Wound Care Products List (by category with examples of Brand Names)

The following list is by Product Category which includes examples of Brand Names and is intended to assist providers with choosing a benefit code, in addition to, finding out if a prior approval is required for these products.

Since this list is not exhaustive, providers may need to consult the section 1.8 Wound Dressing Supplies List, which is organized by Product Type.

The First Nations and Inuit Health Branch (FNIHB) regional office can also assist providers with finding the benefit code and prior approval requirements, if required.

Dressings by category

Dressing Category: Adhesive items

Dressing Category: Adhesive items
Item Description Item Code Prior Approval Frequency Maximum Price Per Item
Adhesive tape, non-hypoallergenic 99400445 No - -
Adhesive tape, hypoallergenic 99400444 No - -
Adhesive suture strips 99400446 Yes - -

Brand Examples

  • Blenderm (3M Health Care)
  • Cloth Adhesive Tape (3M Health Care)
  • Cover Strip (3M Health Care)
  • Durapore (3M Health Care)
  • Gentac (Medline)
  • Hypafix (Smith & Nephew)
  • Kind Removal Silicone Tape (3M Health Care)
  • Leukosan Strip (BSN Medical)
  • Leukoplast Sleek (BSN Medical)
  • LEUKOSTRIP (Smith & Nephew)
  • Medfix (Medline)
  • Medipore (3M Health Care)
  • Medipore H (3M Health Care)
  • Mefix (Mölnlycke)
  • Mepitac (Mölnlycke)
  • Micropore (3M Health Care)
  • Pink Zinc oxide tape (Medline)
  • Shur Strip Wound Closure Strips (Derma Science)
  • Steri Strips (3M Medical)
  • Suture Strip Plus (Derma Science)
  • Transpore (3M Health Care)
  • Ultrafix (Derma Science)

Dressing Category: Alginate / Hydrofibre

Dressing Category: Alginate / Hydrofibre
Item Description Item Code Prior Approval Frequency Maximum Price Per Item
Alginate/Hydrofibre dressing, 5 cm ×  5 cm 99401155 No For any combination of these 2 items:
30 items per year without prior approval
$6.80
Alginate/Hydrofibre dressing, 10 cm × 10 cm 99401156 $16.47
Alginate/Hydrofibre dressing - Other 99400454 Yes - -

Brand Examples

  • ALGICELL Calcium Alginate (Derma Sciences)
  • ALGISITE M (Smith & Nephew)
  • AQUACEL (ConvaTec)
  • Biatain Alginate (Coloplast)
  • CURASORB (Covidien Kendall)
  • CUTINOVA Hydro (Smith & Nephew)
  • Debrisan (Pharmacia & Upjohn)
  • Derma Calcium Alginate (Derma Science)
  • Exufiber (Mölnlycke)
  • KALTOSTAT (ConvaTec)
  • Maxorb II (Medline)
  • Melgisorb Plus (Mölnlycke)
  • Mesalt (Mölnlycke)
  • NU-DERM Alginate (Acelity)
  • Opticell (Medline)
  • Qwick (Medline)
  • Restore Calcium Alginate (Hollister)
  • Sorbsan (Pharma-Plast)
  • Sorbsan Plus (Pharma-Plast)
  • Sorbsan SA (Pharma-Plast)
  • Tegaderm High Gelling Alginate (3M Health Care)
  • Tegaderm High Integrity Alginate (3M Health Care)

Dressing Category: Charcoal

Dressing Category: Charcoal
Item Description Item Code Prior Approval Frequency Maximum Price Per Item
Charcoal dressing, 10 cm × 10 cm 99401157 No 30 items per year without prior approval $10.69
Charcoal dressing - other 99400455 Yes - -

Brand Examples

  • CARBONET (Smith & Nephew)
  • Cliniflex (Clinimed)

