Wound Bed Preparation – TIME Mnemonic
As we have seen, the TIME mnemonic can be used to capture the fundamental principles of wound bed preparation.1,2 Become a professional at appropriate dressing selection for the different stages of wound healing within the TIME trick. As no single wound dressing is suitable for all wound types or healing stages, wounds should be assessed at every dressing change to ensure the most suitable product is always used.3
T: Tissue Debridement
Autolytic and enzymatic debridement can be achieved through the appropriate choice of product or dressing. Enzymatic debridement requires the use of a topical enzymatic agent to digest and liquefy necrotic tissue, while autolytic debridement can be accomplished using moist, interactive dressings such as amorphous hydrogels, impregnated hydrogels, and hydrogel sheets, or by using occlusive or semiocclusive dressings such as transparent films and hydrocolloids. Polysaccharides such as honey-based products may also be effective.3
Bacterial load may be reduced using dressings containing iodine silver or chlorhexidine, or honey-based products. Hydrophobic dressings attract microorganisms and therefore reduce the bioload, while an antiseptic solution may be used for a limited period to stabilize bacterial load. Deep infections require treatment with systemic antibiotics, while use of metronidazole gel is effective for the control of anaerobic bacteria.3
M: Moisture Balance
A granulating, moist wound bed may be dressed with hydrocolloid or permeable film dressings to maintain fluid balance. However, if exudate levels are high, an absorptive dressing such as an alginate, or hydrophilic foam product may be required.3
E: Edge of Wound
Wound healing can be assessed by the extent of granulation tissue formation around the wound edges. It is essential that this wound edge and the surrounding skin should not be damaged by the repeated application or removal of adhesive dressings. Dressings may be kept in place with bandages, while use of very thin hydrocolloid dressings may protect the skin. Barrier creams and barrier spray can also be used to protect the skin against potential damage.3
Learn More With Our Wound Care Education Options
Interested in learning more about wound care and certification? Browse through our wound care certification courses for information on our comprehensive range of education options to suit healthcare professionals across the full spectrum of qualifications and experience.
- Schultz G, Dowsett C. Wound bed preparation revisited. Wounds International March 3(1).
- Ayello EA, Dowsett C, Schultz GS, et al. TIME heals all wounds Nursing. 2004;34(4):36-41.
- Mulder M. The selection of wound care products for wound bed preparation. Prof Nurs Today 2011; 15(6):30–36.
Thank you Ms. Swezey, I appreciate these notes on dressing changes, focusing on if the wound is dry or wet, seeping etc the correct dressing is very important.
I love creating sterile wound bandages..therefore, I may save up to study wound and skin care with focus on the diabetic ulcers.
Charlene Johnson LPN
Hi Charlene, When you are ready I highly recommend that you take the LPN wound care certification course. Feel free to contact us to see some options that might make the course affordable for you at this time: 800-637-5526. Good luck in your pursuit of wound care certification.
Hello, I’m an older LPN with many years in dialysis. I am seeing more and more patients with various wounds coming through the door. I recently have become very interested in wound care and would like to take the course to become specialized, then go out on my own (independent?) while being affiliated with a wound care company. What is the pay rate of a visiting wound care LPN? Thank you