Lotion SPF 30; E45 Sun SPF 50; Spectraban Ultra;

7: Lotion SPF 30; E45 Sun SPF 50; Spectraban Ultra;

dix Sunsense Ultra; Uvistat Lipscreen SPF 50, Uvistat Sun-

cream SPF 30 and 50. Appen Pruritus See Dermatitis, above

BNF 57

A8 Wound management products and elastic hosiery

A8.1 Wound dressings

A8.1 Wound dressings

A8.1.1 Alginate dressings

A8.1.2 Foam dressings

An overview of the management of chronic wounds A8.1.3 Hydrogel dressings

(including venous ulcers and pressure sores) and the A8.1.4 Hydrocolloid dressings

role of different dressings is given below, as is the NICE A8.1.5 guidance on difficult-to-heal surgical wounds; the notes Vapour-permeable films and do not deal with the management of clean surgical membranes

wounds which usually heal very rapidly. The correct A8.1.6 Low adherence dressing and

dressing for wound management depends not only on wound contact materials

the type of wound but also on the stage of the healing

A8.1.7 process. The principal stages of healing are: Odour absorbent dressings 893

cleansing, removal of debris;

A8.1.8 Dressing packs

granulation, vascularisation;

A8.1.9 Surgical absorbents

epithelialisation.

A8.1.10 Capillary dressings

Greater understanding of the requirements of a wound A8.1.11 Other dressings

dressing, including recognition of the benefits of main- taining a moist environment for wound healing, has

A8.2 Bandages and adhesives

895 improved the management of chronic wounds. A8.2.1 Non-extensible bandages

The ideal dressing needs to ensure that the wound A8.2.2 Light-weight conforming ban-

remains:

dages

moist with exudate, but not macerated;

A8.2.3 . Tubular bandages free of clinical infection and excessive slough; 895

free of toxic chemicals, particles or fibres;

A8.2.4 Support bandages

at the optimum temperature for healing;

A8.2.5 Compression bandages

undisturbed by the need for frequent changes;

Appendix

A8.2.6 Multi-layer compression ban-

at the optimum pH value.

daging

As wound healing passes through its different stages, A8.2.7 Adhesive bandages

variations in dressing type may be required to satisfy better one or other of these requirements. The type of

A8.2.8 Cohesive bandages

dressing depends on the type of wound or the stage of

A8.2.9 Medicated bandages

the healing process.

ound

A8.2.10 Surgical adhesive tapes

Functions of dressings manageme

Adhesive dressings

A8.2.11 900

A8.2.12 Skin closure dressings

Type of wound

Role of dressing

A8.3 Dry, necrotic, black Elastic hosiery 900 Moisture retention or rehydration

Yellow, sloughy

If dry, moisture retention or re-

A8.3.1 Graduated compression hosi-

hydration

nt

ery

If moist, fluid absorption Possibly odour absorption

A8.3.2 Accessories

Possibly antimicrobial activity

A8.3.3 Anklets

Clean, exuding

Fluid absorption

(granulating)

Thermal insulation

A8.3.4 Knee caps

Possibly odour absorption

A8.3.5 Lymphoedema garments

Possibly antimicrobial activity

Dry, low exudate

Moisture retention or rehydration

(epithelialising)

Low adherence Thermal insulation

Alginate, foam, hydrogel and hydrocolloid dressings are designed to absorb wound exudate and thus to control the state of hydration of a wound. There have been few clinical trials able to establish a clear advan-

884 A8.1.1 Alginate dressings

BNF 57 tage for any particular product. The choice between

Algisite (S&N Hlth.) different dressings depends not only on the type and

Algisite Ag

stage of the wound, but also on patient preference or tolerance, site of the wound, and cost.

£7.04; cavity dressing 2 g, 30 cm = £5.28 Uses antimicrobial dressing for moderately to heavily exuding

NICE guidance wounds

Algisite M , calcium alginate fibre, non-woven dressing,

Debriding agents for difficult-to-heal surgical wounds (April 2001) Alginate, foam, hydrocolloid, hydrogel, and poly-

Uses moderately to heavily exuding wounds saccharide (as beads or paste) dressings as well as

Algosteril (S&N Hlth.) maggots may reduce pain from difficult-to-heal sur- gical wounds. There is insufficient evidence to sup- port one debriding agent over another and choice

30 cm = £3.47

should be based on patient acceptability (including Uses moderately to heavily exuding wounds factors such as comfort and odour control), type and

Curasorb (Covidien) location of the wound, and total cost (including time for changing the dressings).

