Wound Dressing Guidelines€¦ · dressings in situ and change outer secondary dressing only. This range of products can be insitu for 7-14 days – always check with manufacturer

This Guideline has been approved by: The Area Prescribing Committee – Review 2016

Wound Dressing

Guidelines

This guideline is written for use within Harrogate & District NHS Foundation

Trust, Primary and Secondary care settings. It is based on the best

evidence available at the time of publication. This guidance includes

evidence-based recommendations from which it is intended decisions can

be made for use in daily practice


Acknowledgements

This document was produced by: - Alison Elsworth Tissue Viability Nurse Specialist HDFT (01432 812844) Vera Nedyalkova Tissue Viability Nurse Specialist, HDFT (01423 812844) Lynne Boyd Matron for Adult Community Services, HDFT (01423 545769) Ann Cobb Community Services Senior Nurse, (Quality) HDFT (01423 812844) Sarah Turnbull Governance Pharmacist, Pharmacy dept. Harrogate and District NHS Foundation Trust (01423 554403) This Guideline has been produced in consultation and collaboration with clinicians throughout the Harrogate and District NHS Foundation Trust area. The wound continuums have been adapted from work carried out by David Gray & his team at Wounds UK (Aberdeen & London).


Contents

Wound Dressing Guidelines

Ordering codes for products

The Wound Continuum

Principles of wound assessment

Hand washing

Wound aetiology

Leg Ulceration

Lymphoedema

Diabetic / Ischaemic Ulceration

Burns

Skin Tears

Malignant / Fungating wounds

Reduced Skin Integrity

- Pressure Ulcers - Moisture Lesions

Issues that may complicate healing

Wound Pain

Infection

Hypergranulation

Slough

Exudate

Periwound dermatology problems

Nutrition

Other information


November 2013 Wound Dressing Guidelines

The aim of this evidence based guideline is to aid the practitioner in the choice of dressings and not to remove clinical expertise or skill of any individual. It should be noted that patients should be assessed holistically and treatment planned appropriately for their individual needs. Consent must be obtained prior to procedure. Guidelines to be used in conjunction with the relevant wound management, pressure ulcer and leg ulcer policies within your organisation.

Type, Indications &

Comments Dressing Name

Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Sterile Dressing Packs

Both types of dressing packs contain latex free gloves

Dressit (medium/large) contains: 1 pair Vitrex Gloves / 1 Large Apron 1 Disposable bag / 1 Paper towel 4 Softswabs 4ply / 1 Absorbent pad 1 Sterile field / Tape Measure Nurse It contains 1 pair of powder free, latex free nitrile gloves,1 large apron, 1 Disposable bag/2 sterile fields, paper towel, paper measuring tape, seven non-woven swabs, disposable forceps, disposable bag

Wound cer 3 contains: 5 x Swab Non Woven 7.5 x 7.5cm 4ply 1 x Paper Towel 1 x Orange Bag 1 x Pair of Medium Latex Gloves Powder Free Walleted 1 x Triangular Gallipot Tray 1 x Sterile Field

Dressit Small/medium Medium/large

(For use on FP10)

Or

Nurse It Small/medium Medium /large

(For use on FP10)

Wound care 3- national opt II (From NHS supplies)

1

1

1

60

52

60

36

Solutions for Irrigation

For Irrigation. Use at room

temperature. (Warm before

use).

Irripod Sodium Chloride 0.9%

Stericlens

Sodium Chloride 0.9%

20ml (x 25 pods)

100ml bottle

23 576

200

23 576

460


ADD note

Place Prontosan “gauze soak”

to the wound bed for 10

minutes. Remove then apply

appropriate wound dressing.

Prontosan Solution Wound irrigation solution

containing Betaine which is a gentle effective surfactant which

penetrates, disturbs and removes biofilm and wound debris

40ml amp x24

350ml

14.00

4.58

Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Adhesive Remover

No-sting, non -cold, silicone-based medical adhesive remover

Peel-easy

50ml Spray

Wipes (30)

7.10

11.66

Skin Protectants

Apply sparingly. If the after-feel is oily, too much has been applied.

