A backordered dressing is a clinical problem before it is a purchasing problem. The wound does not wait for the manufacturer's ship date, and the nurse who opens an empty bin will use whatever is next to it. The goal of a substitution process is to make sure "whatever is next to it" was chosen on purpose, by a clinician, before the shortage.
This is the method Keystone uses with wound care buyers, built on the same criteria hospital supply chains and national procurement bodies apply when they publish substitution guidance.
Substitute within the class first
Dressings do specific jobs, and the class describes the job. Substitute inside the class before you cross it.
| Class | Job | Common substitutions |
|---|---|---|
| Gauze and non-adherent | Cover, absorb, protect | Any equivalent size and ply; sterile for sterile |
| Foam | Absorb moderate to heavy exudate, cushion | Another foam of equal size and adhesive style (bordered vs. non-bordered) |
| Hydrocolloid | Maintain moisture on low-exudate wounds | Equivalent thickness and size |
| Alginate and gelling fiber | Absorb heavy exudate, fill cavities | Alginate for alginate; fiber for fiber, same dimensions |
| Hydrogel | Donate moisture to dry wounds | Sheet for sheet, amorphous for amorphous |
| Transparent film | Secure, protect, allow inspection | Equivalent size; check adhesive tolerance |
| Antimicrobial (silver, PHMB, iodine) | Manage bioburden | Same active agent and carrier class |
Crossing classes (foam for hydrocolloid, alginate for gauze) changes how the wound is managed and needs a clinician's decision, not a buyer's.
The eight-point check
When a like-for-like candidate exists, run it through the same criteria procurement teams use for approved substitutions:
- Intended use. Same indication on the manufacturer's labeling.
- Dimensions. Same size, or one size up that can be cut without losing the border or the adhesive.
- Absorbency and capacity. Equal or greater for the exudate level.
- Sterility. Sterile replaces sterile. Never the reverse.
- Packaging. Individual peel packs where the original was individually packed.
- Material and compatibility. Works with the compression system, negative pressure setup, or securement in use.
- Regulatory status. Cleared for the same use; not a veterinary or industrial product.
- Infection prevention. No change to isolation or reprocessing practice.
Then two practical questions: availability in the quantity you need, and cost per dressing change rather than cost per box.
Build the equivalents list before the backorder
Most facilities can cover 80 percent of their wound care volume with fifteen to twenty items. For each of those, have the wound care lead pre-approve one or two equivalents, by manufacturer and item number, and store the list where purchasing and the units can both see it. The next allocation notice becomes a lookup, not a meeting.
Keystone keeps that list on your account so quotes and standing orders reference the approved alternate automatically when the primary is short. We carry wound care from DeRoyal, 3M / Solventum, and Dukal among others, which gives most classes at least two sources.
Log every substitution
Record the date, the original item, the substitute, the approver, and when the original returned. It protects the facility if an outcome is questioned, it shows you which manufacturers backorder most often, and it turns temporary substitutes into permanent second sources when they perform well.
What to send us
If a dressing is on backorder today, email the item number, size, the number of changes per week, and whether the substitute must be sterile and individually packed. We will return the in-class equivalents we can ship, with lot dating and a delivery date, the same business day.
Browse wound care and skin closure or send a backorder list.
Sources
- Gloucestershire Hospitals NHS Foundation Trust, Wound Care Dressing Guide 2025 (dressing classes and indications): https://www.gloshospitals.nhs.uk/media/documents/Wound_Care_Dressing_Guide_2025.pdf
- Keystone Supply Group, "Choosing an Alternate SKU": choosing-an-alternate-sku.html