(other sizes D)

Dressings impregnated with an antiseptic, such as iod-

Curasorb Plus

ine, can be used to treat clinically infected wounds.

Dressings containing silver should be used when clin- Curasorb Rope , calcium alginate cavity dressing, 30 cm = ical signs or symptoms of infection are present, or when

£2.78, 61 cm = £4.88, 91 cm = £5.25 infection has been confirmed by microbiological inves-

Curasorb Zn

nt tigation. Medical grade honey has antimicrobial properties; it

(other sizes D)

Flaminal ageme (Ark Therapeutics)

may improve healing time in mild to moderate super-

ficial and partial thickness burns. Forte gel , alginate with glucose oxidase and lactoperoxidase,

man 15 g = £7.13

Protease modulating matrix dressings (section A8.1.3) Uses moderately to heavily exuding wounds alter the activity of proteolytic enzymes in chronic

Hydro gel , alginate with glucose oxidase and lactoperoxi-

ound wounds; the clinical significance of this approach is

dase, 15 g = £7.13

W yet to be demonstrated.

Uses lightly to moderately exuding wounds

8: Practices such as the use of irritant cleansers may be Kaltostat (ConvaTec) harmful and are largely obsolete; removal of debris and

dix (Alginate Dressing, BP 1993, type C). Calcium alginate fibre,

dressing remnants should need minimal irrigation with physiological saline.

Appen

Uses moderately to heavily exuding wounds Melgisorb (Mo¨lnlycke)

Calcium sodium alginate fibre, highly absorbent, gelling

A8.1.1 Alginate dressings

2.2 cm, (2 g) = £3.30 The gelling characteristics of alginate dressings vary

Uses moderately to heavily exuding wounds including leg ulcers, dermal lesions and traumatic wounds

according to the product used. Some products only gel to a limited extent to form a partially gelled sheet

SeaSorb (Coloplast) that can be lifted off; others form an amorphous gel that

SeaSorb Soft , alginate containing hydrocolloid dressing, can be rinsed off with water or physiological saline. A

secondary covering is needed. They are highly absor- Uses heavily exuding wounds bent and are therefore suitable for moderately or heavily

SeaSorb Soft Filler exuding wounds, but not for eschars or for dry wounds.

, calcium sodium alginate fibre, highly absorbent, gelling filler, 44 cm = £2.52

Dressings containing silver should be used when infec- Uses moderately to heavily exuding cavity wounds tion is suspected as a result of clinical signs or symp-

Sorbalgon (Hartmann) toms, or when infection has been confirmed by micro-

biological investigation. 10 cm = £1.55; cavity dressing, net price 2 g, 32 cm = £3.17 Acticoat Absorbent (S&N Hlth.)

Uses for moderately to heavily exuding wounds Calcium alginate dressing with a silver coated antimicrobial

Sorbsan (Unomedical) Sorbsan Flat , calcium alginate fibre, highly absorbent, flat

Uses antimicrobial dressing for moderately to heavily exuding wounds

Uses moderately to heavily exuding wounds; with silver, anti- ActivHeal (MedLogic)

microbial dressing for moderately to heavily exuding wounds Activheal Alginate , calcium sodium alginate dressing, 5 cm

Sorbsan Plus , alginate dressing bonded to a secondary

ActivHeal Aquafiber , non-woven, calcium sodium alginate

£5.20 Uses moderately to heavily exuding shallow wounds and ulcers Sorbsan Plus SA , alginate dressing with adhesive border

Uses moderately to heavily exuding wounds

BNF 57

A8.1.2 Foam dressings 885

toms, or when infection has been confirmed by micro- £6.40 Uses moderately to lightly exuding shallow wounds

biological investigation. Sorbsan Silver Plus , calcium alginate dressing with

Polyurethane Foam Dressing, BP 1993

Absorbent foam dressing of low adherence 20 cm = £8.65

Lyofoam

Uses antimicrobial dressing for moderately to heavily exuding

chronic wounds

£11.35 (Medlock)