Prevents skin breakdown associated with incontinence and other bodily fluids. Moisturises and replenishes severely dry skin without reducing tape and dressing adhesion

Protective, transparent barrier film

A dimethicone-based skin

protectant. Indicated for intact

and injured skin

Cavilon Durable Barrier Cream

Cavilon No Sting Barrier Film

Proshield Plus

2g sachet (20 pack)

28g

92g

28ml spray

5 x 1ml foam

applicator

5 x 3ml foam

applicator

115g

666

719

813

822

Foam Cleansers

For use as an alternative to soap and water for cleansing skin following contamination with urine, faeces, perspiration where there is high risk of skin breakdown.

Proshield Foam & Spray cleanser

Vernacare – Senset Foam (Only available through NHS Supplies)

235 ml

300ml

638

DT

NA

110


Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Emollients

To re-hydrate dry skin. If applying to leg, ensure product is applied in downward strokes to reduce risk of folliculitis Dermol 500 lotion is an anti-microbial for direct application onto skin or can be used as a soap substitute Requires prescribing by GP

Add 1 -2 capfuls of bath and shower emollient to warm water in a lined bowl or bucket for washing legs when required. Humectant containing emollient-urea and glycerine. Urea retains water and increases skin moisture restoring the barrier function of the skin Lauromacrogols act as a topical anaesthetic and have an anti-puritic effect.

Doublebase gel

Epaderm Cream

Dermol 500 lotion

Hydromol ointment (Hospital Use)

Doublebase bath and shower emollient

Balneum Cream

Balneum Plus Cream

100g 500g

50g 500g

500ml

125g 500g

500ml 1 litre

50g 500g

100g 500g

265 583

168 686

604

284 482

361 411

285 997

329 1499


Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Wound measurement grids Only available from NHS Supply Chain or direct from manufacturers

Wound care grid

145x214mm

50

Odour control

For use on wounds which require management of malodour, a charlcoal Can be applied directly to the wound or as a secondary dressing if exudate present.

Clinisorb

10 cm2

10 x 20 15 x 25

184 245 395

Gauze swabs To cleanse wounds in addition or as an alternative to dressing pack

Gauze swabs

7.5x7.5

(Sterile) 8ply

10x10 8ply

(Non-sterile)

39

Pack (5)

79

(100)

Absorbent Perforated

Low absorption capacity and only suitable for lightly exudating superficial wounds.

Low adherence dressings with adhesive border. Shower proof.

Softpore

6 x 7 10 x10 10 x 15 10 x 20 10 x 25 10 x 30 10 x 35

6 13 20 35 40 49 58

Physical Debridement pad

Removes wound debris, necrotic material, slough and exudate and even long standing hyperkeratotic tissue from surrounding skin.

DebriSoft

A maximum of 2 dressings must be ordered.

10 cm

2

627

Adhesive Tapes

Permeable, hypoallergenic synthetic tape

More cost effective to order as 10m role. Permaeable non-woven synthetic tape

Chemifix

Clinipore

2.5cm x 10m 5cm x 10m

10cm x 10m

1.25cmx5m 2.5cmx10m

5cmx5m

100 140 210

35 73 99


Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Soft Silicone & Wound Contact Layer

For use on superficial or acute traumatic wounds where dressing adherence is a risk. For fragile skin. A

secondary absorbent dressing is required (changed as necessary).

Primary wound contact layer.

Non-adherent polyester mesh,

1mm pore size and impregnation

of neutral triglycerides, prevents

penetration of granulation tissue

Into dressing. Petrolatum free,

effective up to 7 days.

Primary wound contact layer

For most cost effective use -

where appropriate - leave

dressings in situ and change

outer secondary dressing only.

This range of products can be

insitu for 7-14 days – always

check with manufacturer

guidelines in the first instance.

Always Use Clinical Judgement.

Able to irrigate through dressing if

required.

To be used where adherence of products to a wound is likely.

These dressings are NOT to be

used if wound is heavily

bleeding. Consider an alginate

or UrgoClean as an alternative.

