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Nottinghamshire Area Prescribing Committee
Joint Formulary
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 Formulary Chapter 26: A5 - Wound managment products and elasticated garments - Full Chapter
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A5.03.03  Expand sub section  Silver
 note 

Antimicrobial dressings containing silver should be used only when infection is suspected as a result of clinical signs or symptoms. Silver ions exert an antimicrobial effect in the presence of wound exudate; the volume of wound exudate as well as the presence of infection should be considered when selecting a silver-containing dressing. Silver-impregnated dressings should not be used routinely for the management of uncomplicated ulcers. It is recommended that these dressings should not be used on acute wounds as there is some evidence to suggest they delay wound healing.

BNF Sept 20/21

All silver dressings have been classified as grey with the exception of Aquacel Ag+ and Ag+ extra (hydrocolloid) and Atrauman AG (low adherence) which are Amber 2

Suprasorb A+Ag Amber 2 for SFHT ONLY under the direction of a TVN

Acticoat flex 3 - restricted for NUH use only

Urgotul SSD - restricted for NUH burns unit only

Aquacel Ag+ (Silver dressing)
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Formulary
Amber 2

Silver - Hydrocolloid (Hydrofiber)

-Sheets: Aquacel Ag+ Extra (5x5cm, 10x10cm, 15x15cm, 20x30cm)
-Ribbon: Aquacel Ag+  (1x45cm, 2x45cm)

- For short term use (7 – 14 days). Requires a secondary dressing

  • At SFH on TVN advice only
  • Replaced Aquacel Ag in the SFH dressings formulary.
  • Primary care - only to be prescribed on advice of TVN.
 
   
Atrauman Ag (silver dressing)
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Formulary
Amber 2

 Silver dressing - low adherence

Non-adherent polyamide fabric impregnated with silver and neutral triglycerides

- For short term use (7 – 14 days). Requires a secondary dressing

  • Primary care - only to be prescribed on advice of TVN.
  • At SFH for use only on recommendation of the Tissue Viability Team - wards to order from Pharmacy for individual patients.
  • At NUH supply is via NHS supply chain.
  • Available as 5x5cm, 10x10cm and 10x20cm
 
   
A5.03.03  Expand sub section  Low adherence dressings
Acticoat Flex 3
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Restricted Drug Restricted

On specialist advice only at NUH, wards to order from Pharmacy for each individual patient. Not available at SFH

  • Available as 5x5cm, 10x10cm, 10x20cm and 20x40cm
  • Conformable antimicrobial barrier dressing consisting of a polyester core between low adherent silver-coated high density polyethylene mesh (for 3-day wear)
 
   
A5.03.03  Expand sub section  With charcoal
A5.03.03  Expand sub section  Soft polymer dressings
Urgotul SSD
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Restricted Drug Restricted NUH Burns unit only.
  • Available as 10x12cm and 15x20cm 
  •    
    A5.03.03  Expand sub section  Hydrocolloid dressings to top
    A5.03.03  Expand sub section  Foam dressings
    A5.03.03  Expand sub section  Alginate dressings
    Suprasorb A + AG
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    Formulary
    Amber 2

    Silver dressings Aquacel Ag+ and AG+extra  and Atrauman Ag are the Amber 2 formulary dressing choice for Primary care

    Suprasorb A+Ag is Amber 2 for SFHT ONLY under the direction of a TVN

     
       
     ....
     Non Formulary Items
    Acticoat

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    Non Formulary
    Grey
    Previously contained in the South's Wound Care Formulary for restricted use
     
    Acticoat 7

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    Non Formulary
    Grey
    • Five-layer antimicrobial barrier dressing consisting of a polyester core between low adherent silver-coated high density polyethylene mesh (for 7-day wear)
    • Previously contained in the South's Wound Care Formulary for restricted use
     
    Acticoat Flex 7

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    Non Formulary
    Grey
    • Conformable antimicrobial barrier dressing consisting of a polyester core between low adherent silver-coated high density polyethylene mesh (for 7-day wear)
     
    Acticoat Moisture Control

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    Non Formulary
    Grey
    • Three layer polyurethane dressing consisting of a silver coated layer, a foam layer, and a waterproof layer
     
