Wound Bed Preparation
The concept of “wound bed preparation” involves a complete and systematic approach to assess and remove barriers to the healing process so that the wound can heal normally.
WHAT IS BED PREPARATION?
- The concept of “wound bed preparation” involves a complete and systematic approach to assess and remove barriers to the healing process so that the wound can heal normally. It directs the development of effective treatment plans that focus on both the patient as a whole and the underlying illness that resulted in the wound. To achieve this, therapeutic agents are improved to faster endogenous healing or raise the effectiveness of reducing treatments.
WHY IS WOUND BED PREPARATION IMPORTANT?
- In order to use all of material removal but costly wound therapies, wound bed preparation was first created for chronic wounds. The way chronic wounds are treated has improved significantly of it. A systematic approach to wound care treatment that makes use of current medical principles and requirements has been created using this concept, which has helped identify the key components of chronic wound care. In order to overcome the barriers to wound improvement, wound bed preparation also has the potential to ensure that the full benefits of advanced wound-care products are obtained.
THE COMPONENTS OF WOUND BED PREPARATION
- Wound bed preparation consists of four parts that treat the many pathophysiological problems that cause chronic wounds
- management of tissues
- control of infection and inflammation
- Water balance
- epithelial (edge) development
- To maximise the potential for wound healing, the T.I.M.E. framework consists of advanced support that can be used to manage various types of wounds.
TIMES MODEL
Tissue
- In chronic non-healing wounds, necrotic or compromised tissue is frequently present, and its removal has numerous positive effects. By removing bacteria, non-vascularized tissue, and cells that inhibit healing (cellular burden), it creates an environment that encourages the growth of healthy tissue.
- The fact that debridement removes the cellular burden and enables the establishment of a stimulatory environment is particularly significant in light of recent findings about the senescence of wound cells and their lack of sensitivity to certain signals. Contrasting to chronic wounds, which may require repeated debridement, acute wounds often only need debridement once, if at all.
Inflammation
- Healing is delayed by the presence of infection, whether local or systemic. A barrier is also created when there is swelling in the wound bed or around the wound. The body has become infected when they are invaded by microorganisms that are staying longer than usual.
- To completely control the host and induce a systemic infection, an infection can progress through a number of phases. Different levels of interaction between microorganisms and chronic wounds are common. Wound contamination, colonisation, critical colonies, and infection are all possible outcomes.
Moisture Balance
- The healing process can be hindered in a number of ways by excess or insufficient moisture. Promoting re-epithelialization depends on maintaining a regulated moisture level.
Epithelial (edge) Advancement
- Skin function must be recovered along with the development of an intact epithelium for healing to be effective. However, regulatory flaws, reduced cellular mobility, or adhesion within the keratinocytes may directly hinder the process of epithelialization.
- Indirectly, for example, when flaws in the wound matrix or ischaemia inhibit keratinocyte migration.
