Wound management and dressings formulary Quick Reference Guide ...

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Ensure dressing size is appropriate for the wound. Too large is not cost effective. Sizes. Each dressing. Cleansing agen
Wound management and dressings formulary Quick Reference Guide www.northeast.devonformularyguidance.nhs.uk Good Prescribing Practice   

Soft silicone wound contact dressing

Do not put dressings onto patients’ repeat lists. All wounds should be reviewed

5cm x 7.5cm

£1.09

frequently and assessed for healing

7.5cm x 10cm

£2.09

Only prescribe the quantity clinically needed at the time. Prescribed items are

10cm x 18cm

£4.35

the property of the patient; unused dressings must be destroyed

15cm x 25cm

£7.29

7.5cm x 7.5cm

£1.44

10cm x 10cm

£2.11

12.5cm x 12.5cm

£2.59

Ensure dressing size is appropriate for the wound. Too large is not cost effective Sizes

Cuticell contact (first-line)

Biatain silicone (second-line)

Each dressing

Cleansing agents Tap water (first-line)

n/a

n/a

15cm x 15cm

£3.84

Sodium chloride 0.9% (first-line)

25 x 20mL

£4.95

17.5cm x 17.5cm

£5.10

30 tablets

£14.59

Antiseptics

Absorbent dressing – lightly exuding wounds

Permitabs® (second-line)

Cosmopor E (first-line)

Liquid barrier film

5cm x 7.2cm

£0.08

8cm x 10cm

£0.17

Cavilon durable barrier cream

28g

£3.98

8cm x 15cm

£0.28

(first-line)

92g

£8.12

10cm x 20cm

£0.45

2g sachet

£0.37

10cm x 25cm

£0.55

Cavilon no sting barrier film

28mL pump spray

£6.65

10cm x 35cm

£0.77

(first-line)

5 x 1mL applicator

£4.96

Dry absorbent dressing pads, medium to high exudate

5 x 3mL applicator

£7.96

Zetuvit Plus (first-line)

225mL

£6.51

115g

£9.78

Proshield (second-line) foam and spray skin cleanser skin protective Knitted viscose primary dressing N-A Ultra (first-line) Atrauman (first-line)

First line drugs

10cm x 10cm

£0.63

10cm x 20cm

£0.87

15cm x 20cm

£0.99

20cm x 25cm

£1.36

20cm x 40cm

£2.09

10cm x 10cm

£0.73

9.5cm x 9.5cm

£0.33

19cm x 9.5cm

£0.63

15cm x 15cm

£0.97

5cm x 5cm

£0.26

20cm x 30cm

£2.14

7.5cm x 10cm

£0.28

40cm x 60cm

£8.15

10cm x 20cm

£0.62

10cm x 10cm

£1.84

20cm x 30cm

£1.71

10cm x 20cm

£2.43

20cm x 20cm

£4.28

20cm x 30cm

£4.89

Eclypse (second-line)

DryMax Extra (specialist)

Second line drugs

Specialist drugs November 2014

Wound management and dressings formulary Quick Reference Guide www.northeast.devonformularyguidance.nhs.uk Hydrogel sheet dressings Actiform Cool (first-line)

Intrasite conformable (first-line)

Hydrocolloid dressings 5cm x 6.5cm

£1.79

5cm x 10cm

£0.75

10cm x 10cm

£2.63

7.5cm x 7.5cm

£0.79

10cm x 15cm

£3.79

9cm x 15cm

£1.76

20cm x 20cm

£7.93

9cm x 25cm

£2.81

10cm x 10cm

£1.80

9cm x 35cm

£3.93

10cm x 20cm

£2.42

10cm x 10cm

£1.31

10cm x 40cm

£4.33

15cm x 15cm

£2.84

15g

£1.41

5cm x 5cm

£0.99

10cm x 10cm

£2.36

15cm x 15cm

£4.44

1cm x 45cm

£1.81

2cm x 45cm

£2.44

Hydrogel application (amorphous) ActivHeal Gel (first-line)

DuoDERM Extra Thin (first-line)

Hydrocolloid-fibrous dressings Aquacel Extra (first-line)

Vapour-permeable adhesive film dressing C-view (first-line)

6cm x 7cm

£0.38

10cm x 12cm

£1.02

12cm x 12cm

£1.09

15cm x 20cm

£2.36

Vapour-permeable adhesive film dressing with absorbent pad Hydrofilm Plus (first-line)

C-view Post Op (second-line)

First line drugs

Polyurethane foam film dressing with adhesive border ActivHeal Foam Adhesive

7.5cm x 7.5cm

£1.18

(first-line)

10cm x 10cm

£1.63

12.5cm x 12.5cm

£1.68

£0.30

15cm x 15cm

£2.15

£0.45

20cm x 20cm

£4.50

Tegaderm Foam Adhesive

6.9cm x 7.6cm (oval)

£1.45

(first-line)

10cm x 11cm (oval)

£2.37

14.3cm x 15.6cm (oval)

£4.21

£1.10

14.3cm x 14.3cm (sq.)

