Xeroform™ Occlusive Petrolatum Gauze

Xeroform™ Occlusive Petrolatum Gauze. 3% Bismuth Tribromophenate in a special petrolatum blend on fine mesh gauze. Non-adherent. Clings and conforms to all body contours.

Order Information

Order CodeDescriptionShip CaseHCPCS*
8884431302Xeroform™ Occlusive Petrolatum Gauze Strip, Overwrap, 1" x 8" (2.5 cm x 20.3 cm)200A6222
8884431605Xeroform™ Occlusive Petrolatum Gauze Strip, Overwrap, 5" x 9" (12.7 cm x 22.9 cm)200A6223
8884432000Xeroform™ Occlusive Petrolatum Gauze Roll, 4" x 9' (10.2 cm x 2.7 m)36A6224
8884433301Xeroform™ Occlusive Petrolatum Gauze Patch, 1" x 8" (2.5 cm x 20.3 cm)200A6222
8884433400Xeroform™ Occlusive Petrolatum Gauze Patch, 2" x 2" (5.1 cm x 5.1 cm)150A6222
8884433500Xeroform™ Occlusive Petrolatum Gauze Patch, 4" x 4" (10.2 cm x 10.2 cm)150A6222
8884433605Xeroform™ Occlusive Petrolatum Gauze Strip, 5" x 9" (12.7 cm x 22.9 cm)200A6223

* DISCLAIMER: Although the Centers for Medicare and Medicaid Services was the primary source of the information set forth above, Covidien does not represent or guarantee that the information set forth above is complete, accurate, or applicable to any particular patient or third-party payer. Covidien disclaims all liability for any consequence resulting from any reliance on the information set forth above. The final decision of billing for any product must be made by the health care provider considering the medical necessity of the product furnished as well as the requirements of third-party payers and any local, state, or federal laws and regulations that apply to the product furnished. Covidien is providing this information in an educational capacity with the understanding that Covidien is not engaged in rendering legal, accounting, or other professional services. Covidien encourages all health care providers to consult with their own advisors regarding coding and payment.

Features and Benefits

3% Bismuth Tribromophenate in a petrolatum based fine mesh gauze Bacteriostatic action in light exudating wounds
Clings and conforms, low profileUsed for compression therapy and use in deep and shallow wounds
Non-adherent constructionNon-traumatic to the wound and the patient upon removal
Occlusive dressingHelps protect and promote moist wound healing

Instructions for Use

  • Peel foil edges down from point of arrow to allow aseptic removal
  • Place or pack dressing on or into wound
  • Use transparent film, tape, island dressing or roll gauze to secure


  • Irritation may develop with a history of atopy or if sensitivity to Bismuth Tribromophenate exists