Wound Bed Preparation (WBP) was first defined in 2000. WBP can be described as the management of the wound to accelerate endogenous healing or to facilitate the effectiveness of other therapeutic measures. WBP was initially described in terms of removal of necrotic tissue, management of infection, and management of exudate. In 2003, this initial concept was expanded significantly. With the addition of the element of epidermal cell migration as an essential component to wound bed preparation, the concept was expanded to 4 basic aspects. The 4 basic aspects of WBP can now be represented by an acronym, TIME. T= tissue (non-viable or deficient), addressed clinically via debridement. I= infection or inflammation, addressed clinically via antimicrobial agents. M= moisture control, addressed clinically via absorbent dressings and/or compression. E= epidermal margin, addressed clinically via tissue engineered constructs/grafts. Focusing on the “M” in TIME, there are numerous absorbent dressings that are intended to fulfill this need. Typically exudate is cause by the breakdown of necrotic tissue (via enzymatic, autolytic or biological debridement), an inflammatory response contributed to microbial contamination/infection or edema due to venous disease. The ideal wound healing environment is provided by a dressing that maintains a moist wound and warm conditions at the wound surface, providing the following advantages:

• Gaseous exchange and the passage of water vapor. • Prevents microbial attack. • Does not shed fibers of leach toxic materials into the wound. • Absorbs excess exudate. • Removal is trauma-free.

There are several things for the clinician to consider in maintaining a moist wound environment. Often the inclination is to reach for an absorbent dressing, but understanding the cause of the exudate is the real issue. The following is a review of moist wound healing, followed by a suggested method of determining the appropriate dressing type.