Dressing Category: Composite

Dressing Category: Composite
Item Description Item Code Prior Approval Frequency Maximum Price Per Item
Composite dressing 99400811 Yes - -

Brand Examples

  • Alldress (Mölnlycke)
  • Comfeel Plus Hydrocolloid combined with Alginate (Coloplast)
  • Compdress (Derma Sciences)
  • CombiDERM (ConvaTec)
  • Dudress (Derma Sciences)
  • EXU-DRY (Smith & Nephew)
  • Leukomed (BSN Medical)
  • Mesorb (Mölnlycke)
  • Mextra Superabsorbe nt (Mölnlycke)
  • OPSITE Post-Op Smith & Nephew)
  • Stratasorb (Medline)
  • Tegaderm + Pad (3M Health Care)
  • Xtrasorb (Derma Science)

Dressing Category: Conform gauze bandage "Kling" type

Dressing Category: Conform gauze bandage "Kling" type
Item Description Item Code Prior Approval Frequency Maximum Price Per Item
Conform gauze bandage "Kling" type 99400448 No - -

Brand Examples

  • Duform (Derma Sciences)
  • Dutex Conforming Bandages (Derma Sciences)
  • Easifix (BSN Medical)
  • Kerlix (Kendall Health care)
  • Kling (Johnson & Johnson)

Dressing Category: Elastic Bandage

Dressing Category: Elastic Bandage
Item Description Item Code Prior Approval Frequency Maximum Price Per Item
Elastic bandage 99400449 No 8 per year -

Brand Examples

  • Co-Plus (BSN Medical)
  • Coban (3M Health Care)
  • Duban Cohesive Bandages (Derma Sciences)
  • Dusor Elastic Bandage (Derma Sciences)
  • Econo-San (BSN Medical)
  • Elastocrepe (Smith & Nephew)
  • Elastogrip (BSN Medical)
  • Surgigrip (Smith & Nephew)
  • Tensogrip (BSN Medical)
  • Tensor
  • Tubigrip (Mölnlycke)

Dressing Category: Foam dressing / medicated, non-medicated

Dressing Category: Foam dressing / medicated, non-medicated
Item Description Item Code Prior Approval Frequency Maximum Price Per Item
Foam, non-adhesive dressing, 5 cm × 5 cm 99401158 No For any combination of these 4 items:
30 items per year without prior approval
$4.40
Foam, non-adhesive dressing, 10 cm × 10 cm 99401159 $10.95
Foam, adhesive dressing, 7.5 cm × 7.5 cm 99401160 $5.52
Foam, adhesive dressing, 12.5 cm × 12.5 cm 99401161 $12.02
Foam dressing medicated/non-medicated - other 99400456 Yes - -

Brand Examples

  • ALLEVYN (Smith & Nephew)
  • ALLEVYN Gentle Border (Smith & Nephew)
  • AQUACEL Foam (ConvaTec)
  • Biatain (Coloplast)
  • Biatain IBU (Coloplast)
  • Biatain Silicone (adhesive) (Coloplast)
  • Cutimed Cavity (BSN Medical)
  • Cutimed Siltec (BSN Medical)
  • Hydrofera Blue Foam Dressing (Hollister)
  • Hydrocell (Derma Sciences)
  • Kendall AMD Antimicrobial Foam Border (Covidien Kendall)
  • Kendall Foam (Covidien Kendall)
  • Lyofoam (Seton Health Care Group)
  • Mepilex (Mölnlycke)
  • Mepilex Transfer (Mölnlycke)
  • Mepilex Border Post-Op (Mölnlycke)
  • Microfoam (3M Health Care)
  • Optifoam (Medline)
  • Polymem (Ferris Mfg Corp)
  • Restore Foam Dressing (Hollister)
  • Tegaderm Foam High Performance (3M Health Care)
  • Tegaderm High Performance Non-Adhesive (3M Health Care)
  • Tegaderm Silicone Foam Boarder (3M Health Care)
  • TIELLE (Acelity)

