Wound healing and TIME; new concepts and scientific applications

Wound bed preparation is a comprehensive approach to wound management that focuses on optimizing conditions at the wound bed to encourage normal endogenous processes of healing. It is based on an understanding of the underlying molecular processes of the wound and is in a continuous state of evolution as it incorporates and responds to new information about and understanding of cellular mechanisms. This article reviews recent thinking about the relevance of wound bed preparation to diabetic wounds and burns, presents adjustments to the tissue, infection/inflammation, moisture imbalance, epidermis/ edge (TIME) paradigm of wound management to reflect greater understanding concerning migration of the epidermal edge, and provides an extension of the concept to include wound assessment. Finally, it asks whether TIME should now be put to the test. The field of wound management is lacking in robust data, but now that a more systematic approach to wound care exists, perhaps a more systematic approach to gathering the evidence should also be attempted.