Change outer dressing in between times.

Atrauman

N-A Ultra

Mepitel One

Urgotul

5x5

7.5x10 10x20 20x30

9.5 x9.5 9.5 x 19

6 x 7 9 x 10

13 x 15 24 x 27.5

5 x 5

10 x10 10 x40

15 x15 15 x 20 20 x 30

26 27 61

169

33 63

159 319 645 1738

152 303 1020 645 859 1381


Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Vapour-Permeable or Semi-Permeable Adhesive Film Dressing

Use on superficial, shallow wounds such as cuts, abrasions, scalds, donor sites, postoperative wounds, sores and ulcers. Self-adhesive & waterproof to allow bathing.

Film dressings to be used only

as a primary dressing on lightly

exudating wounds.

Contra-Indications Do not use on infected wounds, deep cavity wounds, third degree burns or wounds with moderate to heavy levels of exudate. The exudate may become trapped beneath the film causing skin maceration and inflammation.

C-View

Mepitel Film

6 x 7 10 x 12 12 x12 15 x 20

6.5 x 7 10 x 12 10.5x 25 15.5 x 20

38 102 109 236

49

131 255 324

Absorbent Dressings

For moderate to highly exuding

wounds. May be used as

primary or secondary dressing.

Superabsorbent dressings

Can be used under

compression

Zetuvit E

Flivasorb

Flivasorb adhesive

KerraMaxCare

Eclypse Foot Eclypse Boot Eclypse Boot

10 x10

10 x 20 20 x 20 20 x 40

10 x10

10 x 20

20 x 20 20 x 30

12 x12 15 x15

10x10 10x22 20x22 20x30

33 x 48

60 x70

55 x47

21 24 38

107

88

105 186 235

127 167 295 337

790 1378 990


Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Absorbent Management of moderate to highly exuding wounds For awkward to dress areas Atraumatic non-adherent primary dressing for low to highly exuding wounds. Can be used under compression Superabsorbent leg/foot wrap dressings. Do not use on arterial bleeds or heavily bleeding wounds Management of moderately to highly exuding wounds, with adhesive border

Sorbion Sachet Extra

Sorbion Sachet Multi Star

Sorbion Sana Gentle

Sorbion Sachet Border

5x5 7.5 x 7.5 10 x10

10 x 20 cm 20 x 20 20 x 30

8x8 14x14

8.5 x8.5

12 x12

12 x 22

22 x22

22 x32

15 x 15cm

25 x 15cm

145 178 225 373 700 999

299 489

199 249 449 799

1099

449 699

Hydrocolloid (Semi-Permeable)

Facilitate rehydration & autolytic debridement of dry, sloughy, or necrotic wounds. Suitable also for promoting granulation.

Hydrocolloids are not recommended to be used on diabetic foot ulcers.

For no or low exudate Useful for traumatic wounds, superficial burns, skin abrasions or removal of foreign bodies Free from animal products

Comfeel Plus

Transparent (shower proof)

5 x7

5 x15 5x25

10 x10 9 x14 9 x29 15 x15 15 x20

66 155 253 125 239 339 327 332


These types of dressings are not suitable for infected wounds. Dressing should seal round the borders of the wound.

For low exuding wounds. Absorbent hydrocolloid dressing with added alginate for absorption. Shaped for difficult to dress areas

Comfeel Plus Ulcer (Shower proof)

Comfeel Plus Contour

20 x20

4 x6 10 x10 15 x15 20 x20 18 x20 (sacral)

6 x8 9 x11

334

94 240 515 741 560

218 378

Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Alginate

Shallow/Sloughy Wounds

Highly absorbent. Forms a gel on contact with wound exudate. A secondary dressing is required. Squares can be cut or torn into strips and loosely packed into the cavity of

deeper wounds. (Can be used on

bleeding wounds).

For Cavity Wounds Ribbon or rope for small, deep, open, wet wounds and sinuses. Use flat dressing for larger open wounds.

