ALLEVYN AG SACRUM

Sacral pressure ulcers are among the most frequently occurring and clinically challenging wound types, particularly in patients who are immobile or bedridden. Managing them requires a dressing that can conform to the curved sacral anatomy, manage exudate effectively, and address the high infection risk associated with this anatomical location. ALLEVYN Ag Sacrum is a silver antimicrobial foam dressing from Smith+Nephew shaped specifically for the sacral and coccygeal area. It combines silver sulfate antimicrobial activity, hydrocellular foam exudate absorption, and a contoured butterfly shape with a soft silicone adhesive border. No prescription is required.

ALLEVYN Ag Sacrum is a regulated Class IIb medical device from Smith+Nephew. It brings together three clinical features in a single dressing product. The first is silver sulfate, which provides local antimicrobial activity against infected or at-risk wounds. The second is a hydrocellular polyurethane foam core, which absorbs and manages wound exudate. The third is a contoured butterfly shape with a soft silicone adhesive border, designed to follow the anatomical curves of the sacrum and coccyx and adhere gently to the periwound skin in this area.

The sacrum and coccyx region is one of the most common sites for pressure ulcers, particularly in patients who spend extended periods in bed or a seated position. The area presents specific challenges for dressing management: the curved anatomy means flat square dressings do not conform well; the proximity to the gluteal cleft means moisture, incontinence, and friction are constant concerns; and the combination of pressure, poor perfusion, and potential contamination makes infection risk higher than at many other anatomical sites.

ALLEVYN Ag Sacrum addresses these challenges as a single product. The antimicrobial silver component manages or prevents wound infection. The foam core handles exudate. The butterfly shape follows the sacral contour. The silicone border adheres gently to the surrounding skin with less trauma than a standard acrylic adhesive, which is clinically significant in patients whose periwound skin may already be fragile or macerated from moisture.

ALLEVYN Ag Sacrum is indicated for use on infected or at risk sacral and coccygeal pressure ulcers with moderate to heavy exudate. It is suitable for grades 2 to 4 sacral pressure ulcers and for other infected or at-risk wounds in the sacral region.

Sacral pressure ulcers can develop and deteriorate rapidly, particularly in patients with reduced mobility, poor nutritional status, or compromised circulation. ALLEVYN Ag Sacrum is a dressing, it is not a substitute for a comprehensive pressure ulcer management plan. Pressure redistribution, regular repositioning, skin assessment, nutritional support, and clinical oversight are all essential components of care alongside appropriate dressing selection.

Silver Sulfate Antimicrobial Action

Silver sulfate releases silver ions when the dressing contacts wound exudate. Silver ions disrupt bacterial cell membranes, interfere with the enzyme systems bacteria need to function, and prevent bacterial DNA replication. This provides broad antimicrobial activity against wound pathogens including Staphylococcus aureus, MRSA, Pseudomonas aeruginosa, and other organisms commonly associated with chronic wound infection and sacral pressure ulcers. Silver acts locally at the wound surface. Systemic absorption at wound dressing concentrations is low.

Hydrocellular Foam Exudate Absorption

The hydrocellular polyurethane foam core absorbs wound exudate and draws it upward and away from the wound surface, preventing pooling at the wound bed. This reduces the risk of periwound maceration, which is a particular concern in the sacral region due to proximity to the gluteal cleft and the risk of moisture from incontinence. The foam retains absorbed exudate under light compression and maintains a moist wound healing environment at the wound contact surface.

Contoured Butterfly Shape

The butterfly shape of ALLEVYN Ag Sacrum follows the curved anatomy of the sacrum and gluteal region. Standard square or rectangular dressings tend to lift and wrinkle in this area because they cannot conform to the body contours. The contoured shape provides better coverage of the wound and more consistent adhesion of the silicone border against the periwound skin, reducing the risk of the dressing shifting or lifting between changes.

Soft Silicone Adhesive Border

The adhesive border of ALLEVYN Ag Sacrum uses soft silicone rather than a standard acrylic adhesive. In the sacral region, periwound skin is frequently at risk of damage from moisture, friction, and repeated adhesive removal. Soft silicone forms a gentle physical seal against intact periwound skin and releases with significantly less force than acrylic adhesive, reducing trauma at dressing changes. The silicone border can also be repositioned during application, which is a practical advantage when applying a contoured dressing to the sacral area.

Moisture Vapour Permeable Film Backing

The outer film backing allows moisture vapour to evaporate through the dressing, maintaining the foam absorbent capacity throughout the wear period, while remaining waterproof to external fluids for protection of the wound.

Before Application

• Wash hands and use appropriate gloves.
• Clean the wound with sterile saline or as directed by a healthcare professional.
• Gently clean and dry the periwound skin. In the sacral area, pay particular attention to moisture in the gluteal cleft.
• Apply a skin barrier product to any macerated or moisture-damaged periwound skin before applying the dressing border.

Application

• Position the dressing with the foam pad centred over the wound. The contoured butterfly shape should align with the sacral anatomy, with the narrower indented sections of the border following the natural curves of the lower back and gluteal area.
• Remove the release liner from the silicone border in sections and press gently but firmly onto the surrounding intact skin.
• The silicone border can be lifted and repositioned during application if the first placement is not correctly aligned. This is an advantage of silicone over acrylic adhesive.
• Smooth the border down on all sides to ensure consistent adhesion.
• No secondary dressing is required.

Wear Time and Removal

• ALLEVYN Ag Sacrum can be worn for up to seven days depending on exudate levels and wound condition.
• Change earlier if exudate strikes through to the border, if the border lifts, if there is clinical concern about the wound, or if soiling from incontinence compromises the dressing integrity.
• To remove, lift one edge of the silicone border slowly and peel back parallel to the skin surface. Support the periwound skin with the other hand. The silicone border releases with less resistance than acrylic adhesive.
• Review the wound at each change. Assess whether silver antimicrobial management remains clinically appropriate or whether a non-silver dressing is now more suitable.

