Joint Wound Care Formulary - Primary and Secondary Care


In this section

Introduction
Good practice in wound management
Topical antimicrobial therapy
Joint Wound Care Formulary

Introduction

The Grampian Wound Care Formulary has been developed to support clinicians within Grampian who are prescribing and/or applying wound care products. The aim of the formulary is to promote safe, evidence-based, effective and economical prescribing. 
The formulary is applicable to primary and secondary care, and there may be some variations between primary and secondary care provision of products. The formulary will also be made available to Care Homes across Grampian so their clinical practice reflects local guidance.

The formulary has been devised by a group of practitioners with knowledge and expertise, who are clinically responsible for wound care management. It provides a choice of products that are clinically- and cost-effective to manage the vast majority of wounds.
The products within the formulary are the only products that are to be used in wound care, unless there are particular circumstances where specialist wound care providers have deemed it appropriate to prescribe out with, i.e. Tissue Viability, Dermatology, Vascular, Podiatry, Plastic Surgery. Adoption of the formulary should ensure continuity of wound care across the primary and secondary care settings.

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Good Practice in Wound Management

  • Practitioners should have the skills and knowledge to manage wounds
  • Patients with a wound need a holistic assessment
  • Wounds need to be regularly reassessed
  • Dressing selection should be evidence-based and cost-effective
  • Dressing selection should encourage moist wound healing - where appropriate
  • Dressing selection should be appropriate to the stage of the wound healing
  • Antimicrobial products should only be used where an increased risk of infection or clinical signs of infection are apparent. Once an infection has resolved (recommend use of up to 14 days unless stated otherwise) treatment with an antimicrobial dressing should be stopped.
    Note: Clear instructions on the duration of antimicrobials, in most instances this should be restricted to two weeks unless there is clear clinical justification to continue for longer. If there are any concerns that the infection, local or systemic, may continue, antimicrobial therapy should not be stopped. In line with good practice, continued assessment of the wound should be undertaken.
  • Regular assessment and management of wounds should be documented in the wound assessment chart.  Generic wound assessment forms are available for use across Grampian - Stock number ZKB902
  • Wound pain should be assessed and controlled as appropriate

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Topical antimicrobial therapy

The primary intention of topical antimicrobial therapy such as silver, iodine and honey is to reduce wound bioburden. Where clinically justified preventative use of antimicrobials is indicated, this must be conducted in full recognition of the risk-benefit ratio. Clinical signs and symptoms associated with infection or critical colonization, i.e. delayed healing, increased fluid exudate, malodour, increased pain may indicate the use of topical antimicrobial therapy. Clear instructions on the duration of use, in most instances this should be restricted to two weeks unless there is clear clinical justification to continue for longer. If there are any concerns the infection, local or systemic, may continue, antimicrobial therapy should not be stopped. In line with good practice continued assessment of the wound should be undertaken. Antimicrobial therapy should be used with caution in paediatric patients and patients with decreased renal function.

Adapted from Best Practice Statement, The use of topical antiseptic/antimicrobial agents in wound management, Second edition, May 2011.

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Joint Wound Care Formulary

 
 Product type - monograph
 Date

 Absorbent dressing
 Zetuvit® Plus (super absorbent) - first choice
 Mesorb® - second choice


 August 2015
 August 2015

 Alginate dressing
 Kaltostat®


 August 2015

 Heel dressing
 Askina® Heel - first choice (non adhesive) NOTE: should not be used as a pressure relieving device
 Biatain® Adhesive heel dressing - first choice (adhesive)
 Mepilex (heel) - second choice (non adhesive)
 Mepilex Border (heel) - second choice (adhesive)


 August 2015
 August 2015
 August 2015
 August 2015

 Hydrogel dressing
 ActivHeal® Hydrogel
 ActiFormCool®


 August 2015
 August 2015

 Hydrocolloid dressing
 Comfeel® Plus and Comfeel® Plus Contour (also see sacral dressings)
 DuoDERM® Extra Thin


 August 2015
 August 2015

 Non-adherent dressing
 Atrauman® - first choice
 Adaptic Touch®


 August 2015
 August 2015

 Low absorbent dressing
 PremierPore® - first choice
 Melolin® (podiatry only)


 August 2015
 August 2015

 Polyurethane foam film dressing with adhesive border
 Biatain® Adhesive Dressing - first choice - (also see heel and sacral dressings)
 Mepilex® Border - second choice - (also see heel and sacral dressings)
 Polymem® (with adhesive border) - (also see sacral dressings)
 Tegaderm® Adhesive Foam Dressing


 August 2015
 August 2015
 August 2015
 August 2015

 Polyurethane foam film dressing without adhesive border
 Biatain® Non adhesive Dressing - first choice
 Mepilex® XT (for fragile friable skin)
 Polymem® (without adhesive border)


 August 2015
 August 2015
 August 2015

 Protease modulating matrix 
 Aquacel® Extra Dressing 
 Aquacel® ribbon 
 Cadesorb ointment® 
 Promogran Prisma® 


 August 2015
 August 2015
 August 2015
 August 2015

 Sacral dressing
 Biatain® Adhesive Sacral - first choice (adhesive)
 Mepilex Border Sacrum - second choice (adhesive)
 Comfeel® Plus Sacral
 Polymem® Sacral (with adhesive border)


 August 2015
 August 2015
 August 2015
 August 2015

 Vapour permeable adhesive film dressing
 365 Film - first choice (adults only, for paediatrics see Tegaderm® Film monograph below) 
 Tegaderm® + Pad (use if shower proof dressing required)
 Tegaderm® Film (paediatrics only)

 
 August 2015
 August 2015
 August 2015

 

Antimicrobial
Also see the statement on the use of topical antimicrobial therapy above

 ANTIMICROBIAL - Honey dressing
 Activon tube® topical application®
 Activon Tulle®


 August 2015
 August 2015

 ANTIMICROBIAL - Iodine dressing - Cadexomer-Iodine
 Iodoflex®
 Iodosorb®


 August 2015
 August 2015

 ANTIMICROBIAL - Iodine dressing - Povidone-Iodine
 Inadine®


 August 2015

 ANTIMICROBIAL - Silver Coated Barrier Dressing
 Silvercel® non-adherent (hydrocolloid) - first choice
 Acticoat® Flex 3 - second choice
 Actisorb® Silver 220
 Flamazine® Cream


 August 2015
 August 2015
 August 2015
 August 2015

 Other products

 Barrier products
 Cavilon® Durable Barrier Cream
 Cavilon® No Sting Barrier Film


 August 2015
 August 2015

 Miscellaneous
 Appeel® Sterile 5mL
 DebriSoft®
 Haelan® Tape and Ointment 
 Irripod®


 August 2015
 August 2015
 August 2015
 August 2015

 Tapes
 Mefix®
 Mepitac®


 August 2015
 August 2015

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