Andrew Heenan RMN RGN BA(Hons) Editor, World Wide Wounds a.heenan@smtl.co.uk |
Introduction
|
Submitted: 18 November 1998 Published: 13 December 1998 Edition 4.0 |
The Drug Tariff is not an arbitrary list; it contains only those products that are tried and tested; so it tends to exclude the latest products. The exact criteria for selection are not published, but it may not be a coincidence that products with a lower unit cost have, in the past, had a greater chance of quick inclusion than more expensive products. This, it might be suggested, shows a lack of understanding of the principles of wound management: a higher unit cost might apply to a product which needs applying less frequently and/or requires less time and skill to apply. Such a product might be more cost effective over a period of time.
The Drug Tariff has also shown obscure prejudice against certain areas; cavity wound dressings, and dressings for malodorous wounds have fared badly.
Recently, however, the Drug Tariff seems to have become more closely related to the market place and to patients' needs. New products, particularly those with a CE mark, and new sizes/formulations of existing products, appear to reach the Tariff more easily.
The Drug Tariff matters, because products that are not included cannot be obtained on an FP10 prescription (England and Wales; GP10 in Scotland) (Hospitals are not bound by the Drug Tariff; they are free to draw up their own lists of acceptable purchases - but that is another story!). In practice, non-Tariff dressings are obtained by the time honoured techniques of begging, stealing and borrowing. Hospital staff need to be aware of the Drug Tariff and its limitations, in order to plan for continuity of wound management as patients go home.
This article (and its companion, Bandages on the Drug Tariff reflect on information already available in the Drug Tariff [1], arranged in tables for convenience. These articles intentionally exclude obsolete dressings and gauze swabs which are used for cleansing purposes as well as items like paraffin gauze which are still available on community prescription, but are rarely the dressing of choice[2], particularly those impregnated with antibiotics which are an anachronism to be avoided. Colonization and contamination are not an indication for topical antibiotics, rather an imperative to effect wound healing as quickly as possible, and any sign of significant wound infection is an indication for appropriate systemic antibiotics.
This edition updates May's edition; the article now excludes all
bandages, which are discussed in Bandages on the Drug
Tariff. All details and links have been checked, and price
changes are included from the latest (October) edition of the Drug
Tariff. There is one new sections:
Activated Charcoal Cloth with Silver; this
is a major step forward for the Drug Tariff, which hitherto has
denied the existence of malodorous wounds.
Perforated film absorbent dressings | ||
---|---|---|
Melolin (Smith & Nephew) | 5cm x 5cm | 13p |
10cm x 10cm |
21p
|
|
20cm x 10cm |
41p
|
|
Release (Johnson & Johnson) | 5cm x 5cm |
12p
|
10cm x 10cm |
20p
|
|
20cm x 10cm |
37p
|
|
Skintact (Robinson) | 5cm x 5cm |
10p
|
10cm x 10cm |
17p
|
|
20cm x 10cm |
33p
|
Absorbent, perforated film with adhesive border | Pad | Border | ||
---|---|---|---|---|
Mepore (Mölnlycke) |
6cm x 7cm | 8p | 3cm x 4cm | 1.5cm |
9cm x 10cm |
17p
|
5cm x 6cm | 2cm | |
9cm x 15cm |
29p
|