Silver containing dressings may cause grey or blue grey discolouration of the wound bed and surrounding periwound skin due to silver deposition (argyria). This is expected, localised, and generally reversible when silver use is discontinued. Inform patients in advance to avoid concern at dressing changes.

ALLEVYN Ag Sacrum — 17cm x 17cm

ALLEVYN Ag Sacrum is available in a single size of 17cm x 17cm. The overall dressing dimensions are 17cm x 17cm in a contoured butterfly shape. The foam pad within the silicone border covers the central wound contact area. The contoured shape is designed to accommodate the typical range of sacral wound dimensions encountered in clinical practice.

If the wound is significantly larger than the foam pad area of this dressing, seek clinical guidance from a tissue viability nurse or district nurse. For very large sacral wounds, a different dressing approach may be needed. Do not use a dressing where the foam pad does not fully cover the wound bed, as this leaves areas of the wound without antimicrobial coverage.

Contraindications

• Do not use on patients with a known sensitivity or allergy to silver or any component of the dressing.
• Do not use on dry or minimally exuding wounds.
• Do not use oil-based topical products directly under the dressing as these impair silver ion release.

Precautions

• ALLEVYN Ag Sacrum is a single use product. Do not reuse or reapply a used dressing.
• Reassess the clinical need for silver at each dressing change. Discontinue when infection is controlled and the wound is healing without signs of infection.
• Monitor the wound closely at each change. Sacral pressure ulcers can deteriorate rapidly. Seek urgent clinical assessment if the wound worsens.
• Incontinence management is an important consideration in sacral wound care. If the dressing border is frequently compromised by incontinence, consider incontinence management strategies alongside dressing management. Seek clinical guidance.
• Do not use MRI scanning with the dressing in place. Remove before MRI procedures.
• Use with caution in patients who are pregnant or breastfeeding. Seek clinical advice.

Adverse Effects

• Grey or blue grey discolouration of the wound bed and periwound skin from silver deposition. Expected and reversible.
• Skin sensitivity or irritation at the silicone border. Silicone is generally better tolerated than acrylic adhesive, but reactions can occur. Discontinue if persistent.
• Wound bed desiccation if exudate levels fall and the dressing is not reviewed.

ALLEVYN Ag Sacrum Is Suitable For Use On

• Sacral and coccygeal pressure ulcers grades 2 to 4 with moderate to heavy exudate where infection is present or at risk
• Infected or at-risk wounds in the sacral region where both antimicrobial silver management and anatomically contoured coverage are needed
• Patients with fragile or moisture-damaged periwound skin in the sacral area where a gentle silicone border causes less trauma than a standard acrylic adhesive border
• Adults and children under healthcare professional supervision

ALLEVYN Ag Sacrum Is Not Suitable For

• Dry or minimally exuding wounds
• Patients with known silver sensitivity or allergy
• Wounds where infection is absent and silver antimicrobial management is not clinically indicated, in these cases ALLEVYN Adhesive Sacrum (without silver) is more appropriate
• Wounds significantly larger than the foam pad area of the 17cm x 17cm dressing, seek clinical guidance

Pharmacy Planet stocks both ALLEVYN Ag Sacrum and ALLEVYN Adhesive Sacrum. Both share the same contoured butterfly shape and silicone-style adhesive border for the sacral area. The key difference is that ALLEVYN Ag Sacrum contains silver sulfate for antimicrobial infection management, while ALLEVYN Adhesive Sacrum contains no silver. Use ALLEVYN Ag Sacrum when the sacral wound is infected or at high risk of infection. Use ALLEVYN Adhesive Sacrum when the wound is clean and healing and only exudate management is needed.

ALLEVYN Ag Sacrum 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 the single size of 17cm x 17cm.

Pharmacy Planet stocks ALLEVYN Ag Sacrum alongside ALLEVYN Adhesive Sacrum, the full ALLEVYN Ag range, and a comprehensive selection of wound care products. Our pharmacists can advise on which sacral dressing is most appropriate for a specific wound.

Sacral pressure ulcers should be managed under clinical supervision. Seek assessment from a tissue viability nurse, district nurse, or GP for any sacral wound that is worsening, not healing, or associated with signs of systemic infection.

• 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 dressing 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, apply immediately.
• Keep out of the reach of children.
• Dispose of used dressings as clinical waste in accordance with local guidelines.

Pharmacy Planet is a GPhC registered online pharmacy providing access to the full Smith+Nephew ALLEVYN range and a comprehensive selection of wound care products. We stock both ALLEVYN Ag Sacrum and ALLEVYN Adhesive Sacrum, allowing selection based on whether antimicrobial silver management is clinically indicated.

All products are genuine and sourced through regulated supply chains. Our pharmacists are available to advise on dressing selection, wear time, and when clinical referral for wound assessment is appropriate.

References

1. Smith+Nephew. ALLEVYN Ag Sacrum Antimicrobial Dressing — Instructions for Use. Smith+Nephew Medical Ltd. https://www.smith-nephew.com. Accessed May 2026.
2. National Institute for Health and Care Excellence (NICE). Pressure ulcers: prevention and management (CG179). https://www.nice.org.uk/guidance/cg179. Accessed May 2026.
3. Wounds UK. Best Practice Statement: Wound exudate — effective assessment and management. https://www.wounds-uk.com. Accessed May 2026.
4. NHS. Pressure sores (pressure ulcers). https://www.nhs.uk/conditions/pressure-sores. Accessed May 2026.