imbalances in the wound bed can often delay healing ’

It is widely appreciated that cellular and molecular imbalances in the wound bed can often delay healing (Eming et al, 2007). Models such as the TIME framework — Tissue management, Inflammation and infection control, Moisture balance, Epithelial (edge) advancement — offer a logical and systematic approach to wound bed assessment (Falanga, 2004; Dowsett and Ayello, 2004). Table 1 summarises the disturbances in wound bed remodelling associated with each stage of the TIME framework and the relevant treatment approaches. However, the clinical reality is that clinicians often have to deal with several aspects of the TIME framework at the same time, which requires ongoing assessment and realignments in treatment, often using multiple products.