TIME-H in clinical practice - a pilot study

The concept of wound bed preparation (WBP) has evolved considerably since its formal inception. Several tools have been developed which encourage the process of WBP and wound healing, including TIME which was first introduced in 2003. The acronym TIME (tissue, infection, moisture, edge) remains at the forefront of chronic wound management 10 years on. The tool identifies elements for optimal WBP in order to provide coordinated management of a chronic wound to achieve effective healing.

However, TIME does not offer any prognostic indication — an important aspect of wound management to enable development of management goals and strategies for individual patients. In order to address this issue, Ligresti and Bo³ proposed the concept of TIME-H, which embraces both the local conditions of the wound and the general condition of the patient. The authors assigned a numerical value to each parameter to develop a ‘healing score’ (Tables 1–3) for the purpose of predicting wound healing time and planning an individualised treatment protocol.

Chronic wounds affect around 1% of individuals in developed countries and are estimated to cost the Australian health care system A$3 billion annually. In addition, a myriad of social and physical issues arise from chronic wounds which cause significant morbidity to those affected. Hence, any tool which claims to be able to guide wound healing is worthy of further research to validate this for routine clinical application.

The present study was undertaken as a pilot project to evaluate TIME-H in clinical practice with a case-based approach.