Wound Management — SCE Dermatology MCQ

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EasyWound HealingWound ManagementSCE Dermatology

A 72-year-old man presents with a deep fungating ulcer on his leg. Wound bed assessment using the TIME framework identifies thick yellow slough covering 80% of the wound bed. Which component of TIME does this address and what intervention is needed?

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Correct answer: C — T — Tissue: debridement of non-viable tissue

The correct answer is C, T (Tissue): debridement of non-viable tissue. In the TIME framework, T stands for tissue management, and thick slough covering most of the wound bed is the defining feature of this domain, since non-viable tissue physically obstructs epithelialisation, sustains bacterial bioburden, and prevents accurate assessment of the wound base. The indicated intervention is debridement, achieved by sharp, autolytic, enzymatic, larval or mechanical methods depending on wound type and patient factors, converting the bed to viable, vascularised tissue capable of healing. This fits the stem precisely: 80% slough coverage is a tissue-viability problem, not an infection, moisture or edge problem, so debridement must precede other TIME interventions.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/skin-conditions