Wound bed preparation and TIME

Published on October 7, 2014   66 min

Other Talks in the Series: Wound Healing

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I'm very pleased to be contributing to these Henry Stewart talks on wound healing. And my topic is wound bed preparation with the acronym TIME. I'm Professor David Leaper, Emeritus Professor of Surgery at Newcastle upon Tyne, and Visiting Professor at Imperial College, London. And that's me in the bottom left-hand corner.
The TIME acronym was originally aimed to describe the observable culturistics of chronic wounds within the framework of wound bed preparation. It was developed by an international advisory board just over 10 years ago. The concept of wound bed preparation has been taken from plastic surgery where a wound is prepared to be optimal for a skin graft. But in this context, in chronic wounds, wound bed preparation is a preparation of a chronic wound to allow successful healing by secondary intention. The TIME acronym, which I'll describe throughout the lecture, is based on T for tissue debridement, making the wound as clean as possible. Controlling infection and bioburden and inflammation, that's the I. M is for moisture balance. Wounds heal optimally when they are optimally moist-- not too much moisture, not too dry. And finally, E for the epithelial edge, ensuring the healthiest epithelial edge at the healing edge. And also looking after the periwound skin and making sure it doesn't become too macerated.
This is a very busy slide and summarises the concepts first published in 2003 on the principles for wound bed preparation. And again, we can see on the left-hand side the acronym for tissue cleaning, managing infection and inflammation, managing moisture and looking after the wound edge. The proposed physiology and the background for undertaking this is given, and the clinical actions and their effects. And finally, the concepts of the vast clinical outcomes. Now, I shall be going through this in the lecture in the next few slides.