Smith+Nephew Acticoat Flex 3 Silver Contact Layer — Nanocrystalline Silver, 3-Day Wear, 6 Sizes Including 4" × 48"

The same nanocrystalline silver knitted polyester technology as Acticoat Flex 7 — calibrated for a 3-day change interval. Kills bacteria in 30 minutes. Highly conformable, stretchable single layer. NPWT compatible for up to 3 days. Six sizes including the unique 4" × 48" long-format strip not available in the Flex 7 line. Smith+Nephew Acticoat Flex 3 is a low-adherent, highly conformable antimicrobial barrier dressing consisting of a single layer of knitted polyester coated with nanocrystalline silver (Ag⁰) at 0.69–1.64 mg/cm² — the same fundamental construction as Acticoat Flex 7, with the silver content calibrated for a 3-day rather than 7-day wear period. The nanocrystalline silver provides bactericidal activity within 30 minutes and sustained broad-spectrum antimicrobial protection throughout the 3-day wear period. The open-weave knitted structure transfers exudate through to a secondary dressing without retaining fluid at the wound surface, and the stretch properties of the knit allow the dressing to conform intimately to wound contours and move with the patient through the full range of motion of the affected body part. Available in six sizes — including a 4" × 48" long-format strip for extensive linear wounds and large-format limb coverage that has no equivalent in the Flex 7 range. Box counts vary by size.

✔ Nanocrystalline Silver (Ag⁰) — Calibrated for 3-Day Wear    ✔ Kills in 30 Minutes — Sustained Bactericidal Activity to Day 3    ✔ Single Knitted Layer — Stretches, Conforms, Moves with Patient    ✔ Exudate Transfers Through — No Retention at Wound Surface    ✔ NPWT Compatible — Up to 3 Days Under Negative Pressure    ✔ Cut to Size — Low Adherent, One-Piece Removal    ✔ 6 Sizes Including Unique 4" × 48" Long Format

Product Details & Available Sizes

Indicated For — Wound Types

• Partial and full thickness wounds with infection or elevated infection risk
• First and second degree burns — including extensive body surface area burns (large format sizes available)
• Covering of skin grafts — including meshed grafts
• Surgical sites with infection risk
• Venous leg ulcers
• Pressure ulcers
• Diabetic foot ulcers
• Wounds being managed with NPWT — compatible as wound contact layer under negative pressure wound therapy for up to 3 days
• Infected wounds — as part of a comprehensive clinical treatment protocol
• Wounds requiring frequent inspection intervals with continuous silver antimicrobial protection between assessments

Contraindications and precautions:

• Do not use on patients with known sensitivity to silver
• Remove from the anatomical field being imaged before MRI — if outside the image field, may remain in place
• Remove before radiation therapy — a new dressing may be applied after treatment
• Not compatible with oil-based products such as petrolatum
• Avoid contact with electrodes or conductive gels during EEG, ECG, or other electronic measurements
• Not intended as sole treatment for clinically infected wounds — use as part of a clinical management protocol
• Transient stinging may occur on application — discontinue if continuous pain persists
• Not for third-degree burns
• Use in premature infants under 37 weeks gestation only when clinical benefit outweighs potential risks
• For external use only — do not apply to exposed internal organs

How Acticoat Flex 3 Works — Nanocrystalline Silver on Knitted Polyester

Acticoat Flex 3 and Acticoat Flex 7 share identical construction and technology. Both consist of a single layer of knitted polyester coated with nanocrystalline silver — pure metallic Ag⁰ clusters applied uniformly across the dressing surface. When wound moisture contacts the silver coating, silver ions (Ag⁺) are released from the Ag⁰ clusters into the wound environment, where they exert broad-spectrum bactericidal activity against gram-positive, gram-negative, and yeast wound pathogens including MRSA and Pseudomonas aeruginosa. The nanocrystalline structure provides a high surface area relative to the silver mass, enabling consistent ion release at effective bactericidal concentrations throughout the wear period — killing bacteria within 30 minutes and maintaining that activity for the duration of the 3-day wear interval.

The knitted polyester substrate provides the dressing's mechanical properties. Unlike woven or laminated materials, the knitted loop structure gives Acticoat Flex 3 true bi-directional stretch — the dressing extends in all directions as the patient moves, maintaining intimate wound contact without wrinkling, bridging over surface contours, or resisting the movement of the affected body part. The open-weave structure allows exudate to pass freely from the wound surface through the dressing into a secondary absorbent layer placed above, keeping the wound environment neither desiccated nor saturated. The low-adherent coating allows the dressing to release from the wound surface at change without bonding to healing tissue, and the single-layer construction removes cleanly in one piece without fragmenting.

For the complete technical explanation of nanocrystalline silver chemistry, Ag⁰ vs. silver compound comparison, NPWT mechanism, and single-layer vs. multi-layer construction rationale, see the Acticoat Flex 7 product page — all technology details apply equally to Flex 3.

The 4" × 48" Long Format — What It's For

The 4" × 48" strip (66800434) is unique to the Acticoat Flex 3 line — it has no equivalent size in the Acticoat Flex 7 range. At four feet in length and four inches wide, it is designed for two specific use cases that no standard-format dressing can efficiently address:

• Circumferential limb wounds — burns and trauma: Partial thickness burns and traumatic wounds that encircle a limb require coverage of the full circumferential surface rather than just one face. The 4" × 48" strip can be spirally wrapped around the limb from distal to proximal (or vice versa) like a ribbon, allowing a single dressing to provide continuous nanocrystalline silver antimicrobial coverage over the entire circumference of the arm, leg, or extremity in one application. This eliminates the gap management and edge-overlap challenges of using multiple individual pads to cover a circumferential wound.
• Large surface area coverage on major burns: For extensive burn surface area management — particularly in burn centers managing large body surface area (BSA) partial-thickness burns — the long strip format allows more efficient coverage of large wound areas with fewer individual dressing pieces, reducing application time and the number of dressing interfaces that must be managed during each change.

The 4" × 48" format can also be cut longitudinally or transversely to any desired dimension for wounds that do not require the full length, making it a versatile large-format option for any wound management situation where cutting from a large sheet is more efficient than piecing together multiple smaller dressings.

Acticoat Flex 3 vs. Acticoat Flex 7 — Choosing the Right Change Interval

Acticoat Flex 3 and Acticoat Flex 7 are the same dressing — same construction, same nanocrystalline silver technology, same antimicrobial mechanism — with the silver content calibrated to different wear periods. Flex 3 contains 0.69–1.64 mg/cm² silver; Flex 7 contains 0.84–2.01 mg/cm² silver. The clinical choice between them is entirely about how frequently the clinical situation requires or allows wound assessment:

• Choose Acticoat Flex 3 when: The wound requires assessment every 3 days regardless of antimicrobial status — rapidly changing infection, unstable or unpredictable drainage, early post-operative wounds, wounds where the clinician needs frequent inspection access, or any protocol that mandates 3-day dressing changes. Flex 3 is also appropriate when cost-per-change is more important than minimizing change frequency — each Flex 3 dressing costs less than a Flex 7 for the same size.
• Choose Acticoat Flex 7 when: The wound is stable enough to permit a 7-day assessment interval — chronic wounds with predictable drainage, stable burn management after the acute phase, wounds where reducing the number of dressing changes is a primary goal for nursing efficiency, cost, or patient comfort. Flex 7's extended wear time roughly halves the total number of dressing changes over a treatment course compared to Flex 3.

Size availability also differs between the two lines. Flex 3 offers the 4" × 48" long strip (66800434) with no Flex 7 equivalent. Flex 7 offers a 6" × 6" square and a 1" × 24" rope format with no Flex 3 equivalent. If the wound format specifically requires one of these sizes, that determines the choice regardless of preferred wear time.

Acticoat Flex 3 vs. Standard Acticoat 3 — Understanding the Line

Smith+Nephew also markets a standard Acticoat 3 — a different product with a different construction. The standard Acticoat 3 is a multi-layer laminate: polyethylene mesh outer layers bonded around a rayon/polyester absorbent core, all coated with nanocrystalline silver. The multi-layer construction retains some fluid within the dressing body and is dimensionally more stable but less conformable. Acticoat Flex 3 is the single-layer knitted polyester version — no bonded layers, maximum conformability and stretch, pure transfer function with no fluid retention. When a wound requires maximum dressing conformability, stretch to accommodate movement, or use as a wound contact layer under NPWT, Acticoat Flex 3 is the appropriate choice over standard Acticoat 3.

Choosing the Right Size

• 66800402 — 2" x 2": Small wounds, vascular access and IV sites, small pressure injuries, pediatric wound sites, and any wound where a minimal footprint is needed. Box of 5.
• 66800406 — 4" x 4": Standard size for typical pressure ulcers, diabetic foot ulcers, venous ulcers, surgical wounds, and burn sites of average dimension. The most commonly used Flex 3 size — higher per-box count (12) than Flex 7 reflects more frequent change cadence. Box of 12.
• 66800417 — 4" x 8": For elongated wounds, post-operative incisions, saphenous vein harvest sites, donor sites, and wounds that run longer than the 4x4 can cover without overlapping two pads. Box of 12.
• 66800418 — 8" x 16": Large wounds and extensive burn surfaces — partial-thickness burns over a substantial limb segment, large graft coverage areas, extensive wounds requiring broad-contact silver protection. Box of 6.
• 66800433 — 16" x 16": Maximum-format square — for the most extensive wound surfaces, large-BSA burn management, or any wound where maximum single-dressing coverage in a square format is required. Box of 6.
• 66800434 — 4" x 48": Unique long-strip format — for circumferential limb wound wrapping, large-surface spiral coverage, and any situation where cutting from a long strip is more efficient than piecing multiple pads. Not available in the Flex 7 line. Box of 6.

Not sure which size or wear time is right for your wound? Call 1-866-218-0902 — Mon–Fri, 9am–5pm EST

Application Instructions

1. Cleanse the wound per standard protocol
2. If the wound is dry or has minimal exudate — moisten the Acticoat Flex 3 dressing with drinking water (sterile water or saline also acceptable) before application; for moderate-to-high exudate wounds, moistening is not required
3. Cut to the appropriate size and shape with sterile scissors if needed — all antimicrobial properties are retained after cutting
4. Apply to the wound without stretching — either side of the dressing may be placed against the wound surface; align the stretch direction along the limb for best conformity on limb wounds
5. For circumferential wounds using the 4" × 48" strip — spiral-wrap from distal to proximal in overlapping turns, maintaining gentle contact without compression
6. Secure with an appropriate secondary absorbent dressing to manage exudate volume
7. Keep the dressing moist throughout the wear period — if the secondary dressing becomes dry before the change interval, add moisture at the secondary level
8. Change every 3 days or as indicated by wound condition and exudate level
9. To remove — lift the dressing from the wound; the low-adherent coating allows clean one-piece removal; if stinging occurs during application, ensure the dressing is adequately moistened and recheck application technique

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Questions about Acticoat Flex 3 or any of our antimicrobial wound dressings? Call 1-866-218-0902 — our team is ready to help.