Flaminal® and Flaminal® Hydro - Frequently Asked Questions

NB: Where the answer applies to both Flaminal® Forte and Flaminal® Hydro we have abbreviated to Flaminal® (Hydro).

How do I use Flaminal?
  • Irrigate and clean the wound
  • Carefully dab dry.
  • Apply a thick layer (5mm) of Flaminal® (Hydro)
  • Cover with a secondary dressing
  • Renew Flaminal® (Hydro) whenever the gel structure is altered.
  • Initially the wound may appear larger; this is a normal consequence of the debriding action of Flaminal® (Hydro) which causes dead tissue to be absorbed.
  • The gel colour may change, and there may be a sweetish odour.
  • Dry wax-like flakes (flakes of alginates) may be seen. This is OK if they are found on the wound borders, as they will protect the wound from maceration.
  • If the flakes appear in the wound itself particularly with Flaminal Forte, it might be because the wound is not producing enough exudate and you should  change to Flaminal Hydro.
When should I use Flaminal and when should I use Flaminal Hydro?
  • Flaminal® Forte and Flaminal® Hydro should be used for moist wound healing, especially on those wounds where there is the potential for an acquired wound infection
  • Flaminal® Forte contains a larger amount of alginate and should be used on moderate to heavily exudating wounds
  • Flaminal® Hydro contains less alginate and should be used on light to moderate levels of exudate
How does Flaminal® (Hydro) kill wound pathogens?
  • Flaminal® (Hydro) 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. Lactoperoxidase specifically binds to bacterial cell walls. The reactive oxygen species created destroys bacteria.
Can I use Flaminal® (Hydro) on dry necrotic wounds?
  • In this instance, Flaminal® Hydro should be used rather than Flaminal® Forte. The wound should be irrigated before applying Flaminal® Hydro
Is Flaminal® (Hydro) active against fungi?
  • Flaminal® (Hydro) have been tested against Aspergillus niger (fungus) and against Candida albicans (yeast), but only mild activity was found. However, Flaminal® (Hydro) contains a conservation agent (potassium sorbate) to protect against fungal contamination.
Does Flaminal® (Hydro) have any effect on a wound that is contaminated with MRSA?
  • The antimicrobial activity of Flaminal® (Hydro) is enzymatic. This is a different mechanism of action compared to antibiotics and no resistance has been seen. There is in-vitro evidence to show that Flaminal® (Hydro) kills MRSA strains quickly and effectively.
Does Flaminal® (Hydro) have any effect on a Pseudomonas aeruginosa contaminated wound?
  • There are data demonstrating that Flaminal® (Hydro) kills Pseudomonas in-vitro quickly and effectively and in-vivo data shows a marked reduction over 8 days.
Which secondary dressing should be used with Flaminal/Flaminal Hydro?
  • 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 or superabsorbent. On drier wounds a secondary dressing should be selected which will reduce evaporation and prevent the wound drying out e.g. Film or Hydrocolloid
When does Flaminal/Flaminal HYDRO need to be changed?
  • Flaminal® (Hydro) should be changed when the gel structure becomes altered to the point it has almost disappeared, or alginate flakes have appeared, or 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® (Hydro) can be reapplied every 1–2 days
  • In Granulating wounds Flaminal Forte/Flaminal Hydro can be reapplied every 3-4 days
There is no Flaminal® (Hydro) left in the wound
  • The Flaminal® (Hydro) needs replacing and new dressing applied
Flaminal® Hydro becomes too liquid
  • The wound is too wet for Flaminal® Hydro and should be replaced with Flaminal® Forte which is more absorbent
What should I use on wounds with fibrin slough, but no exudate?
  • Flaminal® Hydro containing 3% alginates would be well suited; it will eliminate the slough from the wound and thereby debride encouraging healing.
Can Flaminal® (Hydro) be painful on application?
  • 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 my also report pain caused by 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.
What is epidermolysis bullosa and can Flaminal® (Hydro) be used to treat it?
  • 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® (Hydro) may be used, although it will not prevent injuries and blisters for which there is no treatment.
Are propylene glycol and fenoxyethanol present in Flaminal® (Hydro)?
  • No. Flaminal® (Hydro) does not have any preservatives in its formulation. Polyethylene glycol (macrogol) is present.
What is the shelf life of Flaminal® (Hydro)?
  • Flaminal can be used until the expiry date (seen on the tube). Two years from manufacture. Even after it is opened, Flaminal can be used until the expiry date shown, provided the cap is replaced securely after use.
Can antiseptics be used prior to applying Flaminal® (Hydro)?
  • Antiseptics are strong antimicrobials, but can harm the key cells involved in wound healing and cause an allergic reaction. Flaminal® (Hydro) will restore the bacterial balance in the wound without causing any allergic reactions or damaging key cells involved in wound healing. There is no need to apply antiseptics prior to using Flaminal
Can antibiotics be administered along with Flaminal® (Hydro)?
  • Yes. When cellulitis is present, antibiotics are indicated. Infection is caused by infiltration of bacteria into the skin surrounding the wound.
Can Flaminal® (Hydro) be applied on a recent suture?
  • Yes, apply Flaminal® Hydro, in a thick layer. If the suture produces a high level of exudate, then use Flaminal® Forte.
Does Flaminal® (Hydro) reduce hypergranulation?
  • Flaminal® (Hydro) restores the bacterial balance in the wound and by continually removing necrotic material allows natural wound healing. Should the wound hyper granulate for reasons other than infection, stop using Flaminal® (Hydro) and keep the wound dry to reduce cell growth. Applying local pressure to the wound bed will also help reduce hypergranulation.
What are the advantages of using Flaminal® Hydro in treating dermatological surgical wounds?
  • Flaminal® Hydro absorbs leaking wound fluid, protects against infection and keeps the wound moist thus avoiding the formation of scabs which may increase the risk of scarring. Flaminal® Hydro stays on the wound till the sutures are removed.
How should Flaminal be stored?
  • Flaminal should be kept in a cool dry place (<25°C) and in its original packaging.
Can Flaminal be stored in the refrigerator?
  • Yes. Flaminal can be stored in the refrigerator. In fact, if the room temperature where the Flaminal is stored is likely to exceed 25°C, it is preferable to keep Flaminal in the refrigerator. Flaminal should not be stored in the freezer.
Can diabetics use Flaminal?
  • Yes, diabetic patients can use Flaminal on their wounds.