Wound Bed Preparation: The key to effective Wound Care

Introduction: Wound bed preparation (WBP) is the process of converting chronic wound into a healing wound ⁽¹⁾. The goal of wound bed preparation is to eliminate the barriers to healing and successfully achieve repair process. However, it is not “a piece of cake” because some acute wounds usually fail to progress through all four phases of healing and get “stuck” in a persistent inflammatory stage and become chronic⁽²⁾. Aim: to evaluate case studies of chronic wounds after incorporating the principles of wound bed preparation and TIME acronym in a formulary to assess and monitor the healing process of wounds that had failed to heal.  Methods: A prospective study of patients with chronic wounds was developed by the author in a Reference Centre for complex wounds in Brazil between November 2012 and March 2012, after approval of an Ethics Committee in Research (No. 2011/139). The evolutions were undertaken using an updated formulary to assess the healing process by incorporating the principals of wound bed preparation and TIME acronym as well as products and dressings to resolving the local barriers. Results: The patient population was composed of 22 patients, being 9 (41%) males and 13 (59%) females, with an age range between 15 and 74 years. The main type of the wound were leg venous ulcers (41%) following by diabetic foot ulcers (14%), leprosy ulcers (14%) and others types (31%). The wound bed preparation occurred in the majority of the cases within 4 weeks (63%) after stating the systemic and local treatment. The time to heal all wounds ranged between 2 to 4 months. Conclusion:  The principles of wound bed preparation associated with the TIME-based treatments⁽²⁾ provides a structured approach to the management of chronic wounds, which are the keys to effective wound care and improvement of the outcomes.