    Actisorb Silver 220

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    Non Formulary
    Grey
     
    Actisorb Silver 220

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    Non Formulary
    Grey
    • Knitted fabric of activated charcoal, with one-way stretch, with silver residues, within spun-bonded nylon sleeve
     
    Algisite Ag

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    Non Formulary
    Grey
    • Calcium alginate dressing, with silver
     
    Allevyn Ag

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    Non Formulary
    Grey
    • Silver sulfadiazine impregnated polyurethane foam film dressing with or without adhesive border
     
    Allevyn Ag Gentle

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    Non Formulary
    Grey
    • Soft polymer wound contact dressing, with silver sulfadiazine impregnated polyurethane foam layer, with or without adhesive border  
     
    Aquacel Ag flat

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    Non Formulary
    Grey
     
    Aquacel Ag ribbon

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    Non Formulary
    Grey

    Replaced by Aquacel Ag+ ribbon in the SFH dressings formulary.

     
    Askina Calgitrol Ag

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    Non Formulary
    Grey
    • Calcium alginate and silver alginate dressing with polyurethane foam backing
     
    Askina Calgitrol Thin

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    Non Formulary
    Grey
    • Calcium alginate and silver alginate matrix, for use with absorptive secondary dressings
     
    Biatain Ag

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    Non Formulary
    Grey
    •  Silver impregnated polyurethane foam film dressing, with or without adhesive border
     
    Melgisorb Ag

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    Non Formulary
    Grey
    • Alginate and carboxymethylcellulose dressing, with ionic silver
     
    Mepilex Ag

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    Non Formulary
    Grey
    • Soft silicone wound contact dressing with polyurethane foam film backing, with silver, with or without adhesive border
     
    Physiotulle Ag

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    Non Formulary
    Grey
    • Non-adherent polyester fabric with hydrocolloid and silver sulfadiazine
     
    PolyMem Silver

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    Non Formulary
    Grey
    • Silver impregnated polyurethane foam film dressing, with or without adhesive border 
     
    Silvercel

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    Non Formulary
    Grey
    • Alginate and carboxymethylcellulose dressing impregnated with silver
     
    Silvercel Non-adherent

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    Non Formulary
    Grey
    • Alginate and carboxymethylcellulose dressing with film wound contact layer, impregnated with silver
     
    Sorbsan Silver Flat

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    Non Formulary
    Grey
    • Calcium alginate fibre, highly absorbent, flat non-woven pads, with silver
     
    Sorbsan Silver Plus

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    Non Formulary
    Grey
    • Calcium alginate dressing with absorbent backing, with silver
     
    Sorbsan Silver Ribbon

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    Non Formulary
    Grey
     
    Sorbsan Silver Surgical Packing

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    Non Formulary
    Grey
     
    Tegaderm Alginate Ag

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    Non Formulary
    Grey
    • Calcium alginate and carboxymethylcellulose dressing, with silver
     
    UrgoCell Silver

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    Non Formulary
    Grey
    • Non-adherent, polyurethane foam film dressing with silver in wound contact layer
     
    Urgosorb Silver

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    Non Formulary
    Grey
    • Alginate and carboxymethylcellulose dressing, impregnated with silver
     
    Urgotul Silver

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    Non Formulary
    Grey
    • Non-adherent soft polymer wound contact dressing, with silver
     
      
    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
    SMC
    Scottish Medicines Consortium
    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

    Grey

    Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.
    Grey / Non-Formulary (undergoing assessment): Work is ongoing and will be reviewed at a future APC meeting.
    Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market.
      

    Red

    Medicines which should normally be prescribed by specialists only. eg hospital only.
    For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.
      

    Amber 1

    Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised.
    Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the Nottinghamshire APC.
      

    Amber 2

    Medicines suitable to be prescribed in primary care / general practice after specialist* recommendation or initiation.
    A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC.
    *Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice
      

    Amber 3

    Primary care/ non specialist may initiate as per APC guideline.
    The supporting prescribing guideline must have been agreed by the relevant secondary care trust D&TC(s) and approved by the Nottinghamshire APC.
      

    Green

    Medicines suitable for routine use within primary care.
    Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.   

    OTC

      

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