WOUND MANAGEMENT FORMULARY - NHS North Somerset

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