

Increase in necrosis 

Dark granulation 

tissue 

Increase in malodour 

Increase in pain 

Increase in wound 

size 

Wound healing static 

Surrounding erythema 

Antimicrobial products are 

suitable for use of infected and 

wounds that are critically 

colonised with bacteria. 

They are indicated for shortterm 

use. If the wound has not 

responded to antimicrobials 

within 2 weeks it will not be 

effective and should be 

discontinued. 

Patient with wound infection 

should also be treated with 

antibiotic therapy.(Refer to the 

BNSSG formulary) 

Wound infection 

Increase in slough. 

Increase in necrosis. 

Increase in malodour. 

Increase in wound 

size. 

Increase in exudate 

that is often purulent 

or bloody. 

Spreading erythema 

Bleeding granulation 

tissue. 

Pockets of pus at 

base of wound. 

Wound painful. 

Patient feels unwell. 

Low 

Med/high 

Urgotull SSD is a non-adherent 

dressing impregnated with silver 

sulphadiazine. It does not require 

moisture to activate and is suitable 

for wounds needing silver 

dressings with low exudates. 

Silvercel is an absorbent 

antimicrobial dressing with a nonadherent 

layer designed to 

protect the wound bed particularly 

at dressing changes 

Iodoflex and Iodosorb contain 

iodine within a cadexomer matrix. 

The design of the dressing 

enables it to absorb large amounts 

of exudate. It is the most effective 

antimicrobial to deslough wounds. 

It is applied directly to the wound 

and changed when the colour 

changes. 

Urgotul SSD 

Silvercel 

Iodoflex 

Iodosorb 


10

Indolent Wounds with 

Delayed Healing. Exudate Management Aims Product 

Choice 

Wounds, which do not 

progress through the normal 

stages of healing, should be 

reassessed and any 

causative factors identified 

and treated where possible. 

Wounds that fail to 

progress through the normal 

stages of healing are 

pathophysiologically 

characterised by chronic 

inflammation and an 

abnormal balance between 

Matrix Metalloproteinases 

(MMP) and growth factors. 

Low 

Mod 

Suitable for chronic non-infected 

wounds on patients who are at 

risk of delayed healing. 

Corrects the biochemical 

balance between MMPs and 

growth factors to kick start the 

healing process. Results often 

not seen for 4 weeks 

Wounds that show no 

progress after six weeks 

using these dressings should 

be referred to the Tissue 

Viability Nurse for 

reassessment. 

Proteinase 

inhibiting 

dressing : 

Urgo 

START 

Contact 

Urgo 

START 

Please seek tissue viability 

support if dealing with an 

indolent wound with high 

exudate levels. 

Cutimed Sorbact is 

indicated for use on wounds 

that are stuck due to 

repeated critical 

colonisation. It can also be 

used first line on wet 

infected wounds 

Mod/high 

This dressing is coated with a 

natural fatty acid, which binds 

microbes to it. It is suitable for 

long-term use on wounds that 

do not progress due to frequent 

periods of critical colonisation. It 

is only suitable for wounds with 

moderate exudates levels. 

Cutimed 

Sorbact 


11

NSCP WOUND MANAGEMENT FORMULARY 

Dressing Type Indications and Tips Product Choice 

Film Dressings 

Vapour permeable films allow the 

passage of water vapour and 

oxygen but not water or microorganisms. 

Only suitable for superficial wounds 

with very low or no exudate. Not 

suitable for patients with thin friable 

skin as may cause damage on 

removal. 

C-view 

11x12cm 

15cm x 20cm 

Non/Low Adherent Wound 

Contact Dressings 

Atrauman is a non-medicated, 

polyester mesh dressing 

impregnated with neutral 

triglycerides. 

Used as a contact layer on larger 

wounds. Low Adherent 

Atrauman and N-A Ultra are 

dressings of choice under 

compression therapy. 

Profore Wound 

Contact Layer 

14 x 20cm 

N-A Ultra 

9.5 x 9.5cm 

Atrauman 

7.5 x10cm 

10 x 20cm 

20 x 30cm 

Telfa consists of a thin layer of 

absorbent cotton fibres, enclosed 

in a perforated sleeve 

Telfa is only suitable for podiatry 

use and as a secondary dressing 

over sutures or in wounds with 

minimal exudate. 

