Chronic wounds — those that have not healed within six weeks despite appropriate care — affect an estimated 2.2 million people in the UK, according to a 2019 analysis published in BMJ Open. The annual cost to the NHS is estimated at £8.3 billion, making wound care one of the largest single items of community healthcare expenditure. Community pharmacists are closely involved in this care pathway, both as suppliers of dressings and as clinical advisers to patients managing wounds at home.
Types of chronic wound seen in community pharmacy
| Wound type | Typical patient | Pharmacy involvement |
|---|---|---|
| Venous leg ulcers | Older adults with venous insufficiency | Dispensing compression hosiery, dressings on prescription, OTC skin protectants |
| Diabetic foot ulcers | Patients with diabetes and peripheral neuropathy | Dressing supply, footwear advice, signposting to diabetic foot team |
| Pressure ulcers (pressure sores) | Immobile or bed-bound patients, often via carers | Dressing supply on prescription, barrier cream supply, equipment signposting |
| Post-surgical wounds | Patients discharged with ongoing wound care needs | Dressing supply, saline for irrigation, recognising signs of infection |
| Arterial ulcers | Patients with peripheral arterial disease | Urgent referral — compression contraindicated, specialist assessment needed |
The pharmacy dressing formulary
The Drug Tariff Part IXA lists the wound dressings available on NHS prescription. Community pharmacies typically stock a core range and can order specialist dressings within 24 hours. The main dressing categories and their primary indications are:
| Dressing category | Examples | Primary indication |
|---|---|---|
| Foam dressings | Allevyn, Biatain, Mepilex | Moderate-to-heavy exudate, pressure ulcer prevention |
| Alginate dressings | Kaltostat, Sorbsan | Heavy exudate, cavity wounds |
| Hydrocolloid dressings | DuoDERM, Comfeel | Low-to-moderate exudate, granulating wounds |
| Hydrogel dressings | Intrasite Gel, Purilon | Dry or sloughy wounds, rehydration of tissue |
| Film dressings | Tegaderm, OpSite | Superficial wounds, secondary dressing, catheter sites |
| Silver-containing dressings | Acticoat, Aquacel Ag | Wounds with signs of localised infection or high bioburden |
| Honey-based dressings | Medihoney, Activon Tulle | Sloughy or malodorous wounds, debriding action |
| Superabsorbent dressings | Flivasorb, Zetuvit Plus | Very heavily exuding wounds |
Pharmacists should note that silver-containing and honey-based dressings are more expensive and should generally be reserved for wounds with clinical signs of infection or colonisation, not used as routine first-line dressings.
OTC wound care products
In addition to prescription dressings, pharmacies stock a range of OTC products relevant to wound care:
- Saline solution (0.9% sodium chloride): the first-choice irrigation fluid for wound cleansing. Preferred over antiseptics for routine use, as antiseptics can delay healing
- Barrier creams and films: products like Cavilon No Sting Barrier Film or zinc-based barrier creams protect peri-wound skin from maceration by exudate
- Compression hosiery: for patients with healed venous ulcers, compression stockings (Class 2, 18–24 mmHg) reduce recurrence. Available on prescription but also purchasable OTC
- Emollients: keeping peri-wound skin moisturised reduces cracking and secondary breakdown
- Adhesive tape and retention bandages: for securing dressings in place
The pharmacist's clinical role
Community pharmacists handling wound care prescriptions can add clinical value in several ways:
Recognising infection
Wound infection is a clinical diagnosis, but pharmacists can identify signs that warrant urgent GP or tissue viability nurse review:
- Increasing pain, redness or swelling around the wound
- Change in exudate colour (green or malodorous discharge)
- New or worsening systemic symptoms (fever, malaise)
- Wound that was improving but has deteriorated
Checking compression appropriateness
Compression therapy is the cornerstone of venous leg ulcer management, but it is contraindicated in arterial disease. If a patient presents with a new prescription for compression hosiery or bandaging but has not had an ankle-brachial pressure index (ABPI) assessment, the pharmacist should flag this to the prescriber. Applying compression to an ischaemic limb can cause tissue necrosis.
Supporting adherence to dressing regimens
Patients or carers managing dressings at home may struggle with technique, frequency or the sheer variety of products prescribed. The pharmacist can simplify the regimen where possible and demonstrate dressing application if the patient is present.
Identifying repeat prescription patterns
Chronic wound patients often have long-running repeat prescriptions for dressings. A wound that has been dressed with the same product for months without healing may need reassessment by a tissue viability specialist. The pharmacist can flag this pattern to the GP practice.
Where to explore further
Pharmacists can use PharmSee's pharmacy search to explore pharmacy provision by area — useful for understanding local wound care service coverage. The job search tool surfaces tissue viability and specialist pharmacy roles, and salary data provides context on how clinical specialist positions compare to generalist pharmacy salaries.
Caveats
Wound care is a specialist clinical area. The information here provides a general overview of the community pharmacy role and should not be used as a substitute for specialist tissue viability assessment. The 2.2 million figure and £8.3 billion cost estimate are from Guest et al., BMJ Open (2019), and cover all chronic wounds including those managed in hospital settings. Dressing selection should be guided by the prescriber and informed by local formulary guidance. Drug Tariff listings are updated regularly; pharmacists should check the current edition.
Sources
- Guest JF et al., "Health economic burden of wounds to the UK's National Health Service", BMJ Open (2019)
- NICE CG179: Pressure Ulcers — Prevention and Management (2014, updated)
- NICE CG168: Varicose Veins — Diagnosis and Management (2013)
- Drug Tariff Part IXA: Wound Dressings
- PharmSee vacancy database, 1,715 active roles as at 15 April 2026