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Broadening of TIME concept in wound healing

1/16/2017

1 Comment

 
The TIME (Tissue, Infection/Inflammation, Moisture, and Edge) framework has been developed in 2002 by a group of wound care experts in an effort to standardize wound assessment and preparation of a wound bed for treatment.

When a patient enters the wound treatment regimen, these components have to be thoroughly assessed in order to optimize the treatment approach and facilitate fast healing of the wound.
​
We interviewed our Clinical Director Vicki Fischenich to find out how the TIME framework may have changed since the entrance of Enluxtra Smart Wound Dressing into the wound care market.


​Does it mean Enluxtra is making the TIME framework obsolete?
​

Ms. Fischenich: No, not at all. On the contrary, I like to point out that with Enluxtra’s arrival the TIME framework not only remains in place, it is also developed further.
It so happens that Enluxtra’s properties are extremely beneficial to the skin around the wound. Unfortunately, skin around the wound has been left outside of the TIME concept, yet it is just as important to healing process as the wound itself. It needs to be included in every pre-treatment assessment and be made part of the updated TIMES acronym where S stands for “skin”. 
Fig. 1 The table below demonstrates the effectiveness of Enluxtra dressing for all components of the TIME concept and even more. Instead of multiple products and therapies Enluxtra can address all the components with an added benefit of the peri-wound skin protection.
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How did Enluxtra’s arrival affect the TIME framework?

Ms. Fischenich: The TIME framework remains important for selecting appropriate treatment for each particular wound based on wound assessment results. However, the challenge that’s always been there is just that: having to choose from a variety of treatment options appropriate for the condition of the treated wound.
With Enluxtra this challenge has been minimized as this product is suitable for all types of wounds at all healing stages.  As a result, the treatment is streamlined and clinicians have received a tool that can address all the components of the TIME framework simultaneously. 
Can you tell us a little bit about each component of the new TIMES framework and how Enluxtra affects each one of them?

Ms. Fischenich: Certainly. Non-viable tissue, such as necrosis or slough impede healing and prolong inflammation. Traditionally debridement takes care of the non-viable tissue. With Enluxtra there is the advantage of strong support of the natural autolytic process that helps eliminate the costly and painful debridement methods.

- Lingering infection and inflammation happen for a number of local and systemic reasons. The presence of pathogens in the wound has traditionally been dealt with by means of cleansing, and topical antibiotics. Persistent infections are treated with systemic antibiotics. Enluxtra’s ability to physically remove microorganisms from the wound and chemically bind the water necessary for their replication addresses infection without the need for additional procedures or medication.

- Exudate management presents the biggest challenge in wound care but moisture is an important factor in physiology of wound healing as it drives cell proliferation and epithelialization processes.  Conventional approach to maintaining moist healing environment is to rely on the correct dressing choice. The smart polymer technology allows Enluxtra dressings to adjust local functions in real time in response to the changes in wound microenvironment. This helps to optimize moisture balance at all times and in all parts of the wound.

- Wound edges contract during the normal healing process. A number of reasons may prevent wound closure and traditionally clinicians rely on the chosen wound dressing’s properties to reduce the factors impeding the migration of epidermal margins and contraction of wound edges. Non-traumatic wound contact surface of Enluxtra combined with its ability to prevent both maceration and desiccation puts this product at a clear advantage over other dressing choices.
​
- Finally, skin around the wound that is vulnerable both to mechanical damage and infection requires protection it is rarely given when traditional treatment options are used. Enluxtra treatment fully focuses on treating peri-wound skin - to the same extent it treats the wound. As a result, skin around the wound never dries out, never becomes macerated; it is protected from both harsh extrinsic factors and mechanical damage.

​Would you say that Enluxtra’s properties constitute exactly what the TIMES framework implies to be a preferred wound treatment?
​

Ms. Fischenich: Most definitely. Enluxtra is universally applicable to any type of wound and its technology supports the natural healing process while minimizing the factors that impede healing. It is definitely the product that addresses every component of the TIMES framework at the same time, and should be regarded as the most advanced and versatile wound care product on the market today. 

​What advice would you give to wound care professionals who use Enluxtra dressings?
​

Ms. Fischenich: Enluxtra dressings perform best when all the manufacturer’s recommendations are followed closely. I would recommend visiting the EnluxtraWoundCare.com website and signing up for the manufacturer’s training program which includes a pre-recorded video course, a live webinar with myself and an opportunity to get certified and become an Enluxtra specialist.

​​See other posts in the Enluxtra Blog
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