Stoma Care Products Formulary Guide - seqo.nhs.uk

Stoma Care Products Formulary Guide

The aim of this guidance is to:
Provide some basic information to prescribers and other healthcare profe
Assist in the prescribing decisions of stoma care products in primary care

This guide provides a list of the most clincically cost effective stoma care pro
The products offering the ‘best value’ in terms of clinical efficacy and cost ef
Suggested prescribing quantities have been indicated where possible. Pricing i

The guidance has been prepared by a small working party comprising of the sp
and East Berkshire Wexham Hospital site in collaboration with the medicines m

Weekly stoma clinics are routinely held at Wexham Park Hospital on Wednesda
Mandeville Hospital on Wednesday afternoons. Appointments are available for
who may be experiencing problems with their stoma (e.g leakage problems, high

Colorectal Nursing Service Contact Details:
Stoke Mandeville Hospital: 01296 315121
Wycombe Hospital: 01494 426235/6
Wexham Park Hospital: phone or fax on 01753 633734

Date revised: Sept 2011
Review date: June 2012

essionals on the use of stoma care products
e.

oducts within each product group as listed in the Drug Tariff.
ffectiveness are highlighted in bold.
information has been taken from the Drug Tariff June 2011.

pecialist stoma nurses within colorectal services from BHT
management team NHS Buckinghamshire.

ay mornings, at Wycombe general hospital on Monday afternoons & Stoke
r either stoma patients wishing to self refer or for Gps to refer patients
h product use).

Stoma Appliance Accessory

ACCESSORY PRODUCTS- FORMULARY CHOICES* INDIC

1. Adhesive Discs/ Rings/ Pads/Plaster Security frames (som
retention strips) offer
Manuf Product Qty/Pk Size Order No Cost/Pk providing an addition
£21.50 prevent leaks. They a
CS Bullen Ltd Shelter Safe-Seal 40 strips UF7000 £11.40
Preferred formular
Salts Healthcare SecuPlast Hydro 30 strips SPH1 £12.35 products used to se

SecuPlast Hydro Aloe 30 Strips SPHA2 £12.55 products are cons
£18.50 hydrocolloids do vary
Clinimed Ltd HydroFrame flange 20 strips WAF H33 (eg Clinimed HydroF
Ostomart Ltd DFW3
extenders whereas Bullen Sh
g
Ostofix Flange Security 40 strips
Product usage is
Frames

2. Adhesive Pastes Sprays & Solutions Used very rarely in sit
sebum requires use o
Adhesive Sprays or solutions are non formulary as they should no longer be required
with newer products

3. Adhesive Removers (AR) Sprays/Liquid/Wipes

Manuf Product Qty/Pk Size Order No Cost/Pk Adhesive removers a
CS Bullen Ltd Niltac Sting Free AR 50ml aerosol TR101 £8.42 adhesive residues &
Coloplast Ltd Adhesive remover TR102 £13.96
30 wipes There are 3 types of
£8.57 based oil based & alc
CD Medical Peel-Easy 50ml spray 12010 of application device -
30 wipes 12011 £14.20
HollisterLtd Adhesive remover 300714 £7.10 are all si
Medi Lifteez non sting 50ml spray 300715 £11.66
Medicare AR 30 wipes All silicon based
International 7731 £13.60 interchangeable wit
Plus Dansac Non Sting AR 76g spray 60314 £12.50
Dansac Ltd Apeel No Sting AR Wipes may be usefu
Clinimed Ltd 75ml aerosol reduced or limited de

Opus Healthcare Lift Plus Medical AR 30 sachets 60321 13.75 adhe
50ml aerosol 082-01 £8.82
Pelican HealthcareRelease non sting AR 50ml aerosol 3500 £8.79 Belts & support ga
50ml aerosol 5503 £8.65 product to skin to pre
ProSys Indepence Adhesive 30 sachets 5502 £14.45 existing hernias. Su
50ml aerosol 130460 £8.95
50ml aerosol appliances i
RS1 £8.95

International Ltd Remover

4. Belts & Support Garments

Should only be prescribed under the advice of a stoma care nurse specialist.

