Preparing the wound bed 2003: focus on infection and inflammation

Area of Science:

• Wound healing and tissue repair
• Dermatology and wound care
• Infectious disease management in wounds

Background:

• Wound bed preparation is crucial for promoting wound closure by addressing underlying causes and local factors.
• Existing evidence for wound bed preparation practices may be limited, necessitating an updated examination.
• Expert consensus from international and Canadian advisory boards is vital for advancing wound care practices.

Purpose of the Study:

• To provide an updated examination of wound bed preparation practices.
• To present a template based on expert opinion for clinical actions in wound bed preparation.
• To differentiate and address bacterial burden/infection versus inflammation in wound beds.

Main Methods:

• A comprehensive review of relevant scientific literature was conducted.
• Input was gathered from the International Wound Bed Preparation Advisory Board and the Canadian Chronic Wound Advisory Board.
• Expert opinion was used to develop a clinical action template for wound bed preparation.

Main Results:

• A template outlining clinical actions for wound bed preparation, focusing on the TIME (Tissue debridement, Infection or inflammation, Moisture balance, and Edge effect) principles, is presented.
• The review differentiates between superficial and deep wound bacterial burden/infection and inflammation, offering a topical treatment approach.
• New therapeutic options, such as topical silver with absorptive dressings for increased bacterial burden, are highlighted.

Conclusions:

• The updated examination provides a framework for optimizing wound bed preparation by addressing local factors.
• Differentiating infection from inflammation is key to effective topical treatment strategies.
• Evidence-based expert opinion guides the development of new therapeutic options for complex wound management.