Sorbsan Silver Plus SA , calcium alginate dressing with Uses treatment of burns, decubitus ulcers, donor sites, granu- absorbent backing and adhesive border, with silver, 11.5 cm

lating wounds

Uses antimicrobial dressing for moderately to heavily exuding For lightly to non-exuding wounds

chronic wounds

Polyurethane Foam Film Dressing with Adhesive Bor-

der

Sorbsan Ribbon

, 40 cm (with probe) = £1.99; with silver, 40 cm (with probe) = £3.97

Avazorb Border

Uses moderately to heavily exuding cavity wounds; with silver,

£1.90 (Advancis)

antimicrobial dressing for moderately to heavily exuding cavity

PolyMem

wounds

Tielle Lite

Sorbsan Surgical Packing , 30 cm (2 g, with probe) = £3.41; with silver , 30 cm (2 g, with probe) = £5.55 Uses moderately to heavily exuding cavity wounds; with silver,

For lightly to moderately exuding wounds antimicrobial dressing for moderately to heavily exuding wounds

Polyurethane Foam Film Dressing with Adhesive Bor-

Suprasorb A (Synergy Healthcare)

der

Lyofoam Extra Adhesive Uses moderately to heavily exuding wounds

= £1.95; (Medlock) Suprasorb P

Tegaderm Alginate (3M)

Tielle

Uses moderately to heavily exuding wounds

Tielle Packing Trufoam

(J&J)

(Unomedical)

Tielle Packing

Polyurethane Foam Film Dressing without Adhesive

Urgosorb (Urgo)

Border

Alginate containing hydrocolloid dressing without adhesive

Allevyn Lite

20 cm = £3.55; cavity dressing, 30 cm = £2.58 Uses moderately to heavily exuding wounds

Allevyn Thin

Urgosorb Silver , alginate containing hydrocolloid dressing, 20 cm = £3.96 (S&N Hlth) FlexiPore

30 cm = £3.41 Uses antimicrobial dressing for heavily exuding wounds

Lyofoam Extra

Appendix

With honey

Suprasorb M

Algivon (Advancis) Absorbent, non-adherent calcium alginate dressing impreg-

Suprasorb P

Healthcare)

Uses lightly to heavily exuding wounds; use with suitable sec-

ound

ondary dressing

Transorbent

Medihoney (Medihoney)

£5.55 (Unomedical)

manageme

Gel sheet , sodium alginate dressing impregnated with For moderately to heavily exuding wounds £4.20

Polyurethane Foam Film Dressing with Adhesive Bor-

Uses lightly to moderately exuding wounds

der

ActivHeal Foam Island

nt

£4.34 (MedLogic)

A8.1.2 Allevyn Adhesive Foam dressings

Foam dressings vary from products that are suitable for £7.18; (sacral) 17 cm x 17 cm = £3.70, 22 cm x 22 cm = £5.32 lightly exuding wounds to highly absorbent structures

(S&N Hlth.)

for heavily exuding wounds. They may also be used as Allevyn Plus Adhesive secondary dressings. In hypergranulating (or overgra-

(sacral) 17 cm x 17 cm = £4.48, 22 cm x 22 cm = £6.49 (S&N nulating) tissue (which may arise from the use of occlu-

Hlth)

sive dressings such as hydrocolloids), changing to a

Biatain Adhesive

more permeable product such as a foam dressing may

be beneficial. £4.76; 17 cm diameter (contour) = £4.59 (Coloplast) Dressings containing silver should be used when infec-

Copa Island

tion is suspected as a result of clinical signs or symp-

886 A8.1.2 Foam dressings

BNF 57

PermaFoam Cavi-Care (S&N Hlth.) Soft, conforming cavity wound dressing prepared by mixing Comfort

thoroughly for 15 seconds immediately before use and 20 cm = £4.59 (Hartmann)

allowing to expand its volume within the cavity. 20 g = £18.12

PolyMem Silver-containing foam film dressings

(Unomedical) Acticoat Moisture Control (S&N Hlth.) Three layer polyurethane dressing consisting of a silver Tegaderm Foam Adhesive

Tielle Plus Uses antimicrobial dressing for lightly to moderately exuding wounds

Tielle Plus Heel Hydropolymer Adhesive Dressing 26.5 cm = £4.37 (J&J)