Sorbsan Flat

Urgosorb

Sorbsan Ribbon with probe

Sorbsan Packing

Urgosorb Rope

5 x5 10 x10 10 x 20

5 x5

10 x10 10 x 20

40cm

30cm

30cm

81 171 320

87

208 382

204

347

270

Hydrogel

An appropriate secondary dressing is required and should be chosen carefully.

Not suitable for infected or heavily-exuding wounds.

For low exuding / dry “flat” wounds.

Consider use when wounds are painful. Use for debridement to soften and rehydrate tissue Not to be used for deep cavity wounds

Aquaform Hydrogel

ActiFormCool

To hydrate dry tissue the dressing top liner should be left in place to occlude the wound.

For exudating wounds both

8g

15g

5 x 6.5 10 x10

10 x 15

166 202

178 261 375


and sinuses.

Must be checked daily or on alternate days initially. There may be odour associated with use of this product.

liners should be removed to improve moisture/vapour transmission.

May be kept in place up to

7days. Change when it

becomes discoloured or

opaque

Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Foam

Can be used as primary or secondary dressings depending on wound type, site, size, depth, tissue type,

exudate levels. In hyper-granulating tissue, which may arise from use of occlusive dressings such as

hydrocolloids, changing to a more permeable product such as foam dressings may be beneficial.

These dressings may be kept in place for up to 7 days.

For patients with sensitive skin.

Choose dressing type appropriate to level of exudate & position of wound.

For patients with sensitive and/or fragile skin

Biatain Silicone

BiotainSilicone Lite

Biatain non adhesive

Urgotul Absorb Border

7.5 x7.5 cm 10 x10cm

12.5x12.5cm 15x15cm

17.5x17.5cm

7.5x7.5cm 10x10cm 12.5x12.5

5 x7 10 x10 10 x20 15 x15 20 x20

8x8 10 x 10 13 x 13 15 x 20

20x20

Sacrum

6 x 8.5 10 x10

140 206 252 374 497

128 232 383 427 635

135 195 239 389

425

180 215


Mepilex Lite

Mepilex

.

(Consult TVN )

Mepilex Border

Mepilex Border

Sacrum

15 x15

10 x 11 11 x 20 15 x 16 20 x21

20 x50

7 x 7.5 10 x 12.5 10 x 20 10 x 30

15 x 17.5 17 x20

15 x15 18 x18 23 x23

417

266 439 482 728

2825

138 272 369 555 469 607

334 485 791

Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Foam – Shaped

Shaped Foam Dressings: - May be used for awkward areas such as heel, knee or elbow, low to high exuding wounds. May be kept in place for up to 7 days

Tegaderm Foam Adhesive

Tegaderm foam adhesive heel

6.9x9.6 mini

wrap 6.9x7.6 mini

oval 10x11

14.3 x15.6 19x22.2 oval

13.9x13.9 14.3x14.3

166

142

233 412 676

410 344


Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Hydrofiber

Ensure dressing extends at least 2 cm beyond the wound margin by selecting an appropriate size

In-patient use For medium to high exuding wounds. Should be covered with an appropriate secondary dressing.

Aquacel Foam dressings

May be used as a secondary dressing for Aquacel range if exudate level very high Ensure central pad is at least 2cm larger than the wound size.

Aquacel Useful for wet & sloughy

wounds. Can be layered if required in high exudate levels

Aquacel Foam Adhesive

Aquacel Foam Non-Adhesive

Ribbon

2 x 45cm 1 x 45cm

8 x8

10 x10 12.5 12.5 17.5 x17.5

21 x21 25 x30

5 x5 10 x10

15 x15 20 x 20 15 x20

239 179

137 235 307 520 761 985

131 248 417 680 570

Antimicrobial

Antimicrobial dressings may be used for critically colonised or clinically infected wounds to reduce bacterial load. Dressing selection should be dependent on tissue type, level / viscosity of exudate, size, type, position and depth of wound.

Alginate

Flaminal is a hydroactive colloid dressing with alginates. Flaminal contains a biological (enzymatic) anti-microbial system. Cover the entire wound-bed with product and apply a suitable non-occlusive secondary dressing.

