Wound Management Formulary

The wound management formulary has been developed by the Joint Wound Management Formulary Group. Please use the links below to navigate to the relevant sections.

Wound Management Formulary – full text – updated contact details March 2018    – currently under review

Contacts

 

*Patients should be encouraged to self-care where appropriate. Practitioners’ responsibilities include a self-care risk assessment, providing patient information leaflets and advising about red flags and when these need to be escalated, and how*.

 

 

Wound Care Bulletins  – currently under review

Bulletin Two – Barrier Film Products

Bulletin Three – Maggots

Bulletin Four – Comfifast

Bulletin Five – Top Tips 1

Bulletin Six – Quantities

Quick Reference Guides

Quick reference guide Debrisoft FINAL

 

Public Health England (PHE)

PHE notes in it’s guidance on primary care infections that widespread use of topical antibiotics, especially those agents also available systemically, is to be avoided. If use is indicated topical use should be limited in most cases.

 

 

Emollients

BBC News Health has recently highlighted the dangers of using emollients whilst smoking or using naked flames.

For further information see this document and  poster which include advice for both healthcare professionals and patients.

West Yorkshire Fire & Rescue Service have created a YouTube Video for Healthcare Professionals.

They would like you to consider:

  • All of these products are safe to use but they all increase the flammability of fabrics. The problem arises when an ignition source (primarily smoking materials such as matches and some lighters) is introduced and the bedding the person is lying on, the chair they are sitting on, the clothes or dressings they are wearing are accidentally set on fire.
  • Changing prescriptions to lower paraffin containing products will not reduce the fire risk.
  • Preliminary scientific research is also showing that non-paraffin alternatives will also not reduce the fire risk.
  • The potential fire risk therefore applies to all emollients.

 

They strongly recommend:

  1. In line with various Coroner’s reports to Prevent Future Deaths that all those who prescribe, dispense or apply these products should give a verbal warning about these fire risks to their patients, customers, clients or people they are caring for. This is in addition to the warnings that will appear on these products.
  2. If anyone has concerns that someone is displaying high risk behaviours around fire and the use of emollients, that a referral is made to us (or your local fire service)so that we can try to mitigate the risk through information, advice and appropriate interventions.

 

Medicines and Healthcare products Regulatory Agency (MHRA)

The MHRA has also highlighted the risks in a press release.

It was previously thought the risk occurred with emollients which contain more than 50% paraffins.  However, evidence now points to a risk with emollients which contain lower levels of paraffin and with paraffin-free emollients. This advice therefore applies to all emollients whether they contain paraffin or not.

It is important people prescribing, dispensing or using any emollient, or caring for someone who uses an emollient, are aware of the potential fire risks and take appropriate action.

Further details are available here Press Release MHRA 181218

 

Advice on diamorphine and intrasite gel

The CDAO are aware of the unlicensed use of Intrasite gel and Diamorphine Injection in certain settings.

The decision to use this would be a clinical judgement for the individual prescriber.

In all cases, if this is the chosen treatment, both the person administering the treatment, and the patient, must be  aware of its unlicensed status. There must also be a full audit trail for the use of the Diamorphine (including destruction details of any part ampoules that may have been discarded)

Regarding treatment suitability and evidence please contact the Yorkshire Cancer Network

 

Resources

Wound dressing selection chart

CHFT – Post-operative wound site information and advice

 

 

 

 

Formulary produced by: Joint Wound Management Formulary Group
Original date: March 2008
First review: March 2010
Second review: April 2012
Third review: July 2015

Fourth review: May 2016
Originally approved by SWY Area Prescribing Committee: 28 March 2008.