Dressing Category: Gauze, non-sterile

Dressing Category: Gauze, non-sterile
Item Description Item Code Prior Approval Frequency Maximum Price Per Item
Gauze, non-sterile, 5 cm x 5 cm (2 x 2) 99400196 No - -
Gauze, non-sterile, 7.5 cm x 7.5 cm, (3 x 3) 99400756 No - -
Gauze, non-sterile, 10 cm x 10 cm, (4 x 4) 99400458 No - -
Gauze, non-sterile, 6 cm x 8 cm (2.36 x 3.15) 99400757 No - -

Dressing Category: Gauze, sterile

Dressing Category: Gauze, sterile
Item Description Item Code Prior Approval Frequency Maximum Price Per Item
Gauze, sterile, 5 cm x 5 cm, (2 x 2) 99400459 No - -
Gauze, sterile, 7.5 cm x 7.5 cm, (3 x 3) 99400759 No - -
Gauze, sterile, 10 cm x 10 cm, (4 x 4) 99400760 No - -
Gauze, sterile abdominal pad 99400457 No - -

Dressing Category: Gel / Hydrogel

Dressing Category: Gel / Hydrogel
Item Description Item Code Prior Approval Frequency Maximum Price Per Item
Gel/hydrogel dressing, 8 g 99401162 No For any combination of these 3 items:
  • 20 items per yearwithout prior approval
  • $5.30
    Gel/hydrogel dressing, 15 g 99401163 $7.47
    Gel/hydrogel dressing, 25 g 99401164 $11.36
    Gel/hydrogel dressing - other 99400460 Yes - -

    Brand Examples

    • Curafil (Including Curagel Hydrogel Impregnated Gauze) (Covidien Kendall)
    • Cutimed Gel (BSN Medical)
    • DuoDERM Hydroactive Gel (ConvaTec)
    • GranuGEL (ConvaTec)
    • Hypergel (Mölnlycke)
    • INTRASITE Gel (Smith & Nephew
    • INTRASITE Conformable (Smith & Nephew)
    • Normlgel (Mölnlycke)
    • NU-GEL Hydrogel (Acelity)
    • Purilon (Coloplast
    • Restore Hydrogel Dressing (Hollister)
    • Skintegrity Gel (Medline)
    • Spenco 2nd Skin (Spenco Medical)
    • Tegaderm Hydrogel Wound Filler (3M Health Care)
    • Tegagel (3M Health Care)
    • Tenderwet (Medline)

    Dressing Category: Honey

    Dressing Category: Honey
    Item Description Item Code Prior Approval Frequency Maximum Price Per Item
    Honey Dressing 99400901 Yes - -

    Brand Examples

    • Medi-Honey (Derma Sciences)
    • Thera-Honey (Medline)

    Dressing Category: Hydrocolloid

    Dressing Category: Hydrocolloid
    Item Description Item Code Prior Approval Frequency Maximum Price Per Item
    Hydrocolloid dressing, standard, 10 cm × 10 cm 99401165 No For any combination of these 2 items:
  • 30 items per year without prior approval
  • $12.17
    Hydrocolloid dressing, extra thin, 10 cm × 10 cm 99401166 $7.67
    Hydrocolloid dressing - other 99400461 Yes - -

    Brand Examples

    • Comfeel Plus Hydrocolloid combined with Alginate (Coloplast)
    • Comfeel Plus Transparent Hydrocolloid (Coloplast)
    • DuoDERM (includes Duoderm Extra Thin, Duoderm Signal) (ConvaTec)
    • Exuderm Satin Hydrocolloid (Medline)
    • Granuflex (ConvaTec)
    • NU-DERM Hydrocolloid (Acelity)
    • Primacol (Derma Sciences)
    • Restore Hydrocolloid Dressing (Hollister)
    • Tegaderm Hydrocolloid (3M Health Care)
    • ULTEC (Including ULTEC Pro) (Covidien)