15g covers approx 40cm2

During Flaminal® Forte treatment, whitish, sticky alginate flakes may appear in the wound. This indicates that the wound is too dry for Flaminal® Forte treatment. In such case, use Flaminal Hydro. Nozzles are also available Both may be left in place as long as gel structure remains unaltered. (1-4 days, depending on the amount of exudate).

Flaminal Hydro

Can be recapped for single patient use.

Flaminal Forte

Can be recapped for single patient use.

15g tube

15g tube

752

752

810

810


Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

PHMB

PHMB (Polyhexamethylene biguanide) has a broad spectrum activity against bacteria, viruses and fungi. An alternative to other antimicrobial products.

Absorbent, polyurethane foam dressing impregnated with broad-spectrum anti-microbial (PHMB 0.5%) Antimicrobial barrier is effective for up to 7 days.

Kendall AMD Foam

Dressing

Kendall AMD Foam Dressing Adhesive

5 x5

10 x10 15 x15 20 x20

8.8 x 7.5

8.9 x8.9 14 x14 19 x19

4.4 x 8.3 8.9 x 14cm

250 471 892

1307 423

308 637

1225 247 485

275 554 984

1434 397

328 702

1350 252 492

Pre-cut antimicrobial dressing for IV/drain/tracheostomy sites impregnated with PHMB

Excilon AMD

5x5

009

Apply Suprasorb X with PHMB to the wound bed and cover with appropriate secondary dressing. Designed to regulate moisture levels in the wound. Can be left in place for 5-7days

Suprasorb X with PHMB

5 x5 9 x9

14 x20 2 x 21 rope

246 491

1161 695

DACC (dialkylcarbamoyl chloride) Hydrophobic, anti-microbial dressing to absorb exudate and bind bacteria. All chronic or acute wounds that are critically colonised or infected Contraindications:- Do not use in combination with ointments and creams as the binding effect is impaired

Cutimed Sorbact

Dressing Pad

Cutimed Sorbact Swab

7 x9

10 x10

10 x20

4 x6

7 x9

336 525 818 157 262

Honey Dressings

For necrotic, lightly exuding, sloughy, malodorous, infected wounds. Honey is an anti-microbial agent that promotes autolytic

Algivon Plus

(Manuka Honey & Alginate)

5 x5

10 x10

196 336


debridement Impregnated with 100% Medical grade Manuka Honey Discomfort may be experienced due to osmotic action of honey. If this persists then review treatment. Caution:- ensure patient does not have a sensitivity or allergy to honey, bee stings or bee products Ensure diabetic patients have blood glucose monitoring

Algivon Plus Ribbon

(Manuka Honey & Alginate)

Activon Tube

2.5 x20

25g

336

202

Topical Antibacterials

Metronidazole 0.75% Gel For wounds infected with anaerobic bacteria. Controls odour from fungating tumours. Prescription only

Anabact Topical Gel (Metronidazole gel)

15g 30g

447 789

Silver

For infected wounds. Active vs. MRSA. Treatment should be limited to 1 months use. Review after 2 weeks, only continue if progress has been made. Apply all silver dressings directly to wound surface. Do not use on third-degree burns or with patients with known sensitivity to silver or alginates.

Silver Alginate

For critically colonised or clinically infected wounds

Alginates have haemostatic properties so can be used on bleeding wounds. Can be left in place for up to 7 days

Urgosorb Silver

Urgosorb Silver Rope

5 x5

5 x 5 10 x10 10 x 20

2.5 x 30cm

157

149 356 671

358

159 369 695

359

Silver Non-adherent

For infected superficial wounds that need a non-adherent dressing.

Urgotul SSD (not to be used on a bleeding wound)

Can be left in place for up to 7 days

11 cm2

16 x 21cm

310 878

426 878

Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Anti-microbial foam dressings Indicated for medium to heavy wounds

Biatain Ag

non adhesive

5 x7

10 x10

324 788

Antiseptic


For chronic, medium exudating or infected or sloughy wounds.

-Maximum single application ≤ 50g.

-Weekly max. not to exceed 150g.

-Any single course of treatment not to exceed 3 months.

