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Nottinghamshire Area Prescribing Committee
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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

A5.03.03  Expand sub section  Low adherence dressings
A5.03.03  Expand sub section  With charcoal
A5.03.03  Expand sub section  Soft polymer dressings
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
 ....
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
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Link to adult BNF
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Link to children's BNF
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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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