Antimicrobial dressings play an important role in wound care but should only be used after careful assessment by your clinician. Antimicrobial dressings are indicated for infected wounds. Antimicrobial dressings have substances with antiseptic activity, which weaken and slow the growth of bacteria and other microorganisms - this antiseptic activity helps prevent the bacteria from causing further infection. It has not been confirmed that bacteria develop immunity (resistance) to antiseptics with extended antiseptic use. Some antiseptics may delay the healing process and worsen a wound's condition. However, new technological advances resulted in products that cause less harm to the wound and are excellent at destroying germs. These include antiseptics such as silver, cadexomer iodine, polyhexamethyl biguanide (PHMB) and honey. Below is a summary of how some of these agents work:
- Silver is effective against many types of bacteria, fungi and viruses. Frequent use can cause some discoloration on the skin around the wound. If absorbed by internal organs it may impair their function. Silver is not recommended for prolonged use as silver may inhibit epithelialization with long term use (>4 weeks).
Manuka honey is thought to have antimicrobial and cleaning properties. Products are available as sheet dressings or as topical applications. Topical applications are applied directly to the wound and are covered with a wound dressing; an additional secondary dressing may be required for wounds with large amounts of fluid. Some individuals experience a stinging sensation when Manuka honey is applied. Manuka honey should not be applied on individuals with hypersensitivity to honey. According to manufacturers, it can be used on persons with diabetes, as it does not alter levels of blood sugar.
- Iodine: Slow-release iodine-based dressings are effective against wound infection. They should not be used on persons with: known or suspected iodine sensitivity, Hashimoto's thyroiditis, non-toxic nodular goitre, children and pregnant or lactating women. Iodine may be absorbed by the internal organs, especially when large wounds are treated.
Iodine dressings have a maximum dosage and maximum length of time over which they can be used. Manufacturers’ instructions should be followed.
Pricing and Suppliers
Is it covered by Medicare Part B?
Some antimicrobial dressings are non-covered under the Medicare Part B surgical dressing benefit, and others are covered. If you see a co-payment amount in the table below under “Medicare DME co-payment Ceiling / Floor”, the item is covered, provided coverage requirements are met. People with Medicare Part B (beneficiaries) who need to change surgical dressings at their homes and who are not being cared for by a home health agency may have specific types of dressings covered by Medicare. Dressings and supplies need to be considered medically necessary for treatment of a surgical or surgically treated wound. Medicare has guidelines that establish what is considered medically necessary and how often an item can be used.
Center for Medicare and Medicaid Services (CMS). Local Coverage Determination for Surgical Dressings (L33831) [Internet]. 2016 [cited 2017 Apr 30].
How can I purchase this product?
If you have coverage through Medicare Part and your condition meets Medicare requirements for coverage, you may be eligible to have this product covered by Medicare. Not all antimicrobial dressings are covered by Medicare. If it is covered, you will need a written order prescribed by a provider enrolled in Medicare, so that you can purchase this product at a Durable Medical Equipment store that accepts Medicare. You will need to pay deductibles and co-payment. The actual co-payment amount varies according to your state. If you do not have Medicare Part B or do not meet the requirements needed for coverage, you can find this product at pharmacies and medical supply stores. When available, please see pricing in "Other Stores" below.
The table below shows highest and lowest Medicare pricing across the country
|Description||Medicare DME co-payment Min / Max
|Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing||
$3.42 / $4.02
If your insurance does not cover this product, you can purchase it directly from any store. A list of online stores and prices is provided below for your convenience. For updated prices, find it on the internet at https://woundreference.com/app/product?id=457
* Indicates whether store accepts Medicare or commercial insurance, but may not apply to this specific product. See coding, coverage and reimubursement for more information.
The information on this handout is for your convenience and educational purposes only. All product claims and specifications are those of the product suppliers. It does not constitute medical advice or a guarantee for reimbursement. Prices may have changed and suppliers may not have product in stock. Please confirm accuracy and appropriateness of information with insurance carrier and product supplier. Clinician and WoundReference assume no liability for inaccuracies or misstatements about products and insurance coverage.