Caution in patients with severe renal impairment or history of thyroid disorders (See BNF for full details). Contra-indications: lithium therapy, thyroid disorders, pregnancy & breast-feeding (See BNF for details).

Iodoflex pad

Apply to wound surface, remove gauze backing and cover; renew when saturated (usually 2–3 times weekly, daily for heavily exuding wounds)

Iodosorb ointment

5g 10g 17g

10g 20g

401 801

1269

437 874

583 972 1538

Inadine

Used as a primary wound contact layer for the prophylaxis & treatment of infections in superficial burns & skin loss injuries. In diabetic wounds up to 4 layers can be applied.

Inadine

5x5

9.5x9.5

33 49

42 62

Protease Modulator

Soft-adherent, hydro desloughing, absorbent dressing with TLC (Technology Lipido-Colloid) For use on chronic/static wounds following holistic assessment. Wound contact layer. Minimum duration 4-5 weeks. Do not use on infected wounds

UrgoClean

UrgoStart

UrgoStart Contact

6 x6 10 x10 15 x20 (Rope) 2.5 x40 5 x40

6 x6 10 x10

15 x 20cm

5 x7 11 x11 16 x21

94 209 393

235 311

430 595

1070

290 412 984

Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Specialist Dressings

These dressings should only be used after recommendation from a Consultant / Specialist in wound care

Foams


This foam contains a mild non-toxic cleansing agent activated by moisture. Moistens wound bed so reducing trauma and wound pain.

Polymem ( non-adhesive )

8 cm2

10 cm2

13 cm2

17 x 19

157 244 407 601

170 287 450

832

Paraffin gauze dressing BP

For low exuding wounds and fragile healed tissue. Only to be used on recommendation of a Consultant/Specialist in wound care

Jelonet

10 x10

40

34

Flamazine

Short term use only

Silver Sulphadiazine 1% Cr.

For the prophylaxis and treatment of infection in burn wounds Caution in use over large areas.

1) For burns, apply daily or more frequently if higher levels of exudate;

Apply with sterile applicator. (50g tube may be used for up to 7 days) Use for 4 weeks max

Flamazine

50g

385

Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Renasys Go Negative Pressure Wound Therapy (Specialist Dressings Continued)


Renasys Go with Soft Port Dressing Kits

Pumps available from equipment library Harrogate

District Hospital Ensure TVN Team informed, Pumps must be returned to

equipment library as soon as discontinued

Contraindications /cautions:-Consideration should be taken for patients on anti-coagulant therapy actively bleeding wounds, difficult wound haemostasis, malignancy (except in palliative care), exposed arteries, veins, organs or nerves, untreated osteomyelitis, unexplored fistulae, anastomic sites, extensive necrotic tissue or non- concordant patients

Renasys-G Small

Gauze Kit Renasys-G Medium

Gauze Kit Renasys G Large

Gauze Kit Renasys-F Small Foam

Kit Renasys-F Medium

Foam Kit Renasys-F Large Foam

Kit

Renasys Go Canisters

Small

Medium

Large

Small

Medium

Large

300ml

750ml

1913

2399

3044

2245

2608

3094

1943

2673

Larval Therapy Biosurgical treatment for the debridement of chronic wounds such as diabetic foot ulcers, venous/mixed aetiology ulcers, pressure ulcers, and dehised surgical wounds. Contraindications should 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 anti-coagulants where the relevant 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.

Biobag

BB50 2.5 x 4cm

BB100 4 x5cm

BB200 5 x 6cm

BB300

6 x 12cm

BB400 10 x 10cm

195.00

220.00

245.00

270.00

295.00

Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)


Bandages

Retentive Bandages

For retention of dressings. Their aim is to keep the dressing close to the wound without inhibiting movement or restricting blood flow.

K Lite

K Lite long

K Band

10cm x 4.5m

10cm x 5.25m

10cm x 4m

98

113

28

72

117

19

Padding

For absorption of any excess exudate, comfort for patient and increase conformability of limb for application of outer bandage. Also used in application of compression bandage to protect & shape leg.