    Dressing Category: Impregnated Venous Ulcer bandage

    Dressing Category: Impregnated Venous Ulcer bandage
    Item Description Item Code Prior Approval Frequency Maximum Price Per Item
    Impregnated venous ulcer bandage 99400450 No - -

    Brand Examples

    • Calaband (Seton Healthcare Group plc)
    • Gelocast (BSN Medical)
    • ICTHOPASTE (Smith & Nephew)
    • Primer Unna boot (Derma Sciences)
    • Unna-Z (Medline)
    • VISCOPASTE PB7 (Smith & Nephew)
    • ZIPZOC (Smith & Nephew)

    Dressing Category: Iodine

    Dressing Category: Iodine
    Item Description Item Code Prior Approval Frequency Maximum Price Per Item
    Iodine gel (ointment), 10 g tube 99401180 No For any combination of these 2 items:
    10 items per year without prior approval
    $25.68
    Iodine dressing, 5 g, 4 cm × 6 cm 99401181 $15.09
    Iodine dressing - other 99400810 Yes - -

    Brand Examples

    • INADINE (Acelity)
    • IODOFLEX (Smith & Nephew)
    • IODOSORB Paste & Ointment (Smith & Nephew)

    Dressing Category: Montgomery ties

    Dressing Category: Montgomery ties
    Item Description Item Code Prior Approval Frequency Maximum Price Per Item
    Montgomery ties (set) 99400447 No - -

    Brand Examples

    • Montgomery Straps (Medline)
    • Montgomery Strap (Bioseal)
    • Montgomery Straps (Deroyal)

    Dressing Category: Non-adherent dressing, impregnated

    Dressing Category: Non-adherent dressing, impregnated
    Item Description Item Code Prior Approval Frequency Maximum Price Per Item
    Non-adherent dressing, impregnated, petrolatum, 7.5 cm × 7.5 cm 99401167 No For any combination of these 3 items:
    50 items per year without no prior approval
    $1.58
    Non-adherent dressing, impregnated, petrolatum, 10 cm × 10 cm 99401168 $1.89
    Non-adherent dressing, impregnated, petrolatum, 7.5 cm × 20 cm - 3 strips 99401169 $2.81
    Non-adherent dressing, impregnated, chlorhex, 5 cm × 5 cm 99401170 No For any combination of these 2 items:
  • 30 items per year without no prior approval
  • $1.13
    Non-adherent dressing, impregnated, chlorhex, 10 cm × 10 cm 99401171 $2.56
    Non-adherent dressing, impregnated - other 99400462 Yes - -

    Brand Examples

    • ADAPTIC (Acelity)
    • BACTIGRAS (Smith & Nephew)
    • Chlorhexitulle (Hoechst Morio Roussell)
    • CURAD Sterile Oil Emulsion Gauze (Medline)
    • Cuticell (Including Cuticell Classic) (BSN Medical)
    • JELONET (Smith & Nephew)
    • Petrolatum Gauze
    • Serotulle (Leo Laboratories)
    • Shur-Conform (Derma Sciences)
    • Unitulle (Hoechst Marion Roussel)
    • Versatel (Medline)

    Dressing Category: Non-adherent dressing, non-impregnated

    Dressing Category: Non-adherent dressing, non-impregnated
    Item Description Item Code Prior Approval Frequency Maximum Price Per Item
    Non-adherent dressing, non-impregnated, 6 cm × 7 cm 99401172 No For any combination of these 2 items:
  • 60 items per year without prior approval
  • $0.58
    Non-adherent dressing, non-impregnated, 9 cm × 10 cm 99401173 $0.66
    Non-adherent dressing, non-impregnated 99400463 Yes - -

