The modified TIME-H scoring system, a versatile tool in wound management practice: a preliminary report

Main Article Content

Giuseppe Guarro
Federico Cozzani
Matteo Rossini
Elena Bonati
Paolo Del Rio


TIME-H, wound care, surgery, wounds, clinical practice


Background and Aims. The concept of WBP (wound bed preparation) has revolutionized the way to diagnose and correctly identify the best therapeutic path about the widespread clinical problem of difficult wounds. Starting from the modified TIME-H, authors conducted a preliminary study with the aim of assessing the impact of skin lesions and soft tissues for the surgical patient.

Materials and Methods.38 patients were preliminarily evaluated. The patients were classified according to the lesion examined, in particular among those who had an infectious or vascular etiology (SSTIs), and patients with surgical site lesions (SSI) and assigned to one of three categories prognosis: favorable (with healing expected within 12 weeks) (0-3A, 0-1B), intermediate (with healing expected over 12 weeks) (4-6A, 2-4B) and uncertain healing (7- 8A, 5-8B).

Results. At the end of the one-year observation period, authors established the healing prediction rate among the studied lesions: the surgical site lesions presented the highest percentage of predictivity (88%), followed by the mixed etiology (72%) and the infectious/vascular injuries (63%)

Conclusion.This modified-TIME-H can be considered as a versatile and useful scoringtool that should be used in daily clinical practice for the study and treatment of chronic wound diseases.


Download data is not yet available.
Abstract 7 |


1. Lindholm C, Searle R. Wound management for the 21st century: combining effectiveness and efficiency. Int Wound J. 2016;13 Suppl 2:5-15.
2. Adeyemi A, Waycaster C. Cost-minimization Analysis of Negative Pressure Wound Therapy in Long-term Care Facilities. Wounds. 2018 Feb;30(2):E13-E15
3. Sun H, Pulakat L, Anderson DW. Challenges and New Therapeutic Approaches in the Management of Chronic Wounds. Curr Drug Targets. 2020;21(12):1264-1275.
4. Schultz GS, Barillo DJ, Mozingo DW, Chin GA; Wound Bed Advisory Board Members. Wound bed preparation and a brief history of TIME. Int Wound J. 2004 Apr;1(1):19-32.
5. Ligresti C, Bo F. Wound bed preparation of difficult wounds: an evolution of the principles of TIME. Int Wound J. 2007 Mar;4(1):21-9.
6. Conduit, C, Free, B, Sinha, S. TIME-H in clinical practice—a pilot study. Wound Pract Res. 2013;21:186-189. 
7. Lim K, Free B, Sinha S. Modified TIME-H: a simplified scoring system for chronic wound management. J Wound Care. 2015 Sep;24(9):415-9
8. Leaper DJ, Schultz G, Carville K, et al. Extending the TIME concept: what have we learned in the past 10 years?. Int Wound J. 2012 Dec;9 Suppl 2:1-19.
9. Falanga V. The chronic wound: impaired healing and solutions in the context of wound bed preparation. Blood Cells Mol Dis. 2004 Jan-Feb;32(1):88-94.
10. Hachach-Haram N, Bystrzonowski N, Kanapathy M, et al. A prospective, multicentre study on the use of epidermal grafts to optimise outpatient wound management. Int Wound J. 2017 Feb;14(1):241-249. 
11. Dowsett C. Using the TIME framework in wound bed preparation. Br J Community Nurs. 2008 Jun;13(6):S15-6
12. Turner NJ, Badylak SF. The Use of Biologic Scaffolds in the Treatment of Chronic Nonhealing Wounds. Adv Wound Care (New Rochelle). 2015 Aug 1;4(8):490-500.
13. Dickinson LE, Gerecht S. Engineered Biopolymeric Scaffolds for Chronic Wound Healing. Front Physiol. 2016 Aug 5;7:341.
14. Mayet N, Choonara YE, Kumar P, et al. A comprehensive review of advanced biopolymeric wound healing systems. J Pharm Sci. 2014 Aug;103(8):2211-30. 
15. Aljghami ME, Saboor S, Amini-Nik S. Emerging Innovative Wound Dressings. Ann Biomed Eng. 2019 Mar;47(3):659-675.

Most read articles by the same author(s)

1 2 > >>