K Soft

K Soft long

10cm x 3.5m

un-stretched

10cm x 4.5m

45

56

49

58

Tubular Bandage (Elasticated Viscose Stockinette)

For retention purposes.

For garments available, consult Tissue Viability Service

Comfi-fast

Blue line

Yellow Line

Beige

Comfi-fast garments Child sizes but able to use on adults

7.5cm x1m 7.5cm x 3m 7.5cm x 5m

10.75cm

x1m 10.75cm

x3m 10.75cm

x5m

17.5cm x1m

Various sizes

available

77 213 374

120

349

604

183

Varies With size

Compression Therapy for venous leg ulcer management

A full leg ulcer assessment must be carried out before using any compression system to assess for arterial disease. The most important aspect of venous leg ulcer management is application of compression therapy. Compression therapy is applied so that the pressure at the ankle is higher than the pressure at the knee (graduated) thereby assisting venous blood in returning to the heart at a faster & more efficient level. It reduces venous pressure. Compression therapy is applied using either bandages or hosiery. (For further information see Leg Ulcer Policy).

Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)


Full Compression Bandages (Short Stretch Bandage)

For venous leg ulceration, oedema and lymphoedema. Applied at full stretch and 50% overlap over padding, which protects areas of high pressure & sites at high risk of pressure damage.

FOR USE ON IRREGULAR

SHAPED LEGS

FOR USE ON REGULAR

SHAPED LEGS. Supplied as

a kit comprising of a comfort

layer and Actico. Additional

padding may be needed

Actico Cohesive

Actico2C Cohesive

6cm x 6m 8cm x 6m 10cm x 6m 12cm x 6m

Ankle size 18 - 25cm 25 - 32cm

269 309 321 409

795 895

269 309 321 409

795 895

Multi-layer Compression Bandaging for mixed aetiology – Reduced compression

Reduced compression bandage system.

Recommendations for reduced compression. Some patients may present with alternative bandaging.

Please continue with treatment as advised and contact consultant/specialist for further information as appropriate.

Also available in KTwo Latex free

K-Four Reduced

Compression 18cm+

(supplied as a kit)

May be prescribed as individual components if kit not available: -

Ankle size 18-25cm

K-Soft K Lite Ko-Flex

Ankle size 25-30cm

K-Soft long K-Lite long

Ko- Flex long

K-Two Reduced Ankle size 18-25cm

Ankle size 25-30cm

18cm +

10cm x 3.5m 10cm x 4.5m 10cm x 6.0m

10 x 4.5cm 10 x 5.25cm

10cm x 7m

Ktech & Kpress

429

43 97 289

54 111

330

Multi-layer Compression Bandaging Latex free system

For 18-25cm ankle sizes. For full compression, use all four layers. For reduced compression, omit third layer.

Profore latex-free Latex Free 4-layer system

970

Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)


Multi-layer Compression Bandaging Full compression

For venous leg ulcerations with a Doppler reading >0.8mmHg (refer to Tissue Viability Nurse for advice on reading below 0.8mmHg).

K Two Multi-layer compression

bandage kit (2 layer system)

K Four Multi-layer compression

bandage kit (4 layer system)

If an alternative to full compression bandaging is required or an alternative ankle size identified contact a specialist for advice.

Ankle sizes up to 18cm (Short) 18-25cm ankle sizes

Ankle sizes 25-32cm

May be prescribed as individual components if kit not available: -

Ankle size 18-25cm

K-Soft K Lite K-Plus Ko-Flex

Ankle size 25-30cm

K-Soft long K-Lite long K-Plus long Ko- Flex long

10cm x 5m

10cm x 6.5m

10cm x 6m 10cm x 7.5m

10cm x 7.3m 10cmx10.5m

Full kit 10cm x 3.5m 10cm x 4.5m 10cm x 8.7m 10cm x 6.0m

Full kit

10 x 4.5cm 10 x 5.25cm 10 x 10.25m 10cm x 7m

655

776

848

674 45 98

224 297

674 56

113 259 340

655

776

848

674 45 98 224 297

674 56 113 259 340

Compression Hosiery Kits

Compression hosiery may be used as an alternative to compression bandages if concordance or patient independence is an issue. Full assessment should be completed prior to application.

