Wound Care Formulary

Transcription

1 Wound Care ormulary This formulary has been developed to support/advise healthcare professionals in the selection of the most appropriate choice of dressing when implementing a wound management plan. f there is any doubt about which product to use, please contact Tissue Viability or Leg Ulcer Nurse. Key Messages - Carry out a full wound assessment before requesting dressings from the formulary. - Refer to the wound images below to guide in the correct dressing choice for the type of skin visible. - Please do not over-order a specific dressing. seven day supply should be sufficient. t is important to remember that wounds change size and appearance therefore over-ordering of a particular product incurs waste and costs. - Wound assessments should be carried out weekly as a minimum to ensure the correct management plan is in place for the patient. - f wound healing does not progress as expected, please contact the Tissue Viability Team or Leg Ulcer Nurse for advice. Page 1 of 14

2 mage mage B mage C mage D mage mage Skin Tear nfected Wound pithelial Cavity Unstable schar Slough/Necrosis mage mage mage mage J mage K mage L Slough Leg Ulcer ranulation Necrotic eel Pressure Ulcer Burn Page 2 of 14

3 Wound Management Products (*no restrictions on use*) Product Uses Contraindications Types of Wound mage pprox. Cost Low dherence Dressings trauman dressing 5cm x 5cm 7.5cm x 10cm 20cm x 30cm Non adherent llows exudate to pass through to absorbent second dressing layer pply allowing a good margin onto healthy skin Skin tears Burns Superficial wounds C 5cm x 5cm (10) cm x 10cm(10) cm x 20cm (10) cm x 30cm (10) N Ultra Silicone coated viscose dressing 9.5cm x 9.5cm 19cm x 9.5cm Non adherent llows exudate to pass through to absorbent second dressing layer Skin tears Burns Superficial wounds C 9.5cm x 9.5cm (40) cm x 9.5cm (25) bsorbent Dressings Kliniderm 7.5cm x 7.5cm 20cm x 20cm 20cm x 30cm bsorption Reduces the risk of maceration ypoallergenic Non adherent DU PU Trauma wounds Leg Ulcers Post-op wounds C 7.5cm x 7.5cm (50) cm x 10cm (50) cm x 20cm (50) cm x 20cm (15) cm x 30cm (10) ydrogel Dressings ntrasite el 8g x 10 15g x 10 25g x 10 promotes debridement Do not use on dry, stable necrosis Not to be used on Diabetic patients Sloughy Necrotic Cavities J 8g x g x g x Page 3 of 14

4 Product Uses Contraindications Types of Wound mage pprox. Cost KerraLite Cool - non bordered 6cm x 6cm 12cm x 8.5cm 18cm x 12.5cm KerraLite Cool Border 8cm x 8cm 11cm x 11cm 15cm x 15cm mprove healing of lightly exuding wounds Cleans the wound, debriding necrotic tissue ncrease granulation tissue of chronic wounds Soothe and cool to minimize discomfort Protect against wound dehydration Barrier to the growth of bacteria elp prevent maceration of the peri-wound area (non-adhesive only) Not to be used on deep cavity wounds or sinuses nsure wound is haemostatic before use Necrosis Slough Radiation Burns Painful wounds aematomas L C 6cm x 6cm (5) cm x 8.5cm (5) cm x 12.5cm (5) cm x 8cm (5) cm x 11cm (5) cm x 15cm (5) Vapour-permeable ilm Dressings Leukomed Control 5cm x 7cm 7cm x 10cm 8cm x 15cm 10cm x 24cm 10cm x 35cm Post-op Suitable on wounds with an increased risk of infection Length of use up to 7 days. Surgical Traumatic 5cm x 7cm (10) cm x 10cm (10) cm x 15cm (10) cm x 24cm (10) cm x 35cm (10) Soft Polymer Dressings without absorbent pad trauman Silicone 7.5cm x 10cm 20cm x 30cm traumatic wound treatment Can be cut to size llows exudate to pass through Length of use up to 7 days. Superficial cute Chronic TNP as a WCL L D 7.5cm x 10cm (5) cm x 20cm (5) cm x 30cm (5) ydrofibre Dressings quacel xtra 5cm x 5cm 15cm x 15cm 2cm x 45cm ribbon Moderate to heavily exuding wounds Debridement of slough/necrosis Moisten product with water before use if wound bed is dry Leg Ulcers PU s DU Trauma Surgical 5cm x 5cm (10) cm x 10cm (10) cm x 15cm (10) cm x 45cm (5) Page 4 of 14

5 Product Uses Contraindications Types of Wound mage pprox. Cost Urgoclean Pad 6cm x 6cm 15cm x 20cm Debridement of slough/necrosis Moderate to heavily exuding wounds Use up to 7 days Do not use in combination with hydrogen peroxide, organomercuric antiseptics or hexamidine. Leg Ulcers PU s Diabetic Ulcer Trauma Surgical 6cm x 6cm (10) cm x 10cm (10) cm x 20cm (10) oam Dressings Urgotul bsorb dressing 6cm x 6cm 15cm x 20cm Moist wound healing environment Less risk of maceration No trauma or disturbance to the wound bed PU s Leg Ulcers Skin tears Trauma Post-op C K 6cm x 6cm (10) cm x 10cm (10) cm x 20cm (10) Urgotul bsorb Border 8cm x 8cm 10cm x 25cm 13cm x 13cm 15cm x 20cm 20cm x 20cm sacral Moist wound healing environment Less risk of maceration No trauma or disturbance to the wound bed PU s Leg Ulcers Trauma Post-op Skin tear C K 8cm x 8cm (10) cm x 10cm (10) cm x 25cm (10) cm x 13cm (10) cm x 20cm (10) cm x 20cm (10) lginate Dressings Kaltostat dressing 5cm x 5cm 7.5cm x 12cm 2g Packing Useful for achieving haemostasis moderate to highly exuding wounds Known sensitivity to Kaltostat or its components Post-op Chronic cute 5cm x 5cm (10) cm 12cm (10) cm x 20cm (10) g packing (5) Page 5 of 14

6 Product Uses Contraindications Types of Wound mage pprox. Cost Odour bsorbent Dressings Clinisorb Charcoal dressing Used to control malodour in wounds Not indicated as a primary dressing for dry wounds Malodourous ungating 10cm x 20cm (10) ntimicrobial Dressing Povidone odine dressing 5cm x 5cm 9.5cm x 9.5cm Prophylaxis of infection in wounds ntimicrobial s get easily transferred into the wound Maximum two week use Known renal problem, use with caution in thyroid diseases DU PU Leg ulcers Skin tears 5cm x 5cm (25) cm x 9.5cm (25) Tracheostomy Dressings Lyofoam T 9cm x 6.5cm ctiveal T Tracheostomy care only 9cm x 6.5cm (10) cm x 10xm (10) Page 6 of 14

7 RSTRCTD ORMULRY - products below may only be used with prior consent from Tissue Viability/Leg Product Uses Contraindications Types of Wound mage pprox. Cost Protease modulating matrix dressings UrgoStart 15cm x 20cm Low to moderate exuding wounds Can be used under compression Contraindicated in cancerous wounds or fistulas which may reveal a deep abscess Leg Ulcer PU s DU s 15cm x 20cm (10) Physical Debridement Pads Debrisoft Pad Can either be used to replace an existing debridement method, e.g. autolytic debridement, or to complement other methods, e.g. to maintain the benefits of surgical or sharp debridement. f emollients have been used, skin should be washed before using Debrisoft Patient with a known sensitivity to Polyester Leg Ulcer PU s DU s Trauma Post op yperkeratosis 10cm x 10cm (5) Vacuum assisted closure therapy Renasys dressing small medium large Protect an incision to reduce complications post-surgery Stabilize traumatic wounds untreated osteomyelitis presence of necrotic tissue with eschar Chronic cute Traumatic D (5) (5) (5) Bolster skin grafts exposed organs, blood dehisced Renasys canister 300ml canister 750ml canister Prevent and treat wound dehiscence Progress non-healing wounds Manage highly exuding wounds vessels or nerves malignancy in the wound bed Ulcers Partialthickness (5) (5) Renasys Y connecter non-enteric or unexplored fistula burns laps & grafts (singles) 3.58 Renasys carry strap anastomotic sites (singles) 6.00 Page 7 of 14

8 RSTRCTD ORMULRY - products below may only be used with prior consent from Tissue Viability/Leg Product Uses Contraindications Types of Wound mage pprox. Cost Renasys gauze Renasys large drape Renasys oam filler 10cm x 25cm Renasys port kit Pico Wound Therapy System 10cm x 30cm 10cm x 40cm 15cm x 15cm 15cm x 20cm 20cm x 25cm 25cm x 25cm Medicated Bandages Only available for stock within: Constable Theatres Central Delivery Theatres ldham Ward reat Tey Ward. ll other requests MUST be authorised by Tissue Viability Nurse except where Consultant led decision for use. PRCUTONS anticoagulation therapy difficult wound haemostasis non-concordant/combative patients Untreated malnutrition Wound close to blood vessels or delicate fascia s for Renasys Post-op (singles) (singles) 5.57 (singles) 8.35 (singles) ll Pico cost per pack Viscopaste dressing Moist wound healing environment over an ulcer. mpregnated with zinc paste. Comfortable and soothing Where venous insufficiency exists, Visopaste may be used under graduated compression bandaging after first assessing the patient to exclude arterial disease. The use of Doppler ultrasound is recommended for this purpose. Leg Ulcers Varicose czema (singles) 5.22 Page 8 of 14