£3.51

£1.60

19cm x 22.2cm (oval)

£6.90

13.9cm x 13.9cm (circ.)

£4.18

5cm x 7.2cm

£0.17

9cm x 10cm

£0.27

9cm x 15cm 10cm x 20cm 10cm x 25cm

£0.60

10cm x 30cm

£0.68

6cm x 7cm

£0.40

10cm x 12cm 10cm x 25cm 10cm x 35cm

£2.60

For intravenous and subcutaneous catheter sites IV 3000 (first-line)

Aquacel Ribbon (first-line)

Polyurethane Foam Film Dressing without Adhesive Border

10cm x 12cm (central line)

£1.39

ActivHeal Non-adhesive foam (first-

5cm x 5cm

£0.75

9cm x 12cm (PICC line)

£1.44

line)

10cm x 10cm

£1.13

20cm x 20cm

£3.92

18cm x 12cm

£2.34

Second line drugs

Specialist drugs November 2014

Wound management and dressings formulary Quick Reference Guide www.northeast.devonformularyguidance.nhs.uk Tegaderm foam (first-line)

8.8cm x 8.8cm

£2.21

(fenestrated) 10cm x 10cm

£2.17

10cm x 20cm

£3.68

20cm x 20cm

£5.87

8cm x 8cm

5cm x 5cm

£2.00

10cm x 10cm

£3.40

6cm x 6cm

£2.24

11cm x 11cm

£4.47

£1.59

11cm x 11cm (adhesive)

£3.06

10cm x 10cm

£2.47

15cm x 15cm (adhesive)

£5.79

13cm x 13cm

£4.12

17cm x 19cm

£6.08

Roll 10cm x 61cm

£13.10

20g

£3.96

Roll 20cm x 60cm

£30.90

50g

£9.90

11cm x 11cm

£2.97

20cm x 20cm

£11.68

5cm x 5cm

£0.33

9.5cm x 9.5cm

£0.49

5cm x 5cm

£0.81

5g

£4.06

10cm x 10cm

£1.71

10g

£8.12

10cm x 20cm

£3.20

17g

£12.86

40cm

£2.04

10g tube

£4.49

20g tube

£8.97

10cm x 10cm

£1.88

10cm x 20cm

£2.50

5cm x 5cm

£5.33

15cm x 25cm

£4.03

10cm x 12.5cm

£12.79

10cm x 10cm

£3.15

5cm x 5cm

£1.95

8cm x 15cm (oval)

£3.78

10cm x 10cm

£4.64

15cm x 20cm

£7.17

15cm x 15cm

£8.75

Actilite (first-line)

10cm x 10cm

£0.98

Cutimed Sorbact Ribbon

2cm x 50cm

£3.96

(gauze dressing)

10cm x 20cm

£1.90

(first-line)

5cm x 200cm

£7.81

Medihoney tulle (first-line)

10cm x 10cm

£2.98

Cutimed Sorbact swabs

4cm x 6cm

Medihoney gel sheet (first-line)

5cm x 5cm

£1.75

10cm x 10cm

£4.20

PolyMem (specialist)

Polymem Max (specialist) Alginates Sorbsan Flat (first-line)

ribbon with probe Odour absorbent dressings Clinisorb (first-line)

Carboflex (specialist)

Antimicrobial dressings, honey

First line drugs

Medihoney apinate (first-line) Medihoney HCS (first-line)

Honey-based topical application Medihoney tube (first-line) Iodine Inadine (first-line) Iodoflex paste (first-line)

Iodosorb ointment (first-line) Silver Acticoat Absorbent (first-line) Aquacel Ag + Extra (specialist)

Other antimicrobials

(first-line) Cutimed Sorbact gel (first-line)

Second line drugs

£1.62

7.5cm x 7.5cm

£2.61

7.5cm x 15cm

£4.40

Specialist drugs November 2014

Wound management and dressings formulary Quick Reference Guide www.northeast.devonformularyguidance.nhs.uk Cutimed Sorbact pad

7cm x 9cm

£3.46

2.5cm x 5m

£1.02

(first-line)