Kits contain 2 liners and 1 medical stocking

Suggested brands:

Activa Leg Ulcer Hosiery Kit ActiLymph Hosiery Kit Altipress 40 Leg ulcer Kit Altipress MTM

Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)


Compression Hosiery

British standard hosiery help manage and prevent various venous leg conditions where limb swelling is not apparent. European class hosiery plays an important role in managing conditions with chronic oedema. It has a stiffer profile that British standard hosiery. Please use made to measure hosiery when the limb is large or irregular shaped

British Standard Class Strength Indication

Class 1 14 – 17mmHg Superficial or early varices & prevention of deep vein thrombosis while travelling

Class 2 18 – 24mmHg Medium varices. Treatment & prevention of venous leg ulcers & associated conditions

Class 3 25 – 35mmHg Gross varices; post thrombotic wound insufficiency; treatment of venous leg ulcers and prevention of recurrence

Suggested Brands : -

Activa Price varies in relation to classification, style and size

Altiform Please always allow the patient to choose their preferred style / type

RAL (European) Standard Class Strength Indication

Low compression 14 – 18mmHg Early / mild oedema, prevention of varicose veins in pregnancy

Class 1 18 – 21mmHg For early / mild chronic oedema, lymphoedema where the oedema is light to moderate with little shape distortion

Class 2 23 – 32mmHg For moderate to severe chronic oedema or lymphoedema where there may be some slight or minor shape distortion

Class 3 34 – 46mmHg For severe chronic oedema and lymphoedema, where resistant oedema features or where lymphatic damage is considerable. Use also when lower compression has failed to control return of oedema.

Suggested Brands : -

Actilymph Carolon Mediven Please refer to company information for measuring

Altiven Jobst Sigvaris & choice of style, price etc.

Types of hosiery & when to use:- Circular Knit – No to moderate oedema with NO skin creases and / or indentations Flat Knit – Moderate to severe oedema with skin changes / creases and or indentations. Below knee or thigh length – use thigh length when:-

Oedema extends to thigh

Varicosities in thigh region

Oedema around knee joint

Pain in knee due to arthritis

Choice between open and closed toe Open toe stockings may be preferred for people who:

Have arthritic or clawed toes, or fungal infection

Prefer to wear a sock over the compression stocking.

Have a long foot size compared with their calf size.

Please contact appropriate specialist for advice / support

Type, Indications &


Sizes

(cm)

Tariff

Cost

(p)

NHS

Supplies

Cost (p)

Liners may be used in place of compression bandages dependant on patient assessment. Each liner gives 10mmHg at the ankle. May start with one liner and build up to two.


Suggested makes Activa-Liners, Urgo-Altipress

Compression Hosiery Applicator

Devices to aid with application of hosiery.

Easy-slide Small 2-4.5 shoe size

Medium 5-7.5 Large 8-11

Actiglide

Sockaid

1

1

1

1198

1364

1288

1364

1288

Waterproof wound dressing and bandaging protector

Waterproof cover, for limbs, to prevent dressings and bandages becoming wet during showering or bathing.

Limbo

Seal-tight

Various sizes available on prescription for both leg or arm use

1056 1050

1056 1050

Footwear

Kerraped shoes may be used when other footwear will not accommodate a bandage system. They are available in a range of sizes to accommodate most foot sizes and additional bandages.

Contact specialist for further information.

Kerraped SIZE Shoe size Foot width Foot width (base of toes) (circum)

Small 2 - 5.5 7.6 - 8.6 23.8 – 27.1

Medium 6 - 7.5 8.8 - 9.2 27.6 - 29

Large 8 - 10 9.4 -10 29.5 – 31.4

X. Large 10.5 – 13 10.1 - 10.9 31.8 – 34.2

1755 All

sizes

1755 All

sizes

Documents

Wound Dressing Guidelines€¦ · dressings in situ and change outer secondary dressing only. This range of products can be insitu for 7-14 days – always check with manufacturer