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Wound bed preparation (WBP) is a systematic approach to wound management by identifying and removing barriers to healing. The concept was originally developed in plastic surgery. In 2000, the concept was applied to systematizing the treatment of chronic wounds. The 2000 proposals〔Cherry GW, Harding KG, Ryan TJ. Wound Bed Preparation. International Congress and Symposium Series 250. London, UK: Royal Society of Medicine Press Ltd, 2000.〕 recommended that wound management address the identifiable impediments to healing in order to achieve more successful outcomes. Three publications appeared that year that focused on the concept of managing the wound healing processes of wound exudate, bioburden and devitalised tissue. Initially, emphasis was placed on debridement, moisture balance and bacterial balance as the three guiding principles of good wound care, while at the same time recognising that the provision of care includes a vast array of patient, clinical and environmental variables.〔 Since 2000, the wound bed preparation concept has continued to be developed. For example, the TIME acronym (Tissue management, Inflammation and infection control, Moisture balance, Epithelial (edge) advancement) has supported the transition of basic science to the bedside in order to exploit appropriate wound healing interventions and has not deviated from the important tenets of debridement, moisture balance and bacterial balance. The TIME framework is not a continuum and as such is applicable to a wide range of wounds. It is important to note that the WBP model can be effectively applied only when a high level of precision is utilized in assessment of the patient and their wound. The corollary of this is that intervention demands an equally high level of precision and this should be preceded by comprehensive wound assessment. Wound assessment is a vital first step in precision management process. The purpose of wound assessment is: To identify; *the origin of the wound, *the effects of the wound on the individual, *the effects of the individual on the wound. To determine; *if healing is taking place, *the most appropriate management of the wound. To gather data, *to permit comparison of wounds and their management. Unfortunately, universal agreement as regards to the precise mechanisms of how this should be accomplished has yet to be agreed. == Debridement, moisture and bacterial balance. == (詳細はwound care. Although this view is deeply rooted in practice it is nonetheless based on empirical observation. Bradley ''et al. '' have stated that it is “unclear whether wound debridement is a beneficial process that expedites healing”. Despite this confusing situation, current recommendation favours regular debridement. It is thought that even in an immune compromised patient debridement can assist in establishing a favourable balance of the wound bioburden.〔 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Wound bed preparation」の詳細全文を読む スポンサード リンク
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