9 RSTRCTD ORMULRY - products below may only be used with prior consent from Tissue Viability/Leg Product Uses Contraindications Types of Wound mage pprox. Cost Maggots Bio bag 2.5cmx4cm 5cmx4cm 5cmx6cm 12cmx6cm 10cmx10cm Retention 30cmx30cm (1 vial) 30cmx30cm (2 vials) Retention boot net kit pack 30cmx30cm (1 vial) 30cmx30cm (2 vials) Special order only Patient details and 24 hours notice required Maggots can be used to treat dirty or infected wounds as they remove dead tissue and bacteria (germs), leaving behind healthy tissue that can heal. The maggots used in this treatment are specially bred and are sterile so they cannot cause infection. pply a barrier product to surrounding skin. Must not be used on wounds that have a tendency to bleed or are close to a major blood vessel. Should not be used on patients on anticoagulants where the relevant clotting marker is not within clinical range. Should be used with caution on wounds over/adjacent to exposed organs or leading to a body cavity and then only under close supervision. Leg Ulcers Pressure Ulcers B dditional Larvae dditional Larvae Page 9 of 14

10 RSTRCTD ORMULRY - products below may only be used with prior consent from Tissue Viability/Leg Product Uses Contraindications Types of Wound mage pprox. Cost Superabsorbent clypse non adherent dressings Boot Rapid absorption igh capacity luid repellent backing Strength and durability Do not use on arterial bleeds or heavily bleeding wounds. Do not cut the absorbent pockets on the clypse Boot dressing. (5) Zetuvit Plus dressings 15cm x 20cm 20cm x 25cm 20cm x 40cm Superabsorbent dressing that contains a blend of cellulose fluff and fluidretaining superabsorbent particles. Water-repellant, air permeable, nonwoven layer protects against contamination. Soft consistency for a cushioning effect. Superficial, heavily exuding acute and chronic wounds (10) 7.23 (10) (10) (10) (10) laminal orte el 5 x 15g or moderate to heavy exuding wounds Once opened, can be sealed and reused on same patient until expiry date Debridement ntimicrobial bsorbs excessive exudate Protects wound edge Cannot be used on the eyelid or in the eye Not indicated for patients with a known allergy to components LU PU s DU ungating Radiotherapy Skin tears Donor sites D L B laminal ydro el 5 x 15g or slight to moderately exuding wounds Keeps the wound bed clean and moist Offers antimicrobial protection Reduces wound odour caused by bacteria Cannot be used on the eyelid or in the eye Not indicated for patients with a known allergy to components DU 2 nd degree burns Oncology wounds Leg ulcers Skin tears B D RSTRCTD ORMULRY - products below may only be used with prior consent from Tissue Viability/Leg Page 10 of 14

11 Product Uses Contraindications Types of Wound mage pprox. Cost ntimicrobial odoflex Paste auze 5g x 5 10g x 3 ntimicrobial cover ffective broad spectrum bacteria Removes slough and debris as high capacity to absorb exudate Creates a moist wound environment Maximum two week use Do not use on dry necrotic tissue Use with caution in people with thyroid dysfunction and with renal impairment nfected Chronic exuding wounds ydroclean Plus 7.5x7.5cm 10x10cm Maximum of x 2 treatments cleanses, debrides, desloughs and absorbs, for optimal wound bed preparation Promotes the natural process of autolytic debridement bsorbs necrosis, fibrinous material, bacteria and exudate Moderately exuding wounds with slough and/or necrosis (10) (10) quacel g dressing 5cm x 5cm 15cm x 15cm 20cm x 30cm 2cm x 45cm ribbon Maximum two week use ntimicrobial or infected or at risk of infection Large absorption capacity Chronic e.g. PU s, LU s, DU s, fungating cute e.g. post-op, abrasions B (10) (10) (5) (5) (5) Urgotul SSD 10cm x 12cm 15cm x 20cm Maximum two week use ntibacterial contact layer ntibacterial on 117 germs, including MRS Pain-free dressing changes Moist wound-healing Do not use in individuals with a known sensitivity to any of the components of the dressing. Do not use on patients undergoing MR scans. void contact with electrodes or conductive gels during electronic measurement procedures Non exuding Low exuding nfected Can be used in cavity wounds B (16) (16) oney Page 11 of 14