Telfa 

10cm x 5cm 

10cm x 12.5cm 

Adaptic Touch is a non-adherent 

silicone dressing 

Adaptic Touch can be left in situ up 

to 14 days. It can also be used to 

line a wound bed during topical 

negative pressure therapy 

Adaptic Touch 

5 x 7.6cm 

7.6 x11cm 

12.7 x15cm 

Acilite is a low-adherent viscose 

net dressing coated with 99% 

Manuka honey and 1% Manuka 

oil 

Actilite is a broad spectrum 

antimicrobial dressing for use on 

low exuding wounds. 

Actilite 

10x10cm 


12


Perforated film absorbent 

Dressings 

For superficial wounds with low 

exudate such as surgical wounds. 

Opsite Post Op 

9.5 x 8.5cm 

8.5 x15.5cm 

12 x 10cm 

10 x 25cm 

Perforated absorbent 

Dressings 

For superficial wounds with low 

exudate such as surgical wounds. 

Mepore 

6 x7cm 

9 x10cm 

9 x 20cm 

9 x 25cm 

Super Absorbent dressing 

Odour Absorbing 

Dressings 

These dressings absorb the 

molecules released by the wound 

which may be responsible for 

wound odour 

If exudate is a considerable 

problem requiring frequent dressing 

changes the secondary dressing 

should be a super absorbent 

dressing 

Useful in managing malodorous 

wounds such as leg ulcers or 

fungating wounds. 

Not a primary dressing and so 

must not come into contact with 

the wound. 

Kerramax 

10 x10cm 

10 x 22cm 

20 x 22cm 

Clinisorb 

10 x10cm 

10 x 20cm 

Paste Bandages 

Use to reduce inflammation and to 

treat varicose eczema in the lower 

limb. 

Can sometimes cause allergic 

reactions 

Ichthopaste 

7.5cm x 6m 

Zinc oxide 

impregnated 

medicated stocking 

17x 13 x 1cm 

Proteases inhibiting 

dressing 

Use in non-infected wounds in 

which are showing signs of delayed 

healing. 

Contain particles, which on contact 

with wound exudates are released 

The particles bind to the excess 

proteases thus promoting the 

activity of growth factors. This will 

kick start chronic indolent wounds. 

Urgo START 

contact 

5 x7cm 

11 x11cm 

Urgo START 

6 x 6cm 

10 x10cm 


13


Alginates 

Calcium Alginate derived from 

seaweed, which becomes a 

hydrophilic gel when in contact 

with wound secretions, providing 

a moist environment. 

Cellulose Fibre Gelling 

Dressing 

Durafiber is a highly absorbent, 

non woven gelling fibre filler 

dressing, which forms a soft 

cohesive gel sheet when it comes 

into contact with exudate 

Hydrofibre Dressing 

Aquacel ribbon is the choice for 

wounds that require packing. 

Hydrofibre dressings are highly 

absorbent and form a gel when in 

contact with the wound bed. The 

ribbon has a knitted thread 

running through the product. This 

minimises the risk of the dressing 

shedding particles into the wound 

Highly absorbent, appropriate for 

medium to heavily exuding wounds. 

Can be left on wound for 3 – 7 

days. 

Not suitable for dry or low exuding 

wounds. 

Alginates have a haemostatic 

component and are useful to stem 

bleeding in a wound. 

Not suitable for dry or low exuding 

wounds 

Both dressings can remain in place 

from 3-7 days 

Use the gelling fibre dressing 

Durafibre for wounds that do not 

require packing 

Use The hydrofibre dressing 

Aquacel for wounds that require 

packing 

Sorbsan Plus 

7.5 x10cm 

10 x15cm 

10 x 20cm 

Sorbsan Plus S A 

11.5 x14cm 

14 x19cm 

Durafiber 

5 x 5cm 

10 x10cm 

15 x15cm 


2g x 45cm ribbon 

1gx 45cm ribbon 

Honey Dressings 

Honey has antibacterial, 

desloughing and deodorising 

properties 

Activon 

25g 

Algivon 

5 x5cm 

10 x10cm 

Actilite 

10 x10cm 


14


Hydrocolloids 

Interactive when in contact with 

wound exudate. Absorbs fluid and 

becomes a gel. 