5cm x 10cm | 2.0 - 2.5cm | |
9cm x 20cm | 35p | 5cm x 15cm | 2.0 - 2.5cm | |
9cm x 25cm | 48p | 5cm x 20cm | 2.0 - 2.5cm | |
9cm x 30cm | 55p | 5cm x 25cm | 2.0 - 2.5cm | |
9cm x 35cm | 60p | 5cm x 30cm | 2.0 - 2.5cm | |
Primapore (Smith & Nephew) |
6cm x 8.3cm | 14p | 3.4cm x 5.7cm | 1.3cm |
8.25 x 12cm | 22p | 4.5cm x 7.3cm | 1.875-2.35cm | |
8.25cm x 18cm | 32p | 4.5cm x 12cm | 1.875-3.0cm | |
8.25 x 25 | 37p | 4.5cm x 19cm | 1.875-3.0cm | |
12cm x 35cm | 80p | 6.6cm x 29cm | 2.7-2.95cm |
Knitted viscose primary dressings | ||
---|---|---|
N-A Dressing (Johnson & Johnson) | 9.5cm x 9.5cm |
30p
|
N-A Ultra (1) (Johnson & Johnson) | 9.5cm x 9.5cm |
28p
|
Tricotex (Smith & Nephew) | 9.5cm x 9.5cm |
26p
|
Povidone iodine fabric dressing | ||
---|---|---|
Inadine (Johnson & Johnson) |
5cm x 5cm |
27p
|
9.5cm x 9.5cm |
40p
|
Vapour permeable adhesive film dressings | ||
---|---|---|
Bioclusive (Johnson & Johnson) |
10.2cm x 12.7cm |
£1.29
|
Cutifilm (Beiersdorf) |
7.5cm x 10cm |
£0.65
|
10cm x 14cm |
£1.11
|
|
EpiView (Convatec) |
6cm x 7cm |
£0.40
|
10cm x 12cm |
£1.05
|
|
Mefilm (Mölnlycke) |
6cm x 7cm |
£0.37
|
10cm x 12.7cm |
£0.99
|
|
10cm x 25cm |
£1.93
|
|
15cm x 21.5cm |
£2.45
|
|
Opsite Flexigrid
(Smith & Nephew) |
6cm x 7cm |
£0.43
|
10cm x 12cm |
£1.22
|
|
15cm x 20cm |
£2.90
|
|
Tegaderm (3M Health Care) |
12cm x 12cm |
£1.21
|
15cm x 20cm |
£2.30
|
Activated charcoal cloth with silver | ||
---|---|---|
Actisorb Plus (Johnson & Johnson) |
10.5cm x 10.5cm | £2.20 |
10.5cm x 19cm | £4.00 |
Alginate dressings | ||
---|---|---|
Algisite (Smith & Nephew) |
5cm x 5cm |
£0.72
|
10cm x 10cm |
£1.49
|
|
15 x 20cm |
£4.00
|
|
Algosteril (Beiersdorf) |
5cm x 5cm |
£0.74
|
10cm x 10cm |
£1.69
|
|
Comfeel
SeaSorb (Coloplast) |
6cm x 4cm |
£0.72
|
10cm x 10cm |
£1.50
|
|
15cm x 15cm |
£3.10
|
|
Kaltogel (Convatec) |
5cm x 5cm |
£0.71
|
10cm x 10cm |
£1.48
|
|
Kaltostat
(Convatec) |
5cm x 5cm |
£0.73
|
7.5cm x 12cm |
£1.59
|
|
Melgisorb (Molnlycke) |
5cm x 5cm |
£0.71
|
10cm x 10cm |
£1.48
|
|
10x 20cm |
£2.78
|
|
Sorbsan (Maersk) |
5cm x 5cm |
£0.91
|
10cm x 10cm |
£1.60
|
|
Tegagel (3M Health Care) |
5cm x 5cm |
£0.73
|
10cm x 10cm |
£1.54
|
Alginate dressing with absorbent backing | ||
---|---|---|
Sorbsan Plus (Maersk) |
7.5cm x 10cm |
£1.43
|
10cm x 15cm |
£2.53
|
|
10cm x 20cm |
£3.23
|
Hydrocolloid dressings: 1. Semipermeable With Adhesive Border | ||
---|---|---|
Comfeel Plus Contour Dressing (Coloplast) |
6cm x 8cm (1) |
£1.70
|
9cm x 11cm (1) |
£2.95
|
|
Granuflex
(Bordered) (Convatec) |
10cm x 10cm (2) |
£2.55
|
10cm x 13cm (3) |
£3.01
|
|
15cm x 18cm (3) |
£4.69
|
|
Hydrocoll Border (Hartmann) |
5cm x 5cm (4) |
£0.84
|
7.5cm x 7.5cm (4) |
£1.38
|
|
6cm x 14cm (5) |
£1.77
|
|
10cm x 10cm (4) |
£2.01
|
|
15cm x 15cm (4) |
£3.78
|
|
15cm x 18cm (5) |
£3.01
|
|
Tegasorb Advanced
Formulation (3M Health Care) |
10cm x 12cm (6) |
£2.05
|
13cm x 15cm (6) |
£3.83
|
Hydrocolloid dressings: 2. Semipermeable Without Adhesive Border | ||
---|---|---|
Comfeel (bevelled
edge) (Coloplast) |
10cm x 10cm |
£2.13
|
15cm x 15cm |
£4.27
|
|
20cm x 20cm |
£6.53
|
|
Comfeel Plus Ulcer
Dressing (Coloplast) |
10cm x 10cm |
£2.19
|
15cm x 15cm |
£4.36
|
|
18cm x 20cm |
£4.40
|
|
20cm x 20cm |
£6.54
|
|
Cutinova Foam (Beiersdorf) |
5cm x 6cm |
£0.99
|
10cm x 10cm |
£2.13
|
|
15cm x 20cm |
£3.88
|
|
Granuflex (Improved
Formulation) (Convatec) |
10cm x 10cm |
£2.14
|
15cm x 20cm |
£4.40
|
|
15cm x 15cm |
£4.06
|
|
20cm x 20cm |
£6.11
|
|
Hydrocoll Basic (Hartmann) |
10cm x 10cm |
£2.04
|
15cm x 20cm |
£4.34
|
|
20cm x 20cm |
£5.98
|
|
Tegasorb Advanced
Formulation (3M Health Care) |
10cm x 10cm |
£2.09
|
15cm x 15cm |
£4.05
|
Hydrocolloid dressings: 3. Thin Semipermeable No Adhesive Border | ||
---|---|---|
DuoDerm Extra Thin (Convatec) | 7.5cm x 7.5cm |
£0.61
|
10cm x 10cm |
£1.01
|
|
15cm x 15cm |
£2.18
|
|
Hydrocoll Extra Thin (Hartmann) |
7.5cm x 7.5cm |
£0.58
|
10cm x 10cm |
£0.96
|
|
15cm x 15cm |
£2.16
|
Hydrocolloid dressings: 4. Thin Semipermeable + Adhesive Border | ||
---|---|---|
Combiderm (Convatec) |
10cm x 10cm (1) |
£1.27
|
14cm x 14cm (2) |
£1.77
|
|
15cm x 18cm (3) |
£3.06
|
|
20cm x 20cm (2) |
£3.40
|
|
20cm x 23cm (4) |
£4.10
|
Hydrocolloid dressings: 5. Fibrous, No Adhesive Border | ||
---|---|---|
Aquacel
(Convatec) |
5cm x 5cm |
£0.89
|
10cm x 10cm |
£2.12
|
|
15cm x 15cm |
£3.99
|
Hydrogel dressings | ||
---|---|---|
AquaForm (Robert Bailey) | 15g |
£1.74
|
Granugel Hydrocolloid Gel (Convatec) | 15g |
£1.78
|
Intrasite Gel (Smith & Nephew) | 8g |
£1.38
|
15g |
£1.85
|
|
Nu-Gel (Johnson and Johnson) | 15g |
£1.75
|
Purilon Gel (Coloplast) | 15g |
£1.78
|
Sterigel (Seton) | 15g |
£1.78
|
Polyurethane foam dressing | ||
---|---|---|
Lyofoam (Seton) |
7.5cm x 7.5cm |
£0.89
|
10cm x 10cm |
£1.05
|
|
17.5cm x 10cm |
£1.63
|
|
20cm x 15cm |
£2.20
|
Polyurethane foam/film dressing: 1. with adhesive border | ||
---|---|---|
Allevyn Adhesive
(Smith & Nephew) |
7.5cm x 7.5cm (1) |
£1.17
|
12.5cm x 12.5cm (1) |
£2.10
|
|
17.5cm x 17.5cm (1) |
£4.14
|
|
22.5cm x 22.5cm (1) |
£6.03
|
|
Lyofoam Extra Adhesive (Seton) |
15cm x 15cm (2) |
£2.10
|
22cm x 22cm (3) |
£4.14
|
|
22cm x 26cm (3) |
£3.26
|
|
30cm x 30cm (4) |
£6.02
|
|
Tielle (Adhesive
Margin) (Johnson & Johnson) |
7cm x 9cm (5) |
£1.07
|
11cm x 11cm (5) |
£1.99
|
|
15cm x 15cm (5) |
£3.25
|
|
15cm x 20cm (5) |
£4.07
|
|
18cm x 18cm (5) |
£4.14
|
|
18cm x 18cm (6) |
£3.01
|
Polyurethane foam/film dressing: 2. Without adhesive border | ||
---|---|---|
Allevyn
(Non-adhesive) (Smith & Nephew) |
5cm x 5cm |
£0.99
|
10cm x 10cm |
£1.96
|
|
10cm x 20cm |
£3.15
|
|
20cm x 20cm |
£5.26
|
|
Flexipore (Polymedica) |
6cm x 7cm |
£0.93
|
10cm x 10cm |
£1.73
|
|
10cm x 30cm |
£3.60
|
|
15cm x 20cm |
£3.70
|
|
20cm x 20cm |
£5.06
|
|
Lyofoam Extra
(Non-adhesive) (Seton) |
10cm x 10cm |
£1.75
|
10cm x 17.5cm |
£2.96
|
|
10cm x 25cm |
£3.59
|
|
15cm x 20cm |
£3.84
|
|
Spyrosorb
(Adhesive) (Perstorp) |
10cm x 10cm |
£1.98
|
20cm x 20cm |
£5.65
|
This article is not intended to provide advice on the suitability of a particular dressing for a particular wound; it is intended simply to be a guide to dressings availability in Great Britain. The warnings and uses given are indicative only, and are largely taken from the Drug Tariff [1] and the British National Formulary [2], but any opinions expressed are those of the author. Readers are urged to refer to manufacturers' information and published research before using any dressing. The Drug Tariff is updated on a monthly basis and is available on subscription from HMSO.
Bandages on the Drug Tariff Edition 1.0 (November 1998)
Dressings on the Drug Tariff: Previous Editions:
Edition 3.1 (07 May 1998)
Edition 3.0 (16 Feb 1998)
Edition 2.0 (19 Sept 1997)
Edition 1.1 (31 July 1997)
Edition 1.0 (14 July 1997)
1. Department of Health. Drug Tariff. London: HMSO, October 1998
2. British National Formulary. London
BMA/RPSGB, September 1998