Most minor cuts, abrasions and blisters seen in community pharmacy can be managed without referral. The choice between a plaster, a wound closure strip and a hydrocolloid dressing affects healing time, scarring and infection risk — and the wrong choice can cause unnecessary scarring or, occasionally, a wound that needs surgical revision.

This guide describes the over-the-counter dressings community pharmacy teams routinely supply, when each is appropriate, and the warning signs that should prompt referral to a minor injuries unit, the GP or A&E. It is based on NICE Clinical Knowledge Summaries on lacerations and wound management, the NHS minor injury self-care guidance and the BNF wound management appendix.

Wound assessment in 60 seconds

Before recommending any dressing, the pharmacy team should establish:

• Mechanism of injury — sharp clean cut, blunt trauma, animal or human bite, burn, abrasion
• Time since injury — closure becomes less effective after six hours and is generally avoided after 12 hours for facial wounds, 24 hours elsewhere
• Location — face, scalp, hand, joint, foot, perineum need a lower threshold for medical review
• Depth and gape — wounds that gape more than 5 mm at rest, expose fat or deeper tissue, or affect tendon function need surgical assessment
• Contamination — soil, glass, organic material; tetanus status
• Bleeding control — wounds still bleeding after 10–15 minutes of firm direct pressure
• Patient factors — anticoagulation, immunosuppression, diabetes, peripheral vascular disease

Any "yes" to gape > 5 mm, animal or human bite, foot wound, deep contamination or active bleeding is a clear referral.

Adhesive wound closure strips (Steri-Strips and equivalents)

Wound closure strips are sterile adhesive bands that approximate the edges of a clean cut. They are the most common over-the-counter alternative to sutures.

Suitable for:

• Clean, straight, low-tension lacerations under 5 cm
• Wound edges that meet without gaping
• Limbs, trunk and other low-mobility sites
• Children's small head wounds where suturing is not preferred (after professional assessment)

Not suitable for:

• Wounds with significant gape or tension
• Joint surfaces and high-mobility skin (knees, knuckles, palms)
• Hairy areas (poor adhesion)
• Bites, contaminated wounds or those more than 24 hours old
• Deep wounds where edges cannot be approximated

Application advice for patients:

• Clean the wound under running water; pat dry, do not rub
• Avoid antiseptic solutions on the wound bed unless instructed
• Apply strips perpendicular to the wound, leaving 2–3 mm gaps for drainage
• Cover with a sterile non-adherent dressing for the first 24 hours
• Keep dry for 48 hours; the strips usually fall off in 5–10 days
• Seek review if redness extends, the wound becomes painful, discharges or smells, or systemic symptoms develop

Standard adhesive plasters

Acceptable for superficial abrasions and minor cuts that do not gape. The choice between fabric, washproof, hypoallergenic and "invisible" plasters is largely cosmetic. Plasters with a non-adherent central pad (most own-label and brand offerings) are preferable to traditional gauze-and-tape combinations.

Latex-free options should be on the counter for known allergies. Children may need plasters changed daily because the central pad becomes saturated more quickly.

Hydrocolloid dressings (Compeed and equivalents)

Hydrocolloid dressings have become the de facto OTC blister treatment. The dressing forms a gel with wound exudate and protects the underlying skin while it heals.

Suitable for:

• Friction blisters (hands, feet)
• Minor pressure sores
• Acne lesions ("pimple patches")
• Cold sores (specific Compeed formulation)
• Chronic small wounds with low to moderate exudate

Not suitable for:

• Heavily exuding wounds
• Infected wounds
• Wounds with surrounding cellulitis
• Wounds in patients with reduced sensation (diabetic foot) without medical review

The dressing is left in place until it lifts at the edges, typically 3–7 days. Premature removal disrupts healing.

Foam dressings

Foam dressings (Allevyn, Mepilex) absorb more exudate than hydrocolloids and are useful for moderate-to-heavy bleeding wounds and donor sites. They are typically supplied by GP practices or district nurses for chronic wound care; over-the-counter foam dressings are mostly small-format adhesive variants for blister and pressure-area protection.

Film dressings

Transparent film dressings (Tegaderm, Opsite) provide a waterproof, breathable cover that allows visual inspection of the wound. They are ideal over Steri-Strips for showering, over IV cannula sites, and as a final layer over a non-adherent pad. Not suitable as a primary contact layer on heavy-exudate wounds.

Gauze and crepe

Sterile gauze swabs and crepe bandages remain the workhorse of acute haemorrhage control. Pharmacy teams should encourage every household first aid kit to include both for direct pressure on a bleeding wound while help is sought.

When to refer

A practical referral list for the counter:

Aftercare counselling

Every wound care sale should include the simple "redness, swelling, pus, fever" message and the timeline for review. The wound should be inspected daily, kept clean and dry within reason, and the patient should know when to seek help.

PharmSee's pharmacy directory helps patients locate the nearest community pharmacy with a consultation room for wound assessment. The pharmacist career hub covers the wider clinical role of the community pharmacist in minor injury triage; the PharmSee jobs board lists pharmacy and pharmacy technician vacancies across the UK.

Sources

• NICE Clinical Knowledge Summary: Lacerations
• NHS — How to treat minor injuries
• BNF Wound Management (formerly Appendix 5)
• Royal College of Emergency Medicine — Best Practice Guideline on Minor Wounds