Suitable for desloughing wounds 

and promoting granulation so can 

be used at any stage of wound 

healing. 

For light to moderate exuding 

wounds. 

Caution should be taken when 

using occlusive dressings on 

diabetic patients as they can 

increase the risk of anaerobic 

infection. 

May cause hyper-granulation. 

Tegaderm 

Hydrocolloid 

10 x12cm 

13 x15cm 

Comfeel Plus 

Transparent 

5 x7cm 

10 x10cm 

Hydrogels 

Gels can rehydrate wounds and 

provide a moist environment 

Barrier Film 

Rehydrates necrotic and sloughy 

wounds to promote debridement. 

Can be used at any stage of 

healing from debridement to 

granulation. Not recommended for 

heavily exuding wounds. Requires 

a secondary dressing. 

Change dressing every 1 – 3 days. 

To protect vulnerable skin from 

exudate and moisture 

Actiform Cool 

5 x 6.5cm 

10 x10cm 

Purilon Gel 

8g 

No sting skin prep 

(name soon to be 

changed to Secura) 

1ml wipe = 41p 


15

Dressing Type 

Foam Dressings 

Absorbent polyurethane 

foam. 

Indications and 

Tips 

Foams absorb excess exudate from the 

wound surface whilst maintaining a moist 

healing environment. 

Available as flat sheets with or without an 

adhesive border. 

The rationale for using foams is extending 

wear time and comfort for the patient. 

Frequent removal of the adhesive dressings 

will cause damage to the surrounding skin. 

If frequent dressing changes are required 

consider using an absorbent dressing pad 

instead. 


Biatain 

5 x7cm 

10 x10cm 

15 x15cm 

20 x 20cm 

Allevyn Adhesive 

7.5 x 7.5cm 

10 x 10cm 

12.5 x 12.5cm 

17.5 x 17.5cm 

Soft Silicone 

Dressing 

Silicone and Silicone 

coated dressings are non 

adherent and are 

removed without trauma 

Cutimed Siltec is a foam dressing that has 

a silicone wound contact layer. This 

ensures that the dressing is removed with 

minimal trauma. 

Allevyn Gentle Border minimises pain and 

trauma to the wound at dressing change 

due to a silicone gel adhesive. 

Both these dressings should be chosen for 

patients with fragile skin 

Allevyn Adhesive 

(sacral) 

22 x 25 cm 

Tegaderm Foam 

10 x 11cm 

14 x 14cm 

Cutimed Siltec 

7.5 x 7.5cm 

10 x 10 cm 

Cutimed Siltec Lite 

5 x 6cm 

10 x10cm 

Allevyn Gentle Border 

7.5 x 7.5cm 

10 x 10cm 

12.5 x 12.5cm 

17.5 x 17.5cm 

Sacrum 

16.8 x 17.1cm 

Allevyn 

Gentle Border Lite 

5 x 5cm 

7.5 x 7.5cm 

10 x 10cm 

7.7 x 8.6cm (oval) 

5.5cm x 12cm 


16

Dressing Type 

Indication and Tips 


Gauze and Dressing 

Pads 

Used for exudate management. An 

effective primary dressing should first be 

chosen to provide an optimal environment 

for the wound to heal. 

Sterile Gauze 

10 x10cm x 25 squares 

Lower limbs that are exudating may benefit 

from compression or supportive bandages 

where appropriate. Seek advice if unsure 

about the suitability. 

Non sterile 

Dressing Pads 

10 x 12cm 

20 x 20cm 

20 x 40cm 

Sterile Dressing Pads 

20 x 20cm 

20 x 40cm 

K-Soft 

10cm x 3.5cm 

K-Soft Long 

10cm x 4.5m 

Tape Securing dressings and bandages Clinipore 

1.25cm x10m 

2.5cm x 10m 

Mefix 

5cm x 5m 

10cm x 5m 

Stockinette Securing dressings and bandages Comfifast 

Red line 3.5cm x1m 

Green line 5.0cm x1m 

Blue line 7.5cm x 5m 

Yellow Line 10.25cm x 

5m 


17


Antimicrobial 

Dressings 

High bacterial burden 

(critical colonisation) in a 

wound is a barrier to 

healing. 

