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.

 

SAFE USE OF EMOLLIENT SKIN CREAMS TO TREAT DRY SKIN CONDITIONS

Take care when using creams to treat dry skin conditions as they can easily dry onto clothing, bedding and bandages making them more flammable.

Watch this video and share it with your family or carer:

Skin creams, sometimes known as emollients are used by many people every day to help manage different dry skin conditions such as eczema, psoriasis and ichthyosis.

The creams are easily transferred from skin onto clothing, bedding and bandages.  Tests and research have shown that the dried-on cream makes the fabric more flammable and the resulting fire burns quickly and intensely, resulting in serious injury or death.

It’s important for anyone using these creams to avoid any naked flame.

If you use an emollient or skin cream to treat a dry skin condition, please follow this advice.

Avoid smoking

Do not smoke, use naked flames or get near to anything which may cause a fire whilst wearing clothing or a bandage that has been in contact with skin creams.

If this is not possible, you must take steps to ensure you are safe when you smoke or use naked flames. For example, by using a flameless lighter or e-cigarette, and removing long sleeved or baggy clothing before using a gas hob.

Change and wash clothes and bedding

Change and wash your clothes and bedding frequently to reduce the build-up of skin cream. However, remember that whilst washing your clothing and bedding even at high temperatures might reduce the build-up, it does not remove it completely and the danger may remain.

Keep cream off furniture

Be careful to make sure the skin cream does not get onto the fabric of armchairs or other furniture, cushions and blankets. Be aware that the cream can transfer from your skin onto the fabric of furniture when you are sitting or lying on it.

Tell relatives and carers

Tell your relatives or carers about your treatment and ask how they can help you to reduce the risk. Download the leaflet  for them.

 

For HEALTHCARE PROFESSIONALS

Ensure patients and their carers understand the fire risk associated with the build-up of dried emollient residue on clothing and bedding and can take action to minimise the risk.

When prescribing, recommending, dispensing, selling, or applying an emollient, instruct patients not to smoke, cook or go near any naked flames or heat source (gas, halogen, electric bar or open fire) whilst wearing clothing or dressings that have been in contact with emollients. If the patient cannot do this advise on measures to do so safely (e.g use safety lighters or e-cigarettes; remove long sleeved or loose clothing before cooking; put on a thick uncontaminated shirt, overalls or apron, move chairs further away from the open fire or other heat source)

Be aware that washing clothing or bedding at a high temperature may reduce emollient build up but does not totally remove it – it is important to minimise risk in additional other ways (as above).

Watch the video above and share it with your patients or customers.

Report any fire incidents associated with the use of emollients to the Yellow Card Scheme

For complex cases contact the local fire and rescue service for advice and support.

Further information is available here.

 

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)

 

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.