12 RSTRCTD ORMULRY - products below may only be used with prior consent from Tissue Viability/Leg Product Uses Contraindications Types of Wound mage pprox. Cost ctilite Manuka oney Tulle 5cm x 5cm 20cm x 30cm 30cm x 30cm 30cm x 60cm Non-adherent viscose net dressing coated with 99% Manuka honey and 1% Manuka oil nti-bacterial - kills harmful bacteria liminates odours without masking them Osmotic effect - harmful tissue is drawn away from the wound bed Maintains the ideal moist wound healing environment Monitor B levels in Diabetes Do not use if allergic to bee venom. Discomfort can be experienced when honey is applied, consider an appropriate level of analgesic. Discomfort usually subsides, if continues, discontinue and irrigate with saline solution. ranulating/or epithelialising wounds. Cuts, abrasions, burns, surgical wounds, leg ulcers, pressure ulcers, diabetic ulcers and infected wounds. - L (10) 6.13 (10) (10) (10) (5) (5) MDONY Medihoney ntibacterial Medical oney 20g tube Promote the removal of necrotic tissue and advance a wound toward healing. totally natural product which is 100% pure medical grade Manuka honey Provides broad spectrum antimicrobial activity and is effective against biofilms anti-inflammatory liminates malodour, thus improving patient s quality of life Provides autolytic debridement, djusts wound p to the range 3-4 creating the optimum environment for wound healing s safe to be used on all ages including paediatrics and neonates The sealable tube can be used for up to 4 months from opening Safe to use of Diabetic patients - monitor blood glucose levels llergy to honey, in this instance it is recommended not to be used. Due to the low p, some patients may notice transient stinging, even pain. f stinging does not stop or persists, a clear protocol for analgesia needs to be followed Deep wounds and sinus cavities nfected and malodorous Necrosis and slough Surgical, post op wounds, donor sites and recipient graft sites Leg ulcers (mixed aetiology ulcers) and DU 1st and 2nd degree burns D L (5) Page 12 of 14

13 RSTRCTD ORMULRY - products below may only be used with prior consent from Tissue Viability/Leg Product Uses Contraindications Types of Wound mage pprox. Cost MDONY s above 100% medical CS with adhesive border: Manuka honey gel nner 7.2cm x 7.2cm, outer 11cm x 11cm nner 11.5cm x 11.5cm, outer 15cm x 15cm nner 4.5cm x 16.5cm, outer 7.5cm x 20cm MDONY pinate 1.9cm x 30cm 63% active Manuka* honey offers proven antimicrobial and anti-inflammatory actions n all in one low profile dressing (adhesive version) ensures ease of application, suitable under compression entle release of honey into the wound provides a low p environment and autolytic debridement, encouraging faster wound healing bsorption of exudate into the dressing is as a solid gel, thus maximises wear time and minimising dressing changes ighly flexible, transparent dressing offers a soothing and cooling effect on application, improving patient comfort traumatic removal minimises disruption to the wound, reducing pain Can be cut to treat different shaped wounds and around exit tube sites Consider use of barrier product to periwound skin Delivers broad spectrum antimicrobial activity. Provides additional absorbency ffective against biofilms Can be easily cut and shaped to fit any wound Cannot be used on third degree burns s above 100% medical Manuka honey gel Cannot be used on third degree burns Page 13 of 14 Diabetic oot Ulcers Leg Ulcers (venous, arterial and mixed aetiology ulcers) Pressure Ulcers 1st and 2nd degree burns Donor sites Traumatic Wounds Surgical and post op wounds Skin tears Suitable for neonatal and paediatric patients LU s DU s PU Sloughy raft/donor sites (10) (10) (10) B D J L (5) (5) 24.40

14 RSTRCTD ORMULRY - products below may only be used with prior consent from Tissue Viability/Leg Product Uses Contraindications Types of Wound mage pprox. Cost MDONY ntibacterial honey tulle dressing 5cm x 5cm Contains 100% medical grade Manuka honey ffective against biofilms Provides autolytic and enzymatic debridement through osmotic action nti-inflammatory - reducing oedema liminates malodour Can be left in place for 7 days s above CS dressing Leg ulcers PUs nfected Sloughy Donor sites 1 st and 2 nd degree burns C (5) 9.22 (5) Page 14 of 14