TIME Wound Bed Preparation: FAQ for Clinicians

The TIME framework (Tissue, Infection, Moisture, Edge) is the shorthand most wound teams use at every dressing change. These are the questions clinicians actually ask when applying it.

What does each letter of TIME stand for?

• T — Tissue: Is the wound bed viable (granulation, epithelium) or non-viable (slough, eschar)? Non-viable tissue is a debridement decision.
• I — Infection/Inflammation: Is there bacterial burden or biofilm? Look for the NERDS (superficial) and STONEES (deep) signs.
• M — Moisture: Is the bed balanced, macerated, or desiccated? Dressing choice follows from this.
• E — Edge: Are edges advancing, rolled (epibole), or undermined?

When should I debride?

When non-viable tissue is present and the patient has adequate perfusion. Never debride an ischemic limb without vascular assessment. Match method (sharp, enzymatic, autolytic, mechanical, biological) to setting, skill, and pain tolerance.

How do I judge moisture balance without lab tools?

Read the periwound and the dressing. Maceration or a saturated dressing at 24 hours means too wet — step up absorbency. A dry, adherent dressing or a tacky wound bed means too dry — add a hydrogel or occlusive.

What does a stalled edge look like?

Rolled, thickened, or pigmented edges (epibole) that haven't moved in two to four weeks despite good bed preparation. That's the trigger to reassess the underlying cause — perfusion, pressure, glycemic control, nutrition — not just change the dressing.

How often should TIME be reassessed?

At every visit. Pair the assessment with a standardized image so trends are visible across clinicians. A healing dashboard makes stalled edges obvious weeks earlier than eyeballing alone.

Does TIME replace a full assessment?

No. TIME reads the wound bed. It doesn't replace vascular, neuropathic, offloading, or nutritional workup — which is where most chronic wounds actually get stuck.