Section 3-1: Classification of wound management materials - (Untitled Section)

The wound management materials available on prescription can be classified into broad performance-related groups as follows.

Primary wound dressings

Primary wound dressings are applied directly to a wound to absorb exudate, provide protection from external contamination and facilitate healing. They are available in many forms. Some are self adhesive and therefore do not require the application of secondary dressings or retaining bandages. Others act as low-adherent interface layers between the wound and a secondary absorbent layer placed upon the outer surface of the primary dressing.

Dressing packs

Dressing packs, sometimes also called procedure packs, provide the nurse practitioner with a selection of sterile wound care items conveniently packaged together. The most commonly used variety contain an inner wrap that opens out to form a sterile field. These packs are generally used when changing a dressing or carrying out some similar procedure.

Surgical absorbents

Surgical absorbents are products which, although not designed to be left in intimate contact with damaged tissue, may be used for cleansing purposes or as secondary absorbent layers over a primary dressing in the management of heavily exuding wounds.

Extensible/Bandages

The bandages in the Drug Tariff may be classified into groups according to their function and performance. Considerable financial savings may be achieved by ensuring that these are used appropriately.

Surgical Tapes

Surgical tapes are used to retain dressings and other medical appliances in position. A number of types are available with various backing materials and adhesive systems. Traditional woven products coated with a zinc oxide-rubber adhesive have been largely replaced by paper tapes bearing synthetic acrylic adhesives for general purpose use such as dressing retention. The majority of expenditure on surgical tapes is on the paper products. Micropore is brand leader within this group but substantial savings could be achieved by the use of alternative products if these are judged to be clinically acceptable.

Paste Bandages

Paste bandages are used for the treatment of eczema[Image-15K], dermatitis[Image-15K] and similar conditions. Paste bandages are also often applied in conjunction with compression bandages in the management of venous ulcers. The principal problem associated with the use of paste bandages is their tendency to induce skin reactions. This is largely due to the presence of parabens preservatives. A recent addition to the Tariff is Steripaste which is preservative free and is therefore claimed to be less likely to induce skin reactions.

Tubular Bandages and Stockinettes

The Drug Tariff contains several different types of tubular bandages and stockinettes. These are used to provide support, act as dressing retention materials or provide protection to clothing or bedding following the application of large quantities of ointments or creams for dermatological conditions.

Pharmaceutical Preparations

The pharmaceutical preparations used in wound management are to be found in Sections 13.10 and 13.11 of the Welsh Prescribing Catalogue. These may be subdivided into the followings groups.