Allevyn Ag (S&N Hlth.) Trufoam

Silver sulfadiazine impregnated polyurethane foam film

Polyurethane Foam Film Dressing without Adhesive Border

Uses antimicrobial dressing for exuding wounds ActivHeal Foam Non-Adhesive

Cautions large open wounds; sensitivity to sulphonamides; G6PD deficiency; significant hepatic or renal impairment; inter-

£3.78 (MedLogic) actions: Appendix 1 (sulphonamides)

nt

Advazorb Plus Avance (Medlock) (Advancis)

Silver impregnated polyurethane foam film dressing, without

ageme adhesive border

Allevyn

man

Allevyn Cavity , circular, 5 cm diameter = £3.86, 10 cm Uses antimicrobial dressing for lightly to moderately exuding wounds

ound W 4 cm = £6.60 (S&N Hlth.)

Allevyn Compression Biatain Ag (Coloplast)

(formerly Contreet Foam ) Silver impregnated polyurethane

dix £4.49 (S&N Hlth.)

Allevyn Lite

border

Appen

Allevyn Plus Cavity Askina Foam

Uses antimicrobial dressing for moderately to heavily exuding wounds

PolyMem (Unomedical) Biatain Non-Adhesive

Silver impregnated polyurethane foam film dressing, with adhesive border

£3.97 (Coloplast) Uses antimicrobial dressing for moderately to heavily exuding Copa

wounds Vacuum assisted closure products

Exsu-Fast (Synergy Healthcare) Dressing kit , Kit 1 (small wound, low exudate) = £28.04; Kit 2

(large wound, heavy exudate) = £35.83; Kit 3 (large wound, (fenestrated) = £1.22 (Covidien)

medium to low exudate) = £35.83; Kit 4 (small wound, heavy exudate) = £28.04

Kerraboot , (clear or white) extra small = £14.27, small = £14.55, large = £14.55, extra large = £14.27 (Ark)

(KCI Medical) V.A.C. GranuFoam

Uses diabetic foot ulcers Dressing kit , polyurethane foam dressing (with adhesive PermaFoam

(Hartmann) PolyMem

Venturi (Talley)

Wound sealing kit , flat drain, standard = £15.00, large = £17.50; channel drain = £15.00

(Unomedical) Tegaderm Foam

V1STA (S&N Hlth.) Dressing kit , flat drain, small = £16.52, medium = £20.70,

large = £26.28; round drain, small = £16.52, large = £26.28; Tielle Plus Borderless

channel drain, medium = £20.70 20 cm = £5.51 (J&J)

WoundASSIST (Huntleigh) Trufoam NA

Wound pack , small–medium = £20.50, medium–large = £23.50

BNF 57

A8.1.3 Hydrogel dressings 887

Wound drainage collection devices

Gel FX (Synergy Healthcare) , canister (with gel), 300 mL = £26.51 (KCI V.A.C Freedom Medical) Venturi , canister kit (with solidifier) = £12.50 (Talley)

Geliperm (Geistlich)

V1STA , canister kit, 250 mL (with solidifier) = £18.63, 800 mL (with solidifier) = £20.70 (S&N Hlth.)

£9.31 ( D)

WoundASSIST , canister, 500 mL = £20.00 (Huntleigh) Uses wound and ulcer dressing, burns, donor sites GranuGel (ConvaTec)

Hydrogel containing carboxymethylcellulose, pectin, and propylene glycol, 15 g = £2.13 Uses dry, sloughy or necrotic wounds, lightly exuding wounds,

A8.1.3 granulating wounds Hydrogel dressings

Hydrosorb (Hartmann) Absorbent, transparent, hydrogel sheets containing poly- Hydrogel dressings are most commonly supplied as an

urethane polymers covered with a semi-permeable film amorphous, cohesive material that can take up the

Hydrosorb

shape of a wound. A secondary covering is needed. These dressings are generally used to donate liquid to

Hydrosorb comfort (with adhesive border, waterproof), dry sloughy wounds and facilitate autolytic debridement but they may also have the ability to absorb limited

12.5 cm = £3.26

amounts of exudate. Hydrogel sheets are also available Uses second degree burns, donor sites; chronic wounds where which have a fixed structure; such products have limited granulation is unsatisfactory, including leg ulcers, pressure sores

fluid handling capacity. Hydrogel sheets are best Intrasite Conformable (S&N Hlth.) avoided in the presence of infection. Hydrogel products

Soft non-woven dressing impregnated with Intrasite gel, that do not contain propylene glycol should be used if

the wound is to be treated with larval therapy.

