Flaminal^® Forte and Flaminal^® Hydro –
Frequently Asked Questions (FAQs)

Clean and rinse the wound as usual

Apply a thick layer of Flaminal^® about 5mm, avoiding the wound edge

Secure with a secondary dressing

Renew Flaminal^® whenever the gel structure is altered

Initially the wound may appear larger; this is a normal consequence of the debriding action
of Flaminal^® which causes dead tissue to be absorbed and removed from the wound

The colour may change, and there may be a slightly sweetish odour

Dry wax-like flakes (flakes of alginates) may be seen. This is fine if they are found on the
wound borders, as they will protect the wound edges from maceration

If the flakes appear in the wound itself, consider changing the secondary dressing to one that reduces evaporation, such as gauze, polyurethane film, bandages with or without a central compress such as Opsite^®, Tegaderm^®, Opsite^® post-op, Tegaderm^® pad

Flaminal^® Forte and Flaminal^® Hydro should be used for moist wound healing, especially
on those wounds where there is infection or the potential risk for wound infection

Flaminal^® Forte contains a larger amount of alginate and should be used on moderate
to heavily exuding wounds

Flaminal^® Hydro contains less alginate and should be used on light to moderate
levels of exudate

Flaminal^® contains two enzymes, glucose oxidase and lactoperoxidase. Glucose oxidase
converts the available glucose, oxygen and water into peroxide ions. Lactoperoxidase
converts the peroxide ions into reactive oxygen species. The reactive oxygen species created then destroy bacteria.

In this instance, Flaminal^® Hydro should be used rather than Flaminal^® Forte.
The wound should be washed with saline before applying Flaminal^® Hydro.

Yes. Flaminal^® has been tested against Aspergillus niger – a fungus – and, in addition,
against Candida albicans – a yeast.

There is in vitro evidence to show that Flaminal^® kills MRSA strains. The antimicrobial activity of Flaminal^® is enzymatic. This is a different mechanism of action compared to other topical antimicrobials and antibiotics and no resistance has been seen and unlike some silver and iodine products, Flaminal^® is not deactivated by slough and necrotic material.

There are data demonstrating that Flaminal^® kills Pseudomonas in vitro quickly
and effectively and in vivo data shows a marked reduction over 8 days.

The type of secondary dressing will depend on the wound condition. On a wetter wound a
more absorbent secondary dressing should be used to prevent maceration, e.g. foam
dressing. On drier wounds a secondary dressing should be selected which will reduce
evaporation and prevent the wound drying out e.g. film or hydrocolloid.

Flaminal^® should be changed when the gel structure becomes altered to the point when it
has almost disappeared, or when alginate flakes have appeared, or when the gel becomes too liquid

When using Flaminal^® Forte, if alginate flakes appear, the wound is too dry for Flaminal^®
Forte and you should switch to Flaminal^® Hydro

When using Flaminal^® Hydro, if the gel becomes too liquid, the wound is too wet for Flaminal® Hydro and you should switch to Flaminal^® Forte

In yellow/sloughy wounds Flaminal^® can be changed every 1–2 days
In granulating wounds Flaminal^® can be changed every 3-4 days

The Flaminal^® needs replacing and new dressing applied.

Replace the Flaminal^® Forte with a thicker layer and cover with a non-adherent dressing.

The wound is too dry for Flaminal^® Forte and Flaminal^® Hydro should be used instead as
it contains a lower concentration of alginate.

The wound is very dry and therefore even the low concentration of alginate in Flaminal^®
Hydro is drying out. Replace the Flaminal^® Hydro and cover with a dressing which will reduce evaporation, e.g. a film or hydrocolloid.

The wound is too wet for Flaminal^® Hydro and should be replaced with Flaminal^® Forte which is more absorbent.

Flaminal^® Hydro containing 3% alginates would be well suited; it will eliminate the slough
from the wound and thereby debride, encouraging healing.

Patients may report pain if the wound is allowed to dry out. With drier wounds, this can
be prevented, by using Flaminal^® Hydro instead of Flaminal^® Forte.

Patients may also report pain caused by the wound edges becoming macerated. With
wetter wounds, this can be prevented, by using Flaminal^® Forte instead of Flaminal^® Hydro. Maceration can also be reduced by using a more absorbent secondary dressing e.g. foam dressing.

Patients may report a reduction in pain as Flaminal^® Hydro can be used to hydrate then
remove slough and necrotic material.

Pain can be caused by infection; allergies and some ulcers can also be painful.

Epidermolysis bullosa is a very rare, congenital skin disease, where the slightest injury
will provoke blisters, which are difficult to heal, often causing scarring and functional
impediments. Flaminal^® may be used, although it will not prevent injuries and blisters
for which there is no treatment.

No. Flaminal^® does not have any preservatives in its formulation.

Flaminal^® can be used until the expiry date (seen on the tube). This is two years from date
of manufacture.

Antiseptics are strong antimicrobials, but can harm the key cells involved in wound healing
and cause an allergic reaction. Flaminal^® will restore the bacterial balance in the wound
without causing any allergic reactions or damaging key cells involved in wound healing.
We therefore recommend Flaminal^® is used alone.

Yes. When cellulitis is present, antibiotics are indicated. Infection is caused by the invasion
of bacteria into the skin surrounding the wound.

Yes, apply Flaminal^® Hydro, in a thick layer. If the suture oozes exudate then use
Flaminal^® Forte.

No. Flaminal^® restores the bacterial balance in the wound and by continually removing
necrotic material allows natural wound healing.
Should the wound hyper granulate due to infection then continue using Flaminal^®. If the
wound is not infected then stop using Flaminal^® and keep the wound dry to reduce
cell growth. Applying local pressure to the wound bed will also help reduce over granulation.

Flaminal^® Hydro absorbs leaking wound fluid, protects against infection and keeps the
wound moist thus avoiding the formation of crusts which may increase the risk of scarring.
Flaminal^® Hydro should stay on the wound till the sutures are removed.

Yes. Use Flaminal^® Hydro.

After use, replace the top and Flaminal^® can be reused as it remains sterile up until its expiry date. It should only be reused on the same patient.

If ingested, Flaminal^® is harmless. Many foodstuffs contain alginates.

Flaminal^® should not be used where patients have a previous sensitivity reaction to alginate dressings or to polyethylene glycol (Macrogol).

Flaminal^® cannot be used on the eyelids or in the eye. Should it come into contact with the eye, rinse the eye thoroughly with running water and consult a physician.