    Brand Examples

    • ADAPTIC DIGIT (Acelity)
    • ADAPTIC TOUCH (Acelity)
    • Cuticell Contact (BSN Medical)
    • Medipore + Pad Soft Cloth Adhesive (3M Health Care)
    • MELOLIN (Smith & Nephew)
    • Mepitel (Mölnlycke)
    • Mepore (Mölnlycke)
    • PrimaPad (Derma Sciences)
    • PRIMAPORE (Smith & Nephew)
    • Restore Contact Layer (Hollister)
    • Tegaderm Wound Contact Layer (3M Health Care)
    • Tegapore (3M Health Care)
    • Telfa (Covidien-Kendall)

    Dressing Category: Silver

    Dressing Category: Silver
    Item Description Item Code Prior Approval Frequency Maximum Price Per Item
    Silver alginate dressing, 10 cm × 10 cm 99401182 No For any combination of these 4 items:
    20 items per year without prior approval
    $20.16
    Silver alginate ribbon, 1 cm × 45.7 cm 99401177 $33.71
    Silver alginate ribbon, 1.9 cm × 45.7 cm 99401178 $34.94
    Silver alginate ribbon, 2.5 cm × 30.5 cm 99401179 $31.38
    Silver dressing - other 99400809 Yes - -

    Brand Examples

    • ACTICOAT 7 (Smith & Nephew)
    • ACTISORB (Acelity)
    • ALGICELL Ag (Derma Sciences)
    • ALLEVYN AG (Smith & Nephew)
    • AQUACEL Ag (ConvaTec)
    • Arglaes Powder (Medline)
    • Biatain AG (Coloplast)
    • Interdry Ag (Coloplast)
    • Maxorb Extra AG (Medline)
    • Melgisorb AG (Mölnlycke)
    • Mepilex AG (Mölnlycke)
    • Opticell Ag (Medline)
    • Optifoam Ag (Medline)
    • Polymem Silver (Ferris Mfg Corp)
    • Restore Calcium Alginate with Silver (Hollister)
    • Restore Contact Layer with Silver (Hollister)
    • Restore Foam Dressing with Silver (Hollister)
    • SILVERCEL (Including SILVERCEL Non Adherent) (Acelity)
    • Sorbsan Silver (Pharma-Plast)
    • Tegaderm Ag Mesh (3M Health Care)
    • Tegaderm Alginate Ag (3M Health Care)

    Dressing Category: Transparent

    Dressing Category: Transparent
    Item Description Item Code Prior Approval Frequency Maximum Price Per Item
    Transparent dressing, adhesive, 6 cm × 7 cm 99401174 No For any combination of these 2 items:
    • 30 items per year without prior approval
    $0.41
    Transparent dressing, adhesive, 10 cm × 12 cm 99401175 $2.30
    Transparent film dressing, spray-on 99400465 Yes - -
    Transparent film dressing, adhesive - other 99400464 Yes - -

    Brand Examples

    • BIOCLUSIVE Plus (Acelity)
    • Hypafix Transparent (BSN Medical)
    • IV3000 (Smith & Nephew)
    • Leukomed T (BSN Medical)
    • Mepitel Film (Mölnlycke)
    • OPSITE - all sizes (Smith & Nephew)
    • OPSITE Spray (Smith & Nephew)
    • POLYSKIN (Covidien)
    • Suresite (Medline)
    • Tegaderm Absorbent Acrylic Clear Dressing (3M Health Care)
    • Tegaderm Transparent Film (3M Health Care)

    Dressing Category: Tubular net dressing

    Dressing Category: Tubular net dressing
    Item Description Item Code Prior Approval Frequency Maximum Price Per Item
    Tubular net dressing 99400451 No - -

    Brand Examples

    • Flexinet (Derma Science)
    • Medi-Grip (Medline)
    • Surgifix (Smith & Nephew)
    • Tubifast (Mölnlycke)
    Report a problem or mistake on this page
    Please select all that apply:

    Thank you for your help!

    You will not receive a reply. For enquiries, contact us.

    Date modified: