Valley Medical Pharmacy 
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Brawley, CA 92227 
eRx ID#0585957 
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Smith & Nephew - Allevyn Adhesive Border 7X7 10 In Each : Box One: Box

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Smith & Nephew - Allevyn Adhesive Border 7X7 10 In Each : Box One: Box


Smith & Nephew - Allevyn Adhesive Border 7X7 10 In Each : Box One: Box Item No.:M--Sm66020045

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ALLEVYN◊ Adhesive - Hydrocellular Dressing

ALLEVYN◊ Adhesive provides the advantages of ALLEVYN◊ Hydrocellular dressings in a adhesive format for simple and effective fixation.
?Low allergy adhesive
?Tapered construction with micro-thin edges
?Unique trilaminate structure
?Perforated wound contact layer
?Highly absorbent central hydrocellular layer
?Waterproof outer film layer
?Full range of sizes
Convenient adhesive presentation
The wound contact layer of ALLEVYN◊ Adhesive is coated with a low allergy adhesive which is designed to adhere well to intact skin, but not to wounds. The adhesive is non-irritating.

Highly absorbent
In-vitro studies and clinical experience demonstrate that ALLEVYN◊ Adhesive dressings can stay in place for up to seven days. This capacity results from a combination of properties:

?The perforated wound contact layer allows even viscous exudate to pass into the dressing.
?The hydrocellular core of the dressing absorbs and holds liquid in its microscopic structure.
?The breathable outer surface of the dressing allows excess moisture to evaporate away from the dressing.
?The result is the formation of a wound environment, which allows wound closure to progress without the need for frequent dressing changes.
Moist Wound Environment
ALLEVYN◊ Adhesive creates and maintains a moist wound healing environment at the wound surface, helping prevent eschar formation.

Profiled dressing edges
ALLEVYN◊ Adhesive has a profiled cross-section, narrowing to micro-thin edges which helps ensure the dressing remains securely in place and prevents accidental removal by friction between the dressing and clothes and bedding.

Waterproof/Aids in the prevention of bacterial contamination

Cushioned comfort
ALLEVYN◊ Adhesive dressings are soft and cushioning, giving excellent patient comfort and protection.

?ALLEVYN◊ Adhesive is indicated for exudate absorption and the management of partial to full thickness wounds. Some typical wounds are:
Ulcers (venous, arterial, diabetic)
Pressure Sores
Donor Sites
Surgical Incisions
Surgical Excisions
Burns (1st and 2nd degree)
?Creation and maintenance of a moist wound environment. Moist wound environments have been established as optimal environments for the management of the wound.
?Provides physical separation between the wound and external environments to assist in preventing bacterial contamination of the wound.
?Do not use any ALLEVYN◊ product with oxidising agents such as hypochlorite solutions (eg Dakins) or hydrogen peroxide, as these can break down the absorbent polyurethane component of the dressings.
?As with all adhesive products, some cases of irritation and/or maceration of the skin surrounding the wound have been reported. It should be noted that too frequent dressing changes, particularly on patients with fragile skin, may result in skin stripping.
?If reddening or sensitization occur, discontinue use and consult a healthcare professional.
?ALLEVYN◊ Adhesive is not indicated for use on third degree burns.
.Ordering Codes / Reimbursement Information
Usual Allowable Amount: Up to 3 per week (sheet) up to 1 per day (filler).
Specific Coverage Criteria: Covered when used on full-thickness wounds with moderate to heavy exudate sheets are covered as both primary and secondary dressings.

Product # Size Pcs/Pkg Pkgs/Case HCPCS Code
66000043 3 x 3 10 4 A6212
66000044 5 x 5 10 4 A6212
66000045 7 x 7 10 4 A6213
66000046 9 x 9 10 8 A6214
Step 1
Select an appropriate size dressing. Prepare and clean the skin around the wound. SKIN-PREP◊ Protective Wipes may be used to protect fragile skin. Peel back the protector papers and anchor the dressing over the wound. Smooth the dressing into place, ensuring that the edges of the dressing are not wrinkled.
.Step 2
During the early stages of treatment, ALLEVYN◊ Adhesive dressings should be inspected frequently dressings can be left in place until exudate can be seen through the outer waterproof film layer and approaches 3/4 from the edge of the dressing.
.Step 3
To remove, lift one corner of the dressing and lift it gently away from the wound.