Wound Bed Preparation – Introduction

Welcome to the first in a new series on wound bed preparation; a subject that we will consider from different angles over the coming weeks. The term ‘wound bed preparation’ is now common in wound management, but it is worth taking a few moments to go back to basics and reconsider exactly what we mean by this term, and how it has revolutionized wound management over recent years.

Wound Bed Preparation: A New Concept

Although wound bed preparation is a very familiar term to all of us, in fact, the phrase was only established as recently as 2003.¹ The concept was created to help formalize an approach to the identification of barriers to healing and to design treatment strategies to overcome these barriers. The field of wound bed preparation has advanced rapidly since 2003, but the same fundamental principals still apply today.

Wound Healing Phases

It is well known that normal wound healing proceeds through four sequential and overlapping phases; hemostasis, inflammation, repair, and remodeling.^1-5 In chronic wounds, this process fails at some point, and the wound becomes stalled in the process of healing. The challenge for wound care experts was to devise a protocol which would address the underlying causes for the failure of a wound to heal and allow the normal processes of wound healing to resume.¹

TIME & Wound Bed Preparation

A collaboration of a number of physicians, nurses, and scientists was formed in 2003 to generate a simple framework of key clinical assessments and treatment options that would identify, remove and correct the barriers to healing in most chronic wounds.¹ The outcome of this process was the concept of wound bed preparation and the development of the well-known TIME mnemonic. TIME is fundamental to wound bed preparation, and underlies much of the work of the wound care specialist.  We will consider the different elements involved in TIME in our article next week.

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References

1. Schultz G, Dowsett C. Wound bed preparation revisited.  Wounds International March 3(1) (Available from http://www.woundsinternational.com/practice-development/wound-bed-preparation-revisited).
2. Acute and chronic wounds. Current management concepts. 3^rd ed. St Louis, Missouri; Mosby Elsevier; 2007.
3. Baranoski S, Ayello EA, eds. Wound Care Essentials: Practice Principles. 2^nd Edition. Lippincott Williams & Wilkins, Ambler PA. 2008.
4. Wound management principles and practice. 2nd ed. Upper Saddle River, NJ: Pearson; 2008.
5. Sussman C and Bates-Jensen B. Wound Care: A Collaborative Practice Manual for Health Professionals. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007.