AQUACEL AG N/RIBBON

Cavity wounds, sinus tracts, and tunnelling wounds cannot be managed effectively with flat sheet dressings alone. The wound bed lies beneath a surface opening, and effective antimicrobial management requires wound contact material to be introduced into the depth of the wound. AQUACEL Ag Ribbon is the narrow ribbon format of AQUACEL Ag from Convatec, designed specifically for this purpose. It uses the same ionic silver CMC hydrofiber technology as the standard AQUACEL Ag sheet but in a narrow ribbon that can be loosely packed into cavities, sinus tracts, and undermining wounds. It is available in 1cm x 45cm and 2cm x 45cm. No prescription is required.

AQUACEL Ag Ribbon is a regulated Class IIb medical device from Convatec. It is the narrow ribbon format of AQUACEL Ag. The ribbon uses exactly the same CMC hydrofiber material with ionic silver as the standard AQUACEL Ag flat sheet, but in a long narrow strip format that can be introduced into wound spaces that a flat sheet cannot reach. Available in 1cm x 45cm and 2cm x 45cm, both providing sufficient length to pack most cavity wounds with ribbon to spare, ensuring a portion always remains accessible at the wound surface.

Cavity wounds, sinus tracts, and tunnelling wounds present a specific clinical challenge. The wound void extends beneath the surface and may have irregular dimensions, corners, or extensions that cannot be visualised or directly accessed. Packing such a wound with a ribbon dressing introduces antimicrobial wound contact material throughout the accessible wound space, managing infection and exudate at depth rather than only at the wound surface opening.

Like the standard AQUACEL Ag sheet, AQUACEL Ag Ribbon absorbs wound exudate vertically, gels in contact with fluid, and releases ionic silver as it does so. The cohesive nature of the CMC gel is particularly important in the ribbon format. When removed, the ribbon should come out as a single coherent piece rather than fragmenting within the wound cavity. This cohesive retrieval is clinically essential — retained dressing material in a wound cavity can act as a foreign body and impair healing.

AQUACEL Ag Ribbon is indicated for moderately to heavily exuding infected or at risk cavity wounds, sinus tracts, tunnelling wounds, and other wound spaces where a narrow ribbon format enables wound contact that a flat sheet cannot provide.

AQUACEL Ag Ribbon must be packed loosely. Do not pack tightly. Tight packing can cause pressure within the wound cavity, impair wound drainage, and make removal more difficult. Always ensure a portion of the ribbon remains accessible at the wound surface opening so the ribbon can be located and retrieved at the next dressing change. Never cut the ribbon shorter than the cavity depth, always use sufficient length so some ribbon remains outside the wound.

CMC Hydrofiber Technology at Wound Depth

The CMC fibres of AQUACEL Ag Ribbon absorb wound exudate vertically into the ribbon structure. Within a wound cavity, exudate from the cavity walls and wound bed is absorbed by the ribbon as it is produced. This absorption at depth helps manage the fluid load within the cavity rather than allowing it to accumulate and pool. The vertical wicking property of CMC fibres reduces lateral spread of absorbed exudate onto the cavity walls and periwound tissue.

Gel Formation and Wound Conformity

As the CMC fibres absorb exudate, they swell and form a soft cohesive gel. Within a cavity wound this gel conforms to the shape of the wound space, maintaining close contact between the ribbon and the cavity walls throughout the wear period. This consistent wound contact ensures the ionic silver is delivered to the wound surface throughout the dressing, rather than being concentrated at points where contact is maintained and absent where the dressing does not conform.

Ionic Silver Antimicrobial Action

Ionic silver is released from the CMC fibres as gelling occurs. The silver ions act against a broad range of wound pathogens including Staphylococcus aureus, MRSA, Pseudomonas aeruginosa, and Candida species. Within a wound cavity this antimicrobial action at depth is clinically important because cavity wounds are at particular risk of persistent infection and biofilm formation within the protected wound space. The delivery of ionic silver throughout the length of the packed ribbon provides antimicrobial coverage across the accessible wound cavity.

