创面修复_TIME_原则及其意义

中国组织工程研究第16卷第11期 2012–03–11出版

Chinese Journal of Tissue Engineering Research March 11, 2012 Vol.16, No.11 ISSN 1673-8225 CN 21-1581/R CODEN: ZLKHAH

2059

创面修复“TIME”原则及其意义****★◆

徐媛，刘宏伟

“TIME” principles and its clinical significance in wound repair Xu Yuan, Liu Hong-wei

Abstract

BACKGROUND: While the cellular and molecular mechanisms of wound healing have been understood gradually and the

experiences of wound bed management have been accumulated, the importance of wound bed preparation to wound repair has

recently attracted more attention.

OBJECTIVE: To fully analyze the mechanisms of wound healing, various influence factors and their effects in this progress.

METHODS: An on line search of CNKI and PubMed databases was performed for articles published between 1994 and 2011,

using key words of “TIME principles, wound bed preparation, wound healing” in Chinese and English, respectively. The clinical

application principles and outcomes of wound healing were analyzed.

RESULTS AND CONCLUSION: A total of 498 papers were collected, and 24 of them were included according to inclusive criteria.

TIME is the initials of four principles in wound bed management. T means to remove the necrotic tissue. I means to control the

infection and to reduce the inflammation. M means to keep the wound moisture under normal condition for the granulation tissue

growth and re-epithelialization. E means to remove non migrating epidermis at the edge of wound. As a valuable guidance tool for

wound management, the TIME concept has been applied to clinical practice, and has been widely appreciated by clinicans.

Xu Y, Liu HW. “TIME” principles and its clinical significance in wound repair. Zhongguo Zuzhi Gongcheng Yanjiu. 2012;16(11):

2059-2062. [ ]

摘要

背景：随着人们对创面愈合机制研究的深入和创面处理经验的积累，创床的准备对于创面修复的重要性越来越引起人们的高

度重视。

目的：全面了解创面愈合的机制，明确影响创面愈合的各种影响因素及其作用。

方法：电子检索中国期刊全文数据库(1994/2011)和 PubMed 数据库(1994/2011)，检索词分别为“TIME原则，创面准备，

创面愈合”和“TIME principles, wound bed preparation, wound healing”，语言分别设定为中文和英文，分析创面愈合临

床应用原则及效果的研究进展。

结果与结论：共检索到文献 498 篇，阅读标题和摘要后，按纳入标准，共纳入22篇。TIME为创面处理过程中创床准备4

项原则性的方法的首个英文字母的缩写，即：T指清除创面坏死组织(tissue)；I指控制炎症、减轻感染(infection/inflammation)；

M指保持创面正常的湿度为肉芽组织生长和创面上皮化创造条件(moisture)；E 指去除创缘迁移受损的表皮(edge of wound,

non migrating)。目前TIME原则作为一个有价值的创面处理指导工具受到临床医生的好评，并应用于临床实践。

关键词：创伤愈合；溃疡；清创；慢性创面；创面分析

doi:10.3969/j.issn.1673-8225.2012.11.037

徐媛，刘宏伟．创面修复“TIME”原则及其意义[J].中国组织工程研究，2012，16(11):2059-2062.

[ ]

0 引言

创面修复是指由于各种因素造成皮肤组织缺损后，通过自身组织的再生、修复、重建或人为进行干预治疗，从而达到创面愈合目的的一系列过程。随着人们对创面愈合机制研究的深入和创面处理经验的积累，创床的准备对于创面修复的重要性越来越引起人们的高度重视。

2002-06在第14届国际创面愈合年会上，致力于创面修复的Sibbald等[1]学者根据目前对创面愈合机制的认识和创面治疗经验的总结提出了创床准备的TIME原则。TIME为创面处理过程中创床准备四项原则方法的首个英文字

母的缩写，即：T指清除创面坏死组织(tissue)；

I指控制炎症、减轻感染(infection/ inflammation)；M指保持创面正常的湿度为肉芽

组织生长和创面上皮化创造条件(moisture)；E

指去除创缘迁移受损的表皮(epidermis, non

migrating)。这4项创面处理的原则最早于2003

年初以表格的形式发表在《Wound Repair and Regeneration》杂志，2003-09又进行了修订，

将“epidermis”改成了“edge of wound”[2]。

TIME原则作为一个有价值的创面处理指导工具

受到临床医生的好评，并应用与临床实践。本文

着重阐述了TIME原则提出的历史背景及临床

意义。

Department of Plastic

Surgery, the First

Affiliated Hospital of

Jinan University, Key

Laboratory for

Regenerative

Medicine, Ministry of

Education,

Guangzhou

510630, Guangdong

Province, China

Xu Yuan★, Master,

Physician,

Department of Plastic

Surgery, the First

Affiliated Hospital of

Jinan University, Key

Laboratory for

Regenerative

Medicine, Ministry of

Education,

Guangzhou

510630, Guangdong

Province, China

yuan_xu@foxmail.

com

Corresponding

author: Liu Hong-wei,

Associate chief

physician, Doctoral

supervisor,

Department of Plastic

Surgery, the First

Affiliated Hospital of

Jinan University, Key

Laboratory for

Regenerative

Medicine, Ministry of

Education,

Guangzhou

510630, Guangdong

Province, China

liuhongwei0521@

Supported by: the

National Programme

for Development of

Key Foundamental

Research, No.

2005CB522603*; the

National Natural

Science Foundation

of China, No.

30772257*,

30973127*; the

Special Funds for

Foundamental

Scientific Research

of the Central Higher

Education

Institutions, No.

21611416*

Received: 2011-07-09

Accepted: 2011-07-21