Antimicrobial dressings 

should be used when 

there are clinical signs of 

critical colonisation 

present which are 

preventing the wound 

from healing. 

NB. Patients with diabetes 

do not always have 

obvious signs of wound 

infection and extra care 

should be taken with this 

group. 

Antimicrobials may reduce the bacterial 

burden and prevent further development 

of infection. Where cellulitis is present a 

swab should be taken and systemic 

antibiotics commenced. 

Cadexomer Iodine, Silver and Honey are 

effective against MRSA 

Iodoflex, and Silvercel are not suitable for 

dry or wounds with little exudate. 

NB: Iodine dressings should be used with 

caution with patients who have thyroid or 

renal disease. They should not be used on 

patients who are receiving Lithium or 

pregnant woman. The amount and time used 

must adhere to the manufacturers’ 

guidelines. 

Cutimed Sorbact binds bacteria to it and 

should be considered as an alternative to 

silver on patients who require frequent 

treatments with silver dressings. It is suitable 

for long-term use. 

If considering using an antimicriobial 

dressing, please see additional 

information in appendix one and two 

Inadine 

5cm x 5cm 

9.5 x 9.5cm 

Urgotul SSD 

10 x12cm 

15cm x 20cm 

Iodoflex 

5g,10g 

Iodosorb 

10g tube 

Silvercel 

5 x 5cm 

11 x11cm 

10 x 20cm 

Rope 

2.5 x 30cm 

Cutimed Sorbact 

Swab 

4 x 6cm 

7 x 9cm 

Ribbon 

2 x 50cm 

Pad 

7 x 9cm 

10 x10cm 


18


Compression 

Bandages 

Retention Bandage 

For use in the management of venous 

ulceration. 

Use in accordance with the Leg Ulcer 

Management Guidelines 

K Four 

K-Soft 10cm x 3.5m 

K-Lite 10cm x 4.5m 

K-Plus 10cm 8.7m 

Ko-Flex10cm x 6m 

K-Lite Long 

10cm x 5.25m 

K-Plus long 

10cm x 10.25m 

K-ThreeC 

10cm x 3m 

Coban 2 multilayer 

Bandage kit 

1 Kit 

Coban 2 Lite 

I Kit 

Actico Cohesive 

10cm x10m 

K-Band 

5cm x 4m 

10cm x 4m 

Irrigation Fluids 

Most wounds do not require cleaning; it is 

more beneficial to leave the wound bed 

undisturbed unless there is debris present. 

Normasol 

25 sachets 

Sterile Dressing 

Packs 

Softdrape 

Small glove 

Medium glove 

Large glove 

Skin Closures 

Steristrips 

6 x 75mm x 3 strips 


19

Appendix One 

Criteria for Starting Antimicrobial Dressings 

Antimicrobial dressings should only be considered for use on wounds that are 

infected or wounds that are critically colonised with bacteria. 

Wound infection should also be treated with 10 -14 days of antibiotic therapy. 

Signs and symptoms of high bacterial burden. 

Wound bed deterioration, increase in slough, necrosis 

Wound exudate increased and change in colour 

Wound has become malodorous 

Increase in pain / discomfort 

Discolouration of granulation tissue ( usually becomes darker) 

Friable bleeding granulation tissue 

Static Healing 

Erythema (redness) surrounding wound 

Additional Signs and symptoms of wound infection 

Friable bleeding granulation tissue 

Bridging of the epithelium 

Pockets of pus at the base of the wound 

Pyrexia patient often unwell 

Other reasons for deterioration must also be explored that may be associated with the 

patients’ general health and the control of any underlying disease processes. 

Diabetic control 

Adequate nutrition 

Anaemia. 

Consider the underlying cause of the wound and ensure this has been addressed as far as 

possible e.g. 

Pressure removed if a pressure ulcer 

Reversal of venous hypertension by compression therapy. 

The wound must be traced or measured and described before commencing an antimicrobial 

so that an accurate evaluation of the progress can be made 

Antimicrobial therapy should only be used whilst the symptoms are present to address the 

bacterial load and then discontinued. 