Cohesive Retrieval

The cohesive nature of the CMC gel is the critical safety property of AQUACEL Ag Ribbon for cavity use. At removal, the gelled ribbon should be retrievable as a single continuous piece. This cohesive behaviour reduces the risk of the ribbon fragmenting or leaving residual material within the wound cavity. Before removing the ribbon, irrigate the wound cavity with sterile saline to soften the gel. Then gently retrieve the ribbon by the accessible end left outside the wound at application.

Before Use

• Wash hands and use appropriate gloves.
• Clean the wound cavity with sterile saline or as directed by a healthcare professional. Irrigate the full depth of the cavity.
• Measure or assess the approximate depth and dimensions of the wound cavity to select the appropriate ribbon width.
• Remove AQUACEL Ag Ribbon from its sterile packaging immediately before use. Do not pre-wet the ribbon.

Packing the Wound

• Select 1cm x 45cm for narrow cavities, sinus tracts, and wounds with a small surface opening. Select 2cm x 45cm for wider cavities with a larger wound opening.
• Loosely introduce the ribbon into the wound cavity using a sterile instrument such as forceps or a probe. Do not pack tightly.
• Ensure the ribbon makes contact with the cavity walls throughout the accessible wound space.
• Always leave a visible portion of the ribbon extending beyond the wound surface opening. This is the retrieval tag. Never pack the ribbon so that all of it disappears into the wound.
• If the cavity is very deep and extends beyond the ribbon length, seek clinical guidance. Do not join two ribbon lengths by knotting or twisting — use an appropriate length of a single ribbon.
• Apply an appropriate secondary dressing over the wound surface to cover the wound opening and secure the accessible end of the ribbon.
• Document the number of ribbons used and confirm in the care record.

Removal

• Irrigate the cavity with sterile saline before removal to soften the gelled ribbon.
• Locate the accessible end of the ribbon at the wound surface.
• Gently retrieve the ribbon in a single continuous motion. The cohesive CMC gel should allow removal as a single piece.
• Confirm the ribbon has been fully removed. Count ribbons in against ribbons out at each dressing change.
• Irrigate the cavity after removal to clear any gel residue.
• Assess the cavity dimensions, wound bed, and exudate at each change.
• Always count ribbons in and ribbons out. Document the number of ribbons packed into the wound at each dressing change. Confirm the same number are retrieved before applying the next dressing. If you are unable to retrieve the ribbon or believe any portion remains in the wound, seek urgent clinical assessment. Do not attempt to force the ribbon out if it feels firmly attached. Irrigate thoroughly and seek clinical guidance.

AQUACEL Ag Ribbon 1cm x 45cm

The narrower ribbon, suitable for sinus tracts, narrow cavities, small wound openings, and tunnelling wounds where a 2cm width would not fit through the surface opening. The 45cm length provides sufficient ribbon to pack most sinus tracts and narrow cavities with retrieval length remaining outside the wound.

AQUACEL Ag Ribbon 2cm x 45cm

The wider ribbon, suitable for larger cavity wounds with a wider wound opening that can accommodate 2cm of ribbon width. The greater width provides more wound contact surface area within the cavity, increasing the volume of CMC hydrofiber in contact with the cavity walls. The 45cm length provides ample packing length with retrieval ribbon remaining outside the wound.

Select the ribbon width based on the size of the wound cavity opening and the cavity dimensions. A 1cm ribbon can be used in cavities where a 2cm ribbon would be too wide to introduce without excessive force. Never force the ribbon into the cavity.

Do Not Use AQUACEL Ag Ribbon If

• The patient has a known sensitivity or allergy to silver, CMC hydrofiber, or any component of the dressing.
• The wound is dry or minimally exuding. The ribbon requires wound exudate to activate gelling.
• The wound is a sinus of unknown depth or origin. Seek clinical assessment before packing.

