Abstract
We read with great interest the article “M.O.I.S.T. Concept for the Local Therapy of Chronic Wounds: An International Update” by Dissemond et al The authors are to be commended for presenting a structured and contemporary framework that refines the established TIME concept and integrates recent advances in chronic wound management. 1
The principal strength of the M.O.I.S.T. concept lies in its systematic and clinically intuitive structure for local wound assessment. In particular, the addition of oxygen balance and supporting strategies broadens the traditional focus on tissue, infection, and moisture, and appropriately reflects current developments in wound diagnostics and biologically active treatment modalities. As such, the framework serves as a valuable educational tool and may facilitate more comprehensive thinking in chronic wound care.2,3
Nevertheless, several practical considerations warrant attention. Components of the “O” (oxygen balance) and “S” (supporting strategies) domains often depend on advanced diagnostic techniques and specialized therapeutic options that may not be universally available in routine clinical practice. This may limit the feasibility of full implementation outside specialized wound care centers.
Moreover, although the separation of local and systemic factors is conceptually clear, these elements are strongly interrelated in clinical practice. Vascular status, infection severity, and metabolic control frequently determine the success of local wound interventions. A more explicit integration of systemic optimization within the M.O.I.S.T. framework could therefore enhance its clinical applicability. 4
Finally, future iterations of the concept may benefit from a stronger emphasis on patient-centered outcomes such as pain, quality of life, and functional recovery, which remain critical yet sometimes underrepresented in structured wound models. 5
In conclusion, the M.O.I.S.T. concept represents a meaningful advancement in structuring local therapy for chronic wounds. With consideration of real-world constraints and further integration of systemic and patient-centered dimensions, it has strong potential for broad clinical adoption.
Footnotes
Ethical Considerations
Not applicable. This Letter to the Editor does not involve original research on human participants, human data, human tissue, animal subjects, protected datasets, or identifiable clinical material; therefore, ethical approval was not required.
Consent to Participate
Not applicable. This Letter to the Editor does not involve human participants.
Consent for Publication
Not applicable. This Letter to the Editor does not include individual patient data, images, videos, or identifiable clinical material.
Author Contributions
Muhammed Said AYDIN: Conceptualization, writing—original draft, writing—review and editing, final approval. Gökay ÖZLER: Conceptualization, writing—review and editing