Intrasite Gel 25g x10 APPLIPAK Hydrogel Wound Dressing 66027313 Border Dressings Specific Coverage Criteria: Covered when

Specific Coverage Criteria: Covered when used on full-thickness wounds with minimal or no exudate

powdered nutritional supplement containing protein (milk protein)

7µg - Iodine 12µg - L-carnitine 1

By keeping fragile granulation tissue moist and allowing the migration of epithelializing cells

Intrasite Gel 25g x10 APPLIPAK Hydrogel Wound Dressing 66027313 Border Dressings Specific Coverage Criteria: Covered whenINTRASITE Gel Hydrogel Wound Dressing Please note quantities relate to the number of single dressings and not packs boxes Description INTRASITE Gel is an amorphous hydrogel which gently re hydrates necrotic tissue, facilitating autolytic debridement, while being able to loosen and absorb slough and exudate. It can also be used to provide the optimal moist wound management environment during the later stages of wound closure. It is non adherent and