Abstract
The concept of TIME in wound management has developed from an earlier framework; Wound Bed Preparation (WBP). The initial drive for producing a systematic wound care framework like WBP was the emergence of new wound care therapies for chronic wounds. However the impact of the therapies on the healing of chronic wounds was hampered by inadequate preparation of the wound bed. The three basic domains of WBP; debridement, bacterial control and moisture balance, were soon adopted as the gold standard for wound care for assessing the barriers to healing and if achieved resulted in a wound bed that is able to commence healing. WBP goes beyond general assessment and systematically focuses on the non-healing aspects of the wound and the underlying causes. However a final piece of the framework was missing and in 2002 a group of experts identified the need for an additional component to the domains of WBP that focused on the epidermal edge of the wound (Schultz et al, 2005). This was a result of clinicians who had completed wound bed preparation and produced a healthy wound bed. However the epithelial cells at the wound edge, for whatever reason, would not migrate across the granulation tissue to ensure wound healing. Therefore this potential barrier to healing was identified and incorporated into the WBP paradigm and a new concept: T.I.M.E. was born, it is an acronym for:
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