40 cm = £3.99 Uses for dry, sloughy or necrotic wounds, lightly exuding

ActiFormCool (Activa) wounds; granulating wounds Intrasite Gel (S&N Hlth.)

Hydrogel containing modified carmellose polymer and pro- Uses exuding or necrotic wounds; with compression bandaging

pylene glycol, 8-g sachet = £1.66, 15-g sachet = £2.22, 25-g for moderately to heavily exuding wounds

sachet = £3.29

Uses ActivHeal Hydrogel for dry, sloughy or necrotic wounds; lightly exuding (MedLogic) wounds; granulating wounds Hydrogel containing guar gum and propylene glycol, 15 g = £1.36

Mesitran (Unomedical) Uses dry or lightly exuding sloughy or necrotic wounds

Absorbent, semi-permeable dressings impregnated with Aquaform (Unomedical)

Hydrogel containing modified starch copolymer, 8 g = £1.57, 15 g = £1.91 Uses for dry, sloughy or necrotic wounds, lightly exuding

Uses pressure ulcers, diabetic ulcers, fungating wounds, donor wounds, granulating wounds

sites, surgical wounds, abrasions, and first and second degree burns

Aquaflo (Covidien) Mesitran Mesh , non-adherent wound contact layer, with-

Appendix

Hydrogel dressing, 7.5 cm diameter = £2.50, 12 cm = £5.16 Askina Gel (Braun)

Uses pressure ulcers, diabetic ulcers, donor sites, abrasions, Hydrogel containing modified starch and glycerol, 15 g = trauma wounds, post-operative wounds, and first and second £1.89 degree burns

Uses exuding, sloughy, or necrotic wounds

Novogel (Ford)

Citrugel (Advancis)

ound

Hydrogel containing polysaccharides, 15 g = £1.35 Uses sloughy or necrotic wounds; lightly exuding wounds

£10.94; 7.5 cm diameter = £2.73 Uses diabetic wounds, burns, leg ulcers, decubitus ulcers, donor

manageme

Coolie (Zeroderma)

sites

Hydrogel dressing with lint backing, 7 cm diameter = £1.96 Uses for sloughy or necrotic wounds, lightly exuding wounds,

Nu-Gel (J&J)

granulating wounds Hydrogel containing alginate and propylene glycol, 15 g = £2.05 Uses dry, sloughy or necrotic, lightly exuding or granulating

nt

Curagel (Covidien)

wounds Prontosan Wound Gel (Braun)

Hydrogel containing betaine surfactant and polyhexanide, Cutimed (BSN Medical)

30 mL = £5.97

Hydrogel , 8 g = £1.56, 15 g = £1.90, 25 g = £2.80 Purilon Gel (Coloplast) Cutinova Hydro (S&N Hlth.)

Hydrogel containing carboxymethylcellulose and calcium Polyurethane gel sheet with waterproof polyurethane film,

alginate, 8 g = £1.61, 15 g = £2.10 Uses for dry, sloughy or necrotic wounds; lightly exuding

= £4.94 wounds; granulating wounds Uses lightly to moderately exuding wounds

Suprasorb G (Synergy Healthcare) Flexigran (A1 Pharmaceuticals)

Hydrogel dressing containing carboxymethylcellulose and Hydrogel containing starch polymer and glycerol, 15 g =

£1.90 (amorphous gel) 6 g = £1.10, 20 g = £1.80

888 A8.1.4 Hydrocolloid dressings

BNF 57 Vacunet (Protex)

Sorbion S (H&R)

Non-adherent, hydrogel coated polyester net dressing, 10 cm Absorbent polymers in cellulose matrix, hypoallergenic Uses lacerations, abrasions, pressure ulcers, burns, surgical and

malignant wounds

With iodine Uses moderately to heavily exuding chronic wounds Iodoflex (S&N Hlth.)