20

If the wound does not respond within 2 weeks of antimicrobial therapy it is not going to 

be effective. It should be discontinued and advice sought from the Tissue Viability 

Service. 


21

Appendix Two 

Using Antimicrobials in Wound Care 

Signs of critical colonisation 

Delayed healing (compared with 

normal rate for site/condition) 

Wound bed deterioration increase in 

slough or necrosis 

Wound has become malodorous 

Increase in pain/discomfort 

Increase in exudate and change of 

colour/consistency 

Wound static or deteriorating 

The patient is not generally unwell 

Use first line antimicrobial for 

two weeks. 

Silvercell or Iodofex/iodosorb 

(mod-high exudate) Urgotul 

SSD (low exudates) 

Signs of wound infection 

Wound bed deterioration increase in slough 

and/or necrosis 

Increased pain. 

Wound has become malodorous. 

Increase in exudates, which can be purulent 

or contain blood. 

Friable bleeding granulation tissue. 

Bridging of the epithelium 

Pockets of pus at the base of the wound 

Spreading erythema 

Patient usually feels unwell 

Swab wound 

Commence antibiotic therapy for 

at least 10 days duration. 

Use first line antimicrobial for two 

weeks. 

Silvercell or Iodofex/iodosorb 

(mod-high exudates) Urgotul SSD 

(low exudates) 

Evaluate outcome of treatment 

Signs and symptoms 

resolved. 

Stop Antimicrobials 


reduced 

Continue for two more 

weeks and then stop 


unchanged. 

Stop 

antimicrobials 

Reassess patient 

Seek advice from 

specialist nurse if 

required 

Wounds that respond to silver but deteriorate once silver is stopped 

should be treated with Cutimed Sorbact providing exudate is moderate. 

Please seek tissue viability support for MRSA infected wounds with low 

exudate.

Appendix 3 

Alphabetical list of dressings in NSPCT Formulary 

Actico cohesive (10cmx10cm) 

Actiform Cool (5x6.5cm, 10x10cm) 

Actilite (10x10cm) 

Activon tube honey. (25g) 

Adaptic Touch (5 x7.6cm,7.6 x11cm, 12.7x15cm) 

Algivon Manuca honey (5x5cm, 

10x10cm) 

Allevyn (5x5cm, 10x10cm, 20x20cm) 

Allevyn Adhesive (7.5cmx7.5cm, 

10x10cm, 12.5x12.5cm 17.5 

x17.5cm, 22 x 25cm) 

Allevyn Gentle Border (7.5cmx7.5cm, 

10cmx10cm, 

12.5x12.5cm)(17.5 x17.5cm) 

Allevyn Gentle Border Lite (5 x 5cm,7.5 x7.5cm 

10x10cm,7.7x8.6cm, 

5.5cm x 12cm) 

Aquacel Ribbon (2x45g,1cmx45cm) 

Atrauman (7x5cmx10cm, 10cmx20cm 

20x30cm) 

Biatain (5x7cm, 10x10cm, 15x15cm, 20x20cm) 

Clinipore tape (1.25cmx5m, 2.5cmx5m) 

CliniSorb (10x10cm, 10x20cm) 

Coban 2 Multilayer Bandage kit 

Coban 2 Lite Multilayer Bandage kit 

Comfeel Plus Transparent (5cmx7cm, 

10x10cm) 

Comfifast ( Red Line, Green Line, Blue Line, 

Yellow Line) 

Cutimed Siltec (7.5x7.5cm, 10x10cm,) 

Cutimed Siltec lite (5x6cm, 10x10cm) 

Cutimed Sorbact (swab 4x6cm, 7x9cm) 

(ribbon 2x50cm) 

(pad 7x5cm, 10x10cm) 

C View (11x12cm, 15 x20cm ) 

Dressing Pads Non sterile (10cm x 12cm, 

20x20cm, 20x40cm) 

Dressing Pads Sterile (20x 20cm 20x40cm) 

Durafiber (5x5cm, 10x10cm, 15x15cm) 

Ichthopaste (7.5cmx6m) 

Inadine (5x5cm, 9.5x9.5cm) 

