Shah Jayesh B
South Texas Wound Associates, PA, San Antonio, TX, USA ; Southwest Center for Wound Care and Hyperbaric Medicine, Southwest General Hospital, San Antonio, TX, USA ; The Wound Healing Center at Northeast Baptist Hospital, San Antonio, TX, USA.
J Am Col Certif Wound Spec. 2011 Oct 9;3(2):26-32. doi: 10.1016/j.jcws.2011.09.001. eCollection 2011 Jun.
Wound bed preparation is an organized approach to create an optimal environment for wound healing by the use of the most cost-effective therapeutic options. It has become an essential part of wound management and seeks to use the latest findings from molecular and cellular research to maximize the benefits of today's advanced wound care products. The international advisory panel on wound bed preparation met in 2002 to develop a systemic approach to wound management. These principles of this approach are referred to by the mnemonic TIME, which stands for the management of nonviable or deficient tissue (T), infection or inflammation (I), prolonged moisture imbalance (M), and nonadvancing or undermined epidermal edge (E). One critical element of pathophysiology, understanding of the hypoxic nature of the wound and correction of hypoxia as a critical element of wound bed preparation, is not covered. This article proposes to add correction of hypoxia to the TIME principle (TIMEO2 principle) based on the evidence. The evidence that will support the reason and the need for modification of the wound bed preparation protocol is discussed.
伤口床准备是一种有组织的方法，通过使用最具成本效益的治疗方案，为伤口愈合创造最佳环境。它已成为伤口管理的重要组成部分，并力求利用分子和细胞研究的最新发现，以最大限度地发挥当今先进伤口护理产品的益处。国际伤口床准备咨询小组于2002年召开会议，制定了一种系统性的伤口管理方法。这种方法的原则用助记符TIME表示，分别代表对无活力或不足组织（T）、感染或炎症（I）、长期水分失衡（M）以及未推进或受损的表皮边缘（E）的管理。伤口病理生理学的一个关键要素，即对伤口缺氧性质的理解以及将纠正缺氧作为伤口床准备的关键要素，未被涵盖。本文建议基于证据在TIME原则中增加纠正缺氧（TIMEO2原则）。文中讨论了支持修改伤口床准备方案的理由和必要性的证据。