Precautions

• Always pack loosely. Tight packing can cause pressure injury within the cavity and impair wound drainage.
• Always leave a retrieval portion outside the wound. Never pack the full length of the ribbon so that no accessible end remains.
• Always count ribbons in and ribbons out. Document at every dressing change.
• Do not use MRI scanning with the ribbon in place. Remove before MRI procedures.
• Silver containing dressings may cause grey or blue grey discolouration of the wound bed and cavity walls. This is expected and localised.
• Silver dressings are not a substitute for systemic antibiotic therapy where there is spreading cellulitis or systemic infection.

Adverse Effects

• Localised silver discolouration (argyria) of wound tissue and cavity walls. Expected and reversible.
• Wound cavity pressure if packed too tightly. Pack loosely and reassess.

AQUACEL Ag Ribbon Is Suitable For

• Moderately to heavily exuding infected or at risk cavity wounds, including pressure ulcer cavities, dehisced post-operative wounds, and other deep wound spaces
• Sinus tracts where the tract opening is large enough to accept the ribbon width without force
• Tunnelling wounds where the tunnel can be accessed and packed with the ribbon leaving a retrieval end accessible
• Adults and children under clinical supervision — cavity wound management should always involve a healthcare professional

Standard AQUACEL Ag is a flat sheet suited to wounds with an accessible, relatively flat wound bed. AQUACEL Ag Ribbon is for wound spaces where a flat sheet cannot be effectively introduced - cavities, sinuses, and tunnels. Both use the same CMC hydrofiber with ionic silver. Both are applied dry and both require irrigation and careful removal. Choose the ribbon format specifically for cavity and sinus wound management. For flat or shallow wounds, the standard sheet provides better wound bed coverage.

AQUACEL Ag Ribbon is a regulated medical device and does not require a prescription. It can be purchased directly through Pharmacy Planet without a clinical consultation. It is available in two sizes: 1cm x 45cm and 2cm x 45cm.

Cavity wounds, sinus tracts, and tunnelling wounds should be assessed and managed under clinical supervision. Seek assessment from a tissue viability nurse, district nurse, or GP for any cavity wound that is complex, worsening, or not reducing in depth and dimensions as expected.

Pharmacy Planet stocks the full AQUACEL Ag range including AQUACEL Ag Ribbon alongside AQUACEL Ag Extra, and AQUACEL Ag Foam Adhesive. Our pharmacists can advise on which AQUACEL Ag format is most appropriate for a specific wound.

• Store in a cool, dry place away from direct sunlight and moisture.
• Store below 25°C.
• Keep in the original sealed packaging until immediately before use.
• Each ribbon is individually sterile packed. Do not use if the packaging is damaged or compromised.
• Check the expiry date before use. Do not use after the expiry date.
• Once opened, use immediately. Do not store a partially used or opened ribbon.
• Keep out of the reach of children.
• Dispose of used ribbons as clinical waste in accordance with local guidelines.

Pharmacy Planet is a GPhC registered online pharmacy providing access to AQUACEL Ag Ribbon in both available widths alongside the full AQUACEL Ag range and a comprehensive selection of cavity wound management products. All products are genuine and sourced through regulated supply chains.

Our pharmacists are available to advise on cavity wound dressing selection and on when clinical referral for wound assessment is appropriate.

References

1. Convatec. AQUACEL Ag Ribbon — Instructions for Use. Convatec Ltd. https://www.convatec.com. Accessed May 2026.
2. Wounds UK. Best Practice Statement: Wound exudate — effective assessment and management. https://www.wounds-uk.com. Accessed May 2026.
3. World Union of Wound Healing Societies (WUWHS). Antimicrobials and non-healing wounds: evidence, controversies and suggestions. https://wuwhs.net. Accessed May 2026.
4. National Institute for Health and Care Excellence (NICE). Wound care products — Drug Tariff prescribing and selection. https://www.nice.org.uk. Accessed May 2026.