10cm x 10cm

£5.40

5cm x 5m

£1.81

10cm x 20cm

£8.42

10cm x 5m

£2.89

£2.50

15cm x 5m

£3.94

20cm x 5m

£5.04

30cm x 5m

£7.24

Kendall AMD foam (without adhesive

5cm x 5cm

border) (first-line)

8.8cm x 7.5cm (fenestrated) 10cm x 10cm 15cm x 15cm 10cm x 20cm 20cm x 20cm

Suprasorb X + PHMB (first-line)

£4.23 £4.71 £8.92 £8.92

£2.53

9cm x 9cm

£5.03

14cm x 20cm

£11.45

Prontosan (contains PHMB)

350mL bottle

£4.75

(second-line)

24 x 40mL pod

£14.12

30mL gel

£6.35

10cm x 10cm

£6.35

Physical debridement pads Dressing packs Richardsons Healthcare

Per pack , ordered from

(first-line)

web basket

Nurse it (second-line)

Per pack

Skin closure strips sterile Leukostrip (first-line)

Seal-tight® Wound care protector (first-line)

100 per packet

£0.83

7.5cm x 7.5cm, 4-ply, sterile

5 per packet

£0.27

K-band (first-line)

7cm x 4m

£0.26

10cm x 4m

£0.28

15cm x 4m

£0.49

Red line

3.5cm x 1m

£0.56

Green line

5cm x 1m

£0.58

5cm x 3m

£1.62

5cm x 5m

£2.81

7.5cm x 1m

£0.77

7.5cm x 3m

£2.13

7.5cm x 5m

£3.74

10.75cm x 1m

£1.20

10.75cm x 3m

£3.49

10.75cm x 5m

£6.04

17.5cm x 1m

£1.83

Tubular bandages and garments Comfifast (first-line)

Blue line

1.25cm x 5m

£0.42

2.5cm x 5m

£0.68

5cm x 5m

£1.18

7.5cm x 10m

£2.56

Yellow line

Surgical tape Scanpor (first-line)

First line drugs

£10.50

Light-weight conforming bandages

Non-woven fabric swabs 10cmx10cm, 4 ply , non-sterile

£0.63

Dressing protector

£0.38 £0.52

6.4mm x 76mm (3 strips per envelope)

£13.07

5cm x 5cm

Debrisoft (first-line)

Mefix (first-line)

Beige line

Second line drugs

Specialist drugs November 2014

Wound management and dressings formulary Quick Reference Guide www.northeast.devonformularyguidance.nhs.uk Bandages, light support K-lite (first-line)

Hosiery class 4 treatment 5cm x 4.5m

£0.55

Activa leg ulcer hosiery kit 40mmHg

£22.56

7cm x 4.5m

£0.76

10cm x 4.5m

£0.99

Altipress 40 ulcer kit

£14.28

15cm x 4.5m

£1.44

10cm

£2.90

K-Plus (first-line)

10cm x 8.7m

£2.26

K-ThreeC (first-line)

10cm x 3m

£2.81

K-Soft (first-line)

10cm x 3.5m

£0.45

10cm x 4.5m

£0.56

4cm x 6m

£2.38

6cm x 6m

£2.79

8cm x 6m

£3.21

10cm x 6m

£3.33

12cm x 6m

£4.24

10cm x 6m

£3.00

Cohesive Bandages Coban (first-line) Compression bandages

Bandages, short stretch Actico (first-line)

Multi-layer compression bandaging Ko-Flex (first-line)

Specialist wound care products Complex wound management – specialist dressings 

These are specialist products, for use where products from the core formulary have failed or are unsuitable. They are considered non-formulary for the purposes of monitoring practice’s data.



If some of these products are selected further assessment/guidance may be required from the Specialist/Tissue Viability Service. Further education/training and assessment of competence may be required.



Silver Dressings should only be considered for critically colonised and infected wounds. If no improvement to the wound is noted within 2 weeks then the silver products should be replaced with a non-silver product.

Topical negative pressure Dressings required for this indication will be initiated by tissue viability specialists

£6.79 -

K-Two (first-line)

£11.10

K-four (first-line) Actico 2C (second-line)

25 – 30cm

£6.80

Greater than 30cm

£9.36

18cm – 25cm

£7.95

25cm – 32cm

£8.95

Juxta CURES (specialist)

Emollients Please refer to the North and East Devon Formulary 

Chapter 13, section 13.2.1 Emollients (www.northeast.devonformularyguidance.nhs.uk)

£151.50

Juxta FIX (specialist) Medicated stocking Zipzoc

4 pouch carton

First line drugs

£12.52

Second line drugs

Specialist drugs November 2014