Paste Suprasorb C (Synergy Healthcare)

, iodine 0.9% as cadexomer–iodine in a paste basis with gauze backing, 5-g unit = £3.73; 10 g = £7.46; 17 g = £11.81 Uses for treatment of chronic exuding wounds, such as leg

12 cm = £7.65

ulcers, apply to wound surface, remove gauze backing and cover; Uses lightly to moderately exuding chronic uninfected wounds renew when saturated (usually 2–3 times weekly, daily for heavily

exuding wounds); max. single application 50 g, max. weekly Tegaderm Matrix (3M) application 150 g; max. duration up to 3 months in any single

Cellulose acetate matrix, impregnated with polyhydrated course of treatment Cautions iodine may be absorbed, particularly from large wounds or during prolonged use; severe renal impairment; history

Uses chronic uninfected wounds of thyroid disorder Contra-indications children; patients receiving lithium; thyroid disorders; pregnancy and breast-feeding

Iodosorb (S&N Hlth.) Ointment , iodine 0.9% as cadexomer–iodine in an ointment

A8.1.4 Hydrocolloid dressings

basis, 10 g = £4.04; 20 g = £8.24 Powder , iodine 0.9% as cadexomer–iodine microbeads, 3-g

nt Hydrocolloid dressings are usually presented as a

sachet = £1.76 Uses for treatment of chronic exuding wounds, such as leg

hydrocolloid layer on a vapour-permeable film or ulcers, apply to wound surface to depth of approx. 3 mm and

foam. Because of their impermeable nature, hydro-

ageme

cover; renew when saturated (usually 2–3 times weekly, daily for colloid dressings facilitate rehydration and autolytic heavily exuding wounds); max. single application 50 g, max.

debridement of dry, sloughy, or necrotic wounds; they

man

weekly application 150 g; max. duration up to 3 months in any single course of treatment

are also suitable for promoting granulation. Fibrous Cautions iodine may be absorbed, particularly from large

dressings made from modified carmellose fibres resem- ble alginate dressings (e.g. Aquacel ound c wounds or during prolonged use; severe renal impairment; history ); these are not

of thyroid disorder

occlusive.

8: Contra-indications children; patients receiving lithium; thyroid

disorders; pregnancy and breast-feeding Dressings containing silver should be used when infec- tion is suspected as a result of clinical signs or symp-

dix Iodozyme (Insense) toms, or when infection has been confirmed by micro- Hydrogel (two-component dressing containing glucose oxi-

biological investigation.

Appen

Uses antimicrobial dressing for lightly to moderately exuding ActivHeal Hydrocolloid (MedLogic) wounds

Semi-permeable polyurethane film backing, hydrocolloid Cautions children; pregnancy and breast-feeding

Contra-indications thyroid disorders; patients receiving lithium Oxyzyme (Insense)

18 cm (sacral) = £3.24 Hydrogel (two-component dressing containing glucose oxi-

Uses lightly to moderately exuding wounds

Uses non-infected, dry to moderately exuding wounds Alione (Coloplast) Cautions children; pregnancy and breast-feeding

Semi-permeable hydrocolloid dressing with adhesive border, Contra-indications thyroid disorders; patients receiving lithium

Protease modulating matrix Protease modulating matrix dressings alter the activ- ity of proteolytic enzymes in chronic wounds; the clin-

Uses chronic and exuding wounds ical significance of this approach is yet to be demon-

strated. Aquacel (ConvaTec)

Cadesorb (S&N Hlth.) Ointment , starch-based, 10 g = £4.96, 20 g = £8.46

Uses chronic wounds free of necrotic tissue and infection Uses moderately to heavily exuding wounds Aquacel Ag

Promogran (J&J) Collagen and oxidised regenerated cellulose matrix, applied directly to wound and covered with suitable dressing, 28 cm (hexagonal) = £5.09, 123 cm (hexagonal) = £15.32

Uses antimicrobial dressing for moderately to heavily exuding Uses chronic wounds free of necrotic tissue and infection

wounds Aquacel Ag Ribbon

Promogran Prisma Matrix (J&J)

Collagen, silver and oxidised regenerated cellulose matrix, Uses antimicrobial dressing for moderately to heavily exuding applied directly to wound and covered with suitable dressing,

cavity wounds

28 cm (hexagonal) = £6.19, 123 cm (hexagonal) = £17.63

Aquacel Ribbon

Uses chronic wounds free of necrotic tissue Uses moderately to heavily exuding cavity wounds

