T.I.M.E – a practical wound care framework
T.I.M.E is a global wound care framework used to implement appropriate care plans and promote wound healing. The TIME framework can be used to apply wound bed preparation to practice. The correct implementation of TIME depends on patient and wound assessment.
TIME is not a sequential process, every wound is different; simultaneous attention to one or more of the components may be required.
B. Braun wound dressing portfolio in synergy with the T.I.M.E concept
Debridement and wound bed preparation
Antimicrobial treatment
Restore moisture balance
Promote epithelization and healthy skin
Treatment guide
Black necrotic wounds (non-ischemic)
Level of exudate: low
Necrotic tissue or eschar consists of an accumulation of dead cells, tissue and cellular debris. Removal of wound eschar through appropriate debridement techniques (surgical or medical) is a prerequisite for the wound healing processes to start.
Remark: sharp debridement can bring about haemorrhage. Conversely, eschar is normally not the result of haemorrhage but much more often of ischaemia.
Therapeutical objectives: Removal of dry necrotic tissue
Procedure / Action:
- Hydrating the wound with hydrogel
- Mechanical or surgical debridement
Wound bed preparation: Only a clean wound can heal
Secondary wound dressing: Askina® Derm
Dressing replacement frequency: up to 3 days
Dry fibrinous wounds
Level of exudate: low
Dry, fibrinous tissue is a result of dead cells and must be removed.
Therapeutical objectives: Fibrinous tissue removal and exudate management
Procedure / Action:
- Mechanical or surgical debridement if needed
- Wound cleansing and setting a moist environment to promote autolytic debridement
Wound bed preparation: Only a clean wound can heal.
Primary wound dressings: Askina® Foam and Askina® Heel
Secondary wound dressing: Askina® Pad and bandage, tape
Dressing replacement frequency: daily
Moist fibrinous wounds
Level of exudate: medium to high
Fibrinous tissue is the result of an accumulation of dead cells, these tissues must be removed.
These wounds can produce various amounts of exudate, that must be managed.
Therapeutical objectives: Fibrinous tissue removal and exudate management
Procedure / Action:
- Mechanical or surgical debridement if needed
- Wound cleansing, encouraging a moist environment to promote autolytic debridement
Wound bed preparation: Only a clean wound can heal.
Primary wound dressings:
- Deep: Askina® Sorb Rope, Askina® Foam Cavity, Askina® Cavity Strips
- Superficial: Askina® Sorb, Askina® Foam and Askina® Heel
Secondary wound dressing: Askina® Pad and bandage, tape
Dressing replacement frequency: daily
Fibrinous to Granulating wounds
Level of exudate: medium to high
The wound is yellow and red due to the presence of fibrin and newly formed red granulating tissues.
Therapeutical objectives: Fibrinous tissue removal and exudate management
Procedure / Action:
- Wound cleansing, encouraging a moist environment to promote autolytic debridement
Wound bed preparation: Only a clean wound can heal.
Primary wound dressings:
- Deep: Askina® Sorb Rope, Askina® Foam Cavity, Askina® Cavity Strips
- Superficial: Askina® Sorb, Askina® Foam and Askina® Heel
Secondary wound dressing: Askina® Pad and bandage, tape
Dressing replacement frequency: daily
Granulating wounds
Level of exudate: medium
The wound is red, with predominant newly formed granulating tissue.
Therapeutical objectives: Exudate management and promote granulation
Procedure / Action:
- Wound cleansing and maintaining a moist environment
- Protect newly formed tissue and of surrounding skin
Wound cleansing and wound bed preparation: Prontosan® Wound Irrigation Solution
Primary wound dressings:
- Deep: Askina® Foam Cavity, Askina® Cavity Strips
- Superficial: Askina® SilNet, Askina® DresSil range, Askina® Transorbent
Secondary wound dressing: bandage, tape
Dressing replacement frequency: every 1 to 3 days
Granulating to Epithelializing wounds
Level of exudate: low
The wound is pale pink, with a newly formed, fragile, epithelializing tissue.
Therapeutical objectives: Remaining exudate absorbtion and to encourage epithelialization
- Wound cleansing
- Protect newly formed tissue and of surrounding skin
Wound cleansing and wound bed preparation: Prontosan® Wound Irrigation Solution, Prontosan® Wound Gel, Prontosan® Wound Gel X
Primary wound dressings:
- Deep: Askina® Foam Cavity, Askina® Cavity Strips
- Superficial: Askina® SilNet, Askina® DresSil range,
Secondary wound dressing: bandage, tape
Dressing replacement frequency: every 3 to 5 days
Epithelializing wounds
Level of exudate: none
Therapeutical objectives:
- Encourage epithelialization
- Protect newly formed tissue
Primary wound dressing:
- Superficial: Askina® Derm
Secondary wound dressing: bandage, tape
Dressing replacement frequency: up to 7 days
Infected wounds
Level of exudate: medium to high
The wound is characterized by pain, erythema, edema, heat, a high level of exudate and odor. Healing is delayed.
Therapeutic objectives:
- Reduce bacterial load
- Manage exudate
- Control odor
Procedure / actions: Wound cleansing, preventing contamination from external bacteria, balance moist wound environment
Wound cleansing and wound bed preparation: Prontosan® Wound Irrigation Solution, Prontosan® Wound Gel, Prontosan® Wound Gel X
Primary wound dressings:
- Deep: Askina® Calgitrol® Thin, Askina® Calgitrol® Paste
- Superficial: Askina® Calgitrol® Ag
See also Silver dressings.
Secondary wound dressing: Askina® Carbosorb, Askina® Pad, bandage, tape
Dressing replacement frequency: daily