Iodoflex paste (5g,10g) 

Iodosorb (5g tube) 

K-Band (5cmx4m, 10cmx4m) 

K-Four 

1. K-Soft (10cm x 3.5 cm,10cm x 

4.5cm) 

2. K-Lite (10cmx4.5m) 

3. K-Plus (10cmx 8.7m) 

4. Ko-flex (10cmx6m) 

K-four for ankles above 25cm 

Components K-lite (10cm x 5.25cm) 

K-plus (10cm x 10.25cm) 

Ko-flex (10cm x 7m) 

K-ThreeC (10cm x 3m) 

Kerramax (10x10cm, 10x22cm, 

20x22cm) 

Mefix (5cm x5m, 10cmx5m) 

Mepore (6x7cm, 9x10cm, 9x20cm, 

9x25cm) 

N-A Ultra (9.5mx9.5cm) 

No Sting Skin Prep (1ml wipes) 

Non-woven fabric swabs. 

(sterile 10x10cm) 

Normasol Sachets 

Op-site Post Op (9.5x8.5cm 

8.5x15.5cm, 12x10cm, 10 x 25cm) 

Profore Wound Contact Layer 

Purilon Gel (8g) 

Silvercel (5x5cm, 11x11cm, 10x20cm, 

2.5x30cm) 

Softdrape dressing packs (small, 

medium, large) 

Sorbsan plus (7.5x10cm, 10x15cm 

10x20cm) 

Sorbsan plus SA (11.4x14cm, 14x19cm, 

14x24cm) 

Steristrips (6 x 75mm) 

Tegaderm Foam (10x11cm, 

14x15cm) 

Tegaderm hydrocolloid (10x12cm, 

14x15cm) 

Telfa (10x5cm, 10x12.5cm) 

Urgo Start (6x6cm, 10x10cm) 

Urgo Start Contact (5x7cm, 11x11cm) 

Urgotul SSD (11x11cm, 16x2cm) 

Zinc oxide impregnated stocking 


23

Appendix 4 

Specialist Formulary 

This template has been posted on every joint nhs.net account and can be used to access a 

dressing that might be required for specific named patients. It is expected that formulary 

products will be used in the first instance and all requests must demonstrate a sound rationale 

for requesting the product. 

Alleyyn Heel dressing 10.5 x 13.5cm 5 per box 

Acticoat Flex 3 10x10cm 12 per box 

10x20cm 12 per box 

Mepilex 15cm x16cm 5 per box 

20cm x21 cm 

Octenaline Wound 300mls 1 

Cleaner 

Flaminal Forte 50g Tube 

Debrisoft 10x10cm 5 pads 

Urgo Clean 6x 6cm 10 per box 

10x10cm 10 per box 

Sorbion S Sachet 7.5 x7.5cm 10 per box 

10x10cm 

15x15cm 

20x20cm 

Sorbion Sana 8.5 x8.5cm 10 per box 

Biatain IBU 10x12cm 5 per box 

15x15cm 

Prosheild Plus 115g each 

Prosheild Spray cleaner 235mls each 

If you wish to request one of these products please complete the request form below 

Patients Name……………………………………………… 

Team requesting item ………………… ……………………… …………… 

Wound type 

Current 

dressing 

used and 

frequency of 

change 

Item 

requested 

Rational for 

request 

Number of 

boxes 

requested 

( no more 

than 2 weeks 

supply) 

Date approved and ordered…………… 

Reason for refusal ………………………………………………………………….. 

…………………………………………………………………………………………

Formulary working Group 

Linda Davies 

Jenny Dalton 

Sue Garrett 

Karen Hann 

Martyn Williams 

Tissue Viability Nurse 

Community Nurse Tynsfield Ward 

Practice Nurse Tudor Lodge Surgery 

Staff Nurse Clevedon Hospital 

Deputy Lead Podiatrist 

Wider Consultation 

Debbie Campbell 

Angela Stinchcombe 

Head of Medicines 

Management 

Medicines Management 

Pharmacist 

April 2012 

April 2012 

2 nd Version June 12 

1 st Version now superseeded

WOUND MANAGEMENT FORMULARY - NHS North Somerset

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