BNF 57

A8.1.4 Hydrocolloid dressings 889

Askina Biofilm Transparent (Braun) Hydrocoll (Hartmann) Semi-permeable, polyurethane film dressing with hydro-

Hydrocolloid dressing with adhesive border and absorbent

Biofilm S (Braun) D Hydrocolloid dressing with polyurethane-polyester backing; also in powder form for direct application into wound, 10 cm

Uses lightly to moderately exuding wounds Biofilm

powder, 1 sachet = £1.82

NU DERM (J&J)

CombiDERM (ConvaTec) Semi-permeable hydrocolloid dressing without adhesive Dressing with hydrocolloid adhesive border and absorbent

Uses lightly to moderately exuding wounds CombiDERM N

Replicare Ultra (S&N Hlth.) Adhesive hydrocolloid dressing with outer semi-permeable

£4.34 Uses lightly to moderately exuding wounds

Comfeel (Coloplast) Uses lightly to moderately exuding wounds Soft elastic pad consisting of carmellose sodium particles

urethane film backing; available as sheets, powder in plastic Hydrocolloid and alginate dressing impregnated with silver, blister units and paste for direct application into the wound:

embedded in adhesive mass; smooth outer layer and poly-

Silvercel (J&J)

Uses antimicrobial dressing for moderate to heavily exuding = £1.19; powder 6 g = £4.04; paste 12-g sachet = £1.61; 50 g

wounds

= £6.33 Suprasorb H (Synergy Healthcare) Comfeel Plus (Coloplast)

Semi-permeable hydrocolloid dressing, with adhesive bor- Hydrocolloid dressings containing carmellose sodium and

Uses lightly to moderately exuding wounds Tegaderm Hydrocolloid (3M)

diameter = £3.18, 10 cm = £4.26, 15 cm = £6.42 Contreet Hydrocolloid (Coloplast)

Uses chronic wounds such as leg ulcers and pressure sores Semi-permeable, antimicrobial barrier dressing with ionic

Tegaderm Hydrocolloid Thin , semi-permeable, clear film

Uses antimicrobial dressing for low to moderate exuding venous leg ulcers

Appendix

Uses lightly to moderately exuding wounds

DuoDERM Extra Thin (ConvaTec)

Ultec Pro (Covidien)

Semi-permeable hydrocolloid dressing with adhesive border,

8: W

Uses lightly exuding wounds DuoDERM Signal , hydrocolloid dressing with ‘Time to

ound

Uses lightly to moderately exuding wounds

manageme

Versiva

(ConvaTec)

£5.64 Semi-permeable hydrocolloid dressing with fibre layer and Uses leg ulcers, pressure sores, diabetic ulcers, burns, post-

operative wounds Flexigran (A1 Pharmaceuticals)

nt

Semi-permeable hydrocolloid dressing without adhesive Uses chronic and acute exudating wounds Flexigran Thin

Versiva XC , hydrocolloid gelling foam dressing, with Granuflex (ConvaTec)

Hydrocolloid wound contact layer bonded to plastic foam

20 cm = £6.20

Granuflex Bordered Dressing Bio-cellulose dressings Suprasorb X (Synergy Healthcare) Uses chronic ulcers, pressure sores, open wounds, debridement

of wounds; powders, gel, and pastes used with sheet dressings to Biosynthetic cellulose fibre dressing

fill deep or heavily exuding wounds

(rope) = £5.99

Granuflex Paste ( D), 30 g = £2.73 Uses lightly to moderately exuding wounds

890 A8.1.5 Vapour-permeable films and membranes

BNF 57 Keloid dressings

heavily exuding wounds and are probably not suitable Silicone gel and gel sheets are used to reduce or

for chronic leg ulcers. They are most commonly used as prevent hypertrophic and keloid scarring. They

secondary dressings over alginates or gels; they are also should not be used on open wounds. Application

sometimes used to protect fragile skin of patients at risk times should be increased gradually. Silicone sheets

of developing minor skin damage. can be washed and reused.

Advasil Conform (Advancis)

Vapour-permeable Adhesive Film Dressing, BP 1993

Self-adhesive silicone gel sheet with polyurethane film (Semi-permeable Adhesive Dressing) Extensible, waterproof, water vapour-permeable poly-