* Products highlighted in BOLD identified as offering best value in terms of clinical efficacy

y Products Formulary Guide COMMENTS

CATIONS FOR USE

metimes called flange extensions or Hydrocolloid security frames are more appropriate to

r further security to an appliance, by prescribe than the use of adhesive tapes and plasters as

nal support to secure a pouch and plasters are more likely to cause allergic skin reactions and

are designed to increase wear time of leave adhesive residues.

a pouch.

ry choices are hydrocolloid based Pouches and flanges are now available with integral taped

ecure stoma flanges to the skin. All hydrocolloid adhesive borders and this may be easier for

sidered interchangeable although patients to use than additional security frames. It may also be

y in composition & source of gelatin a more cost effective Rx option if having to use flanges with

Frame uses a bovine based gelatin every bag change.

helter Safe-seal is a porcine based

gelatin product) Bullen Shelter Safe Seal & Salts Secuplast offer clinically

usually 2 strips per stoma pouch and cost effective options to use.

tuations where excessive sweat or Individuals still using these adhesive products should be

of an adhesive paste. refered to a stoma care nurse for review

are used to facilitate removal of any Sprays are suitable for general use and usually more cost
to reduce skin trauma on removing effective to prescribe. Only products considered to be
comparable in terms of price equivalence are included.
appliance.

adhesive removers (ARs) - silicon Products vary in nozzle design & product delivery & some pts

cohol based and available in 2 types may find one product more efficient to use than another.

- sprays & wipes . Formulary choices Pelican Release has a spearmint odour which may help to

ilicone based products. mask unpleasant odours & provide a cost effective option for

patients finding odour a problem to cope with. Opus lift plus

adhesive remover products are wipes also contain aloe vera.

thout compromise to patient care.
Frequency of use will depend on no of bag changes but Rx

ul for the elderly or individuals with quantities >2- 3 sprays or 1 wipe/bag per month should be
exterity or where problems of excess reviewed.
esive residue exist . .

.

arments are used to secure stoma Belts & support garments are washable. No more than 3 belts

event parastomal hernias or support or support garments should be required per year.

upport briefs designed to hold stoma These items should be trialled before use andonly issued as

in place are non formulary. a single item at any one time on an acute Rx

y cost effectiveness.

Stoma Appliance Accessory

ACCESSORY PRODUCTS- FORMULARY CHOICES* INDIC

5. Deodorants - Odour Neutralising Products only

Manuf Product Qty/Pk size Order No Cost/Pk Deodorants should o
£2.67 an odour neutralise
Salts Healthcare No-Roma 28ml 833021 £3.78 patient's a
£3.90
Freshaire Odour Elim Spray 50ml aerosol FA1 There are 3 differen
£1.81 available on prescrip
OstoMart Ltd Ostomist Neutralising 50ml SPN5
£3.45 sachets. Only deo
Mint Drops properties have been

Loxley Products a

Lemon Day-drop 15ml LL08

Lemon day-drop Spray 50ml aerosol LL010

ProSys Independence Odour 59ml PUMP PR310
080-00
International Ltd eliminator Lemon & lime spray 080-01 £4.70 Deodorising drops
£4.17 prescribe a deodora
Dansac Ltd Nodor S 50ml aerosol 60352 £8.52
250ml aerosol 2200 pouch before it is
ACD60 £4.25 Non lubricating deodo
Medicare Inter- Medi Citrone Ostomy 50ml aerosol £4.03
national Plus deodorant £4.27 therefo
The use of peppermi
Pelican Ltd Citrus Fresh deodorant 50ml spray or taking probiotic su
UCI Healthcare Auricare faecal Odour 60ml
Eliminator to help pati

6. Deodorants -Odour Neutralising + Lubricating products

Manuf Product Qty/Pk size Order No Cost/Pk These products are
'pancaking' where th
OstoMart Ltd OstoZyme Multi 300ml TCB6 £7.50 pancake shape aroun

Hollister Ltd Adapt Lubricating deod 236ml 78500 £8.89 It can occur when
Adapt Lubricating deod 50 sachets 78501 £12.63 causing the inside o
drops of oil eg baby o
Opus Healthcare DeoGel 200ml 2010 £7.73 filter covers supplied

pr
Filter covers are avai

7. Skin Powders Product Qty/Pk size Order No Cost/Pk
S103 £2.02
Manuf 1907 £2.23
ABP1 £2.28
Convatec Ltd Orahesive Powder 25g 7906 £2.43 Powders are used to
skin around stoma s
Coloplast Ltd Ostomy Pdr 25g
OstoMart Ltd OstoSEAL Protective pdr 25G Powders are usual
Hollister Ltd Adapt Stoma Powder indicated for
1

