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 Formulary Chapter 26: A5 - Wound management products and elasticated garments - Full Chapter
Notes:

 Please note: silk garments are non-formulary

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A5.03.04  Expand sub section  Other antimicrobials
Flaminal ® Forte Gel
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First Choice
Green
Alginate gel. Moderate to heavily exuding wounds. Contains antimicrobial enzymes.

Type of wound product is suitable for
Colonised wound bed. More suited to sloughy wounds. Can be used on all wound types
Useful for cavity wounds and sinus’s
Requires a secondary dressing

Duration dressing remains on wound before changing
1-7 days

Frequency of dressing change
1-7 days dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Sensitivity to alginate dressings or polyethylene glycol
Full thickness burns

Rationale for inclusion in formulary
1st line antimicrobial in paediatrics
Consider as first line product if signs of colonisation or clinical infection
Does not cause cellular damage 
Kytocel®
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First Choice
Green
Absorbent gelling fibre wound dressing

Type of wound product is suitable for
Moderate to heavily exuding chronic and acute wounds that are sloughy and clinically infected.
Haemostatic properties for minor bleeds in superficial wounds
Autolytic debridement properties

Duration dressing remains on wound before changing
1-3 days

Frequency of dressing change
1-3 days, dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Allergy to Shellfish (Chitin)
Full thickness burns
Heavily bleeding wounds
Dry wounds

Rationale for inclusion in formulary
Cost effective
Alternative to available antimicrobials
Can be used on heavily exuding wounds 
Flaminal ®Hydro Gel
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Formulary
Green
Alginate gel. Low to moderate exuding wounds. Contains antimicrobial enzymes

Type of wound product is suitable for
Colonised wound bed. More suited to sloughy wounds. Can be used on all wound types
Useful for cavity wounds and sinus’s
Requires a secondary dressing

Duration dressing remains on wound before changing
1-7 days

Frequency of dressing change
1-7 days dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Sensitivity to alginate dressings or polyethylene glycol
Full thickness burns

Rationale for inclusion in formulary
1st line antimicrobial in paediatrics
Consider as first line product if signs of colonisation or clinical infection
Does not cause cellular damage 
   
Cutimed ®Sorbact
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Formulary
Amber
DACC coated dressings providing antimicrobial properties, available in a pad, gel, gel sheet, ribbon, round swab and rectangular swab

Type of wound product is suitable for
Colonised or clinically infected moist wound, suitable for any wound type

Duration dressing remains on wound before changing
1-3 days

Frequency of dressing change
1-3 days dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Do not use in combination with oils and creams
Known hypersensitivity to ingredients
Not for dry wound
Not for heavily exuding wounds

Rationale for inclusion in formulary
Alternative to available antimicrobials 
   
Kendall AMD®
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Formulary
Red
Absorbent, non adherent foam disc impregnated with PHMB. Double sided with a centre hole and radial slit
Type of wound product is suitable for
For use on pin sites, drains and tubes.
Duration dressing remains on wound before changing
1-7 days
Frequency of dressing change
1-7 days dependent on exudate levels
Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Not intended as a primary treatment for infection
Do not use as a primary treatment for full thickness burns
Not for patients sensitive to PHMB
Rationale for inclusion in formulary
Provides local exudate management and antimicrobial properties
Absorbent
Non adherent and semi occlusive
For specialist use only 
   
Prontosan Wound Gel 30ml
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Formulary
Amber
A gel containing betaine, a surfactant to remove biofilm and debris and PHMB to help control bacterial bioburden.

Type of wound product is suitable for
Cleansing, decontamination and moisturising of acute and chronic wounds including 1st and 2nd degree burns.

Duration dressing remains on wound before changing
Apply at each dressing change

Frequency of dressing change
As determined by the wound and exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
None

Rationale for inclusion in formulary
Gel to cleanse and decontaminate wounds
Antimicrobial
Breaks down biofilms in chronic wounds 
   
Prontosan Wound Irrigation Solution
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Formulary
Green
Wound irrigation solution containing betaine a surfactant to remove biofilm and debris and PHMB to help control bacterial bioburden.

Type of wound product is suitable for
Cleansing, decontamination and moisturising of acute and chronic wounds including 1st and 2nd degree burns.

Duration dressing remains on wound before changing
Apply at each dressing change

Frequency of dressing change
As determined by the wound and exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
None

Rationale for inclusion in formulary
Solution to cleanse and decontaminate wounds
Antimicrobial
Breaks down biofilms in chronic wounds
Can be used as an irrigation fluid with VAC Veraflow 
   
Suprasorb X + PHMB
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Formulary
Amber
Biocellulose gel sheet dressing with PHMB antimicrobial properties

Type of wound product is suitable for
Light to moderately, critically colonised or infected exuding wounds
Can be used on all wound types at all stages of wound healing
Can be cut or folded to wound shape size

Duration dressing remains on wound before changing
1-3 days

Frequency of dressing change
1-3 days, dependent on exudate levels

Caution/contraindications (when not to use the dressing, patient groups to avoid etc.)
Known sensitivity to PHMB or any components of the dressing
Heavily exuding wounds

Rationale for inclusion in formulary
Light to moderate exudate in clinically infected wounds.
Suitable for all wounds at all stages of wound healing
Doesn’t affect healthy cells, suitable for long term use when necessary
Specialist recommendation 
   
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Prescribing in children

The APC notes that the informed use of unlicensed medicines or of licensed medicines for unlicensed applications (‘off-label’ use) is often necessary in paediatric practice.

The APC advises GPs to consider specialist prescribing recommendations for Green and Amber medicines that are not subject to ESCAs or RICaDs in combination with the information provided in the BNFC which goes beyond that of marketing authorisations. The BNFC has been designed for rapid reference and the information presented has been carefully selected to aid decisions on prescribing.

  

Green

Medicines which are suitable for initiation and maintenance prescribing by primary and secondary care clinicians. These medicines should be initiated and prescribed within their licensed indications.  

Amber

Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate, or initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.

Some amber medicines require agreement with the local (internal) medicines committee prior to initiation; others may require a framework to support safe transfer and maintenance of care such as a RICaD or ESCA. The Formulary will be annotated to reflect these requirements.   

Red

Medicines for initiation and maintenance prescribing by Specialists only  

Black

Non-formulary medicines- medicines not recommended for routine primary care prescribing.  

Grey

Positive NICE TA and /or awaiting local clarification on place in therapy ; Please contact your Medicines Optimisation team for more information.  

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