WOUND MANAGEMENT FORMULARY - NHS North Somerset

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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 NSCP and <strong>NHS</strong> NS Wound Management Formulary Version 2. June 2012 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 NSCP and <strong>NHS</strong> NS Wound Management Formulary Version 2. June 2012 11
Page 1 and 2: Wound Management Formulary June 201
Page 3 and 4: Introduction This third edition of
Page 5 and 6: Wound Healing Continuum and Appropr
Page 7 and 8: Description of Wound Yellow Wound S
Page 9: Description of Wound Exudate Manage
Page 13 and 14: Dressing Type Indications and Tips
Page 17 and 18: Dressing Type Indication and Tips P
Page 21 and 22: If the wound does not respond withi
Page 23 and 24: Appendix 3 Alphabetical list of dre
Page 25: Formulary working Group Linda Davie

WOUND MANAGEMENT FORMULARY - NHS North Somerset

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