Salts HealthCare Karaya Pdr Puffer pk 1 833004 £4.98

* Products highlighted in BOLD identified as offering best value in terms of clinical efficacy

y Products Formulary Guide COMMENTS

CATIONS FOR USE

only be prescribed where the use of Most stoma pouches now have integral charcoal odour

er is considered essential to the filters, so odour should not be apparent apart from when

acceptance of the stoma . emptying or changing a pouch. Odour could mean leakage

or the filter on the bag may have come into contact with the

nt types of deodorant formulations contents of the bag rendering it ineffective.

ption - drops, sprays and deodorant In the majority of cases a commercially available household

odorants with odour neutralising deodorant neutraliser (eg Neutadol) represents an

included as odour masking products appropriate option for general home use and should be used

are less effective. first line as a room or bag odour neutraliser.

are the most cost effective way to Deodorants are interchangeable although patients may have

ant. Drops can be put in to a clean preference for a particular fragrance. Loxley LL010 & Prosys

s attached & after bag removal. PR310 are same fragrance as Clinimed LiMone Acceptable

orant sachets are not cost effective & Rx quantity 1-2 x 50ml sprays or 15-30ml as drops per

ore not been included. month . Pelican adhesive remover 130460 includes a

int capusles or eating natural yogurt peppermint deodoriser. It may offer a cost effective option
upplements have also been reported where both an adhesive reomver spray and deodoriser are
ients with odour problems.
being prescribed.

e occasionally used for problems of Pancaking can cause faeces to seep under the flange

he stool sits at the top of the bag in a leading to stoma leaks and skin excoriation around stoma

nd the stoma instead of going down site.

into the bag. Pancaking can be caused by "sticky" faeces or by soft or

there is little or no air in the pouch loose stools. Increasing dietary fibre &/or fluid intake may

of the pouch to stick together. A few help. The use of Lactulose 15ml once to twice daily may help

or olive oil &/or covering the filter with colostomists where poor fluid intake is the cause of the

in each box of stoma bags can help problem.

revent pancaking. Prescriptions for these products should be issued as

ilable from stoma bag manufacturers acute items only

free of charge.

o help heal sore excoriated or wet If a patient is continually receiving repeat prescriptions for
site and enable adherence of stoma powders they should be referred for review by stoma care
nurse to confirm indication for long term use.
appliance. Osteoseal is in a small handy puffer pack making application
lly only required as a one off order easy. If a powder is needed in the long term, Salts Karaya
r short term acute use only.
pdr likely to be a more cost effective choice

y cost effectiveness.

ACCESSORY PRODUCTS- FORMULARY CHOICES* Stoma Appliance Accessory

INDIC

8. Skin Barrier Wipes & Sprays

Manuf Product Qty/Pk size Order No Cost/Pk Barrier wipes & spray
Medicare Plus Medi Derma-S Barrier Film effects of stoma outpu
International Wipes 30 sachets 60307 £19.40 for ileostomists and u

Smith & Nephew 28ml 66800710 £5.32 should not routinely
Healthcare Ltd No sting pump spray 50 wipes 66800712 £22.00 with hea
£6.54
CNaovsiltoinng pNrootecSttiivneg wiBpaersrier 28ml 3346P All silicon base
3M Healthcare Ltd Film Pump Spray £14.77 interchangeable wit
30 sachets PPS1 £20.76 Smith & Nephew & 3M
Salts Healthcare Peri-prep sensitive non sting £10.93 most cost clinically an
protective wipe
has sufficient dexte
CS Bullen Ltd Trio Silesse barrier wipe 30 sachets TR103 Smith & Nephew &
Trio Silesse Spray 50ml TR104 effective barrier wipe

Coloplast Ltd Skin barrier wipe 30 sachets 12021 £21.12
Skin barrier spray 50ml 12020 £11.12

9. Skin Barrier Creams

Manuf Product Qty/Pk size Order No Cost/Pk Used as an alterna
Coloplast Ltd Comfeel barrier cream 60g 4720 £4.59 Applied around stoma
50g £4.51 prevent failure of adh
Pelican Ltd Ultra barrier cream 52g 130105 £5.49
90g 5271001000 £7.75 Cavilon barrier crea
Coloplast Ltd Chiron barrier cream £7.40 protection for stoma
20 sachets 60345 not be used as they f
Medicare Plus Medi Derma-S Barrier 60338
International Cream appl

10. Skin Pastes & Fillers

Manuf Product Qty/Pk size Order No Cost/Pk
30g S103 £2.02
Conva Tec Ltd Orabase paste 50g £3.40 These pastes are us
Dansac Ltd Dansac soft paste 60g 77550-0 £3.57 around the stoma to f
stoma paste 57g sp60 £3.54
Pelican Ltd 128g 79300 £8.05 Some pastes are
100g 7910 £7.67 protecti
Hollister Ltd Adapt paste 60g £7.46
60g 130101 £8.17 Salts Healthcare c
Hollister Ltd Karaya paste S105 130101 and Hollist
839010 pastes which contain
Pelican Ltd Paste to mucous membrane

Conva Tec Ltd Stomahesive paste
Salts healthcare Cohesive paste

* Products highlighted in BOLD identified as offering best value in terms of clinical efficacy

y Products Formulary Guide COMMENTS

CATIONS FOR USE

ys protect the skin from the corrosive

ut and help to maintain skin integrity All the wipes listed apart from Salts periprep wipes are
urostomists. Barrier wipes or sprays silicon based. Peri-prep wipes PPS1 is a patented water

y be needed for colostomy patients based wipe and is an alternative cost effective non silicon

althy functioning stoma. based barrier wipe option but as it contains a small amount of

alcohol to facilitate evaporation it should not be used on sore

ed barrier wipes & sprays are or excoriated skin.

thout compromise to patient care.

M Cavilon Barrier Film Spray are the Oil and alcohol based wipes are no longer recommended as

nd cost effective choice if the patient barrier wipes of choice.

erity to use the pump action spray.

& Medi Derma S are the most cost

es for patients prefering or needing a

barrier wipe.

ative to barrier wipes for sore skin. For acute limited short term use only until skin has healed.

a, left for 2 minutes then wiped off to For acute Rx short term use only - these products should not

hesive. Films dry to form a protective be issued on repeat Rx & only be prescribed on the advice of

layer. stoma specialist.

am is not suitable for use as barrier Barrier cream sachets may be more cost effective to
a sites. Normal creams should also prescribe as tubes of cream can work out to be more
form a greasy surface, prevening an
liance from sticking expensive due to the amount of product waste.

sed to fill up skin folds and cavities Use will depend on the depths of skin folds etc but

form an even surface for flange/bag. prescription requests for more than the equivalent of 2x60g

e formulated to also provide skin tubes per month should be reviewed.

ion around the stoma. Orabase paste is oil based and stomahesive paste is alcohol

based product.

cohesive paste, Pelican paste ref Product choice is under advice from stoma specialist.

ter karaya paste are all protective

n karaya & are formulated to adhere

e and raw weeping areas to promote

healing.

y cost effectiveness.

Stoma Appliance Accessory

ACCESSORY PRODUCTS- FORMULARY CHOICES* INDIC

11.Pressure Plates & Shields Pressure plates his
These products should only be prescribed under the advice of a stoma nurse Stoma shields are us
specialist. Product List is as specified in drug tariff. during contact spor

some patients requ
prevent the b

12. Skin Protectors (Wafers, Blankets, Foam Pads & Washers) Seals and washers a
List as drug tariff crevices, fistulas or s
stoma uneven. Used i
are due to either a di
or recessed or flat s

13. Discharge Solidifying Agents

Manuf Product Qty/Pk size Order No Cost/Pk These are thickening
CS Bullen Trio Diamonds sachets TR 105 100 £29.90 from stoma output, re
30 £7.50 for more frequent pou
Medicare Plus Absorbian Sachet Plus UFAS-02 30 £8.95 needed for ileostomy
Medi Gelsorb Sachets 60369
200 £19.00 output unresponsi
P200AS dietary measures

ProSys Independence Absorbent For ProSys independ
first line thickening
International Ltd Strips
requiring a regular th
be useful for problem

neutralise

Discharge solidifyin
in

14. Stoma Caps

Manuf Product Qty/Pk size Order No Cost/Pk A stoma cap is a sm
£45 e.g. while swimming
CS Bullen Mini-Stomacap cut to fit 10-32mm x50 1740/00 irrigate their stoma a
Salts Healthcare SCG13 £33.78 are designed to co
Confidence Gold with £38.34
filter starter hole £37.16 have littl
13mm x30 £36.82
£36.89 Stoma caps are usua
Coloplast Ltd Assura minicap 20mm starter hole x30 2501 st

ConvaTec Ltd Colodress Plus 19mm starter hole x30 S281

Dansac Ltd Nova Mini Caps cut to fit 20-50mm x 30 829-20

Unique Mini cap cut to fit 20-50mm x 30 229-30

* Products highlighted in BOLD identified as offering best value in terms of clinical efficacy

y Products Formulary Guide COMMENTS

CATIONS FOR USE

storically used for retracted stomas. The need for use of pressure plates is extremely limited as
sed to protect the stoma from injury stoma bags with built in convexity are nowavailable. Patients
rts or manual /physical jobs and in still using pressure plates would benefit from a review by a
uiring a hernia support belt to help stoma care nurse.
belt squashing the pouch. . For acute Rx use only.

are used on parastomal skin that has Seals and washers are easily mouldable to all the body

scar tissue making skin surrounding contours to ensure increased comfort and fit. As these

in patients with problems of leakage products can help to increase pouch wear time, they may be

ifficult sited stoma (eg in a skin fold) a cost effective option for stoma patients.

stomas (ie stomas flush to the skin). The choice of product is generally governed by the type of

problem causing the leak.These products should only be

prescribed under the recommendations of a stoma nurse

agents designed to absorb moisture Liquid stools have increased tendency to leak.

educing risk of leakage and the need Solidifying agents are useful at night if output is liquid as they

uch change. They should be only be can help to prevent black flow causing blockage of the flatus

y or stoma patients with high watery filter and stoma leaks.

ive to drug treatment strategies or Loperamide (as loperamide dispersible tablets) can be used

s to control excessive fluid loss. to help reduce & thicken up stoma output and hence need for

dence strips (use 2 strips/bag) is the more frequent bag change especially in patients with an

agent option of choice for patients Ileostomy or an ascending colostomy

hickening agent. Trio Diamonds may Methylcellulose (celevac) tablets are also licenced for use in

ms of ballooning and has both odour the control of colostomy and ileostomy output.

er and gelling properties. These products should only be on repeat Rx if for patients

with high output stomas such as jejunostomies and

ng products are considered to be ileostomies and ocasionally tranverse colostomies.

nterchangeable.

mall mini pouch for short-time wear, They are not suitable for ileostomy patients due the high
g, playing sports, etc. Patients who activity of this type of stoma.
also find these products useful. They
over a stoma or mucous fistula but Product choice and size should be under the guidance of a
le or no actual capacity. stoma nurse specialist

ally cut to fit according to a patient's For acute prescription only unless prescribed or patients with
toma/fistula size. a mucus fistula or managing their colostomy by irrigation
where a repeat Rx is clinically justified.

y cost effectiveness.

ACCESSORY PRODUCTS- FORMULARY CHOICES* Stoma Appliance Accessory

INDIC

15. Filters & Bridges

Manuf Product Qty/Pk size Order No Cost/Pk The need for filters
30 7700 £9.66 pouche
Opus Healthcare ClearWay Stoma Bridge
Stoma bridges are de
form the pouch apart

questionable valu

16. Bag Covers & Closures Bag covers are used
Product list as drug tariff hide contents & to
contact
Items now consid

* Products highlighted in BOLD identified as offering best value in terms of clinical efficacy

y Products Formulary Guide COMMENTS

CATIONS FOR USE

s is considered obsolete as all new Patients still using some of these older products should be

es have built in filters. referred for review by stoma nurse specialist. Filter bridges

esigned to keep the plastic films that are of questionable value since a piece of rolled up kitchen or

t, thus avoiding pancaking but are of toilet roll placed into the bag works just as well in keeping

ue in terms of cost effectiveness. the plastic sides of a pouch separate.

Acute Rx use only.

d for transparent stoma pouches to Modern bags come in soft backing & opaque options with
o reduce discomfort resulting from integral fastenings so that bag covers are now rarely needed.

of bag against the skin Pouch covers are washable.
dered obsolete for new patients Average use 3 per year for existing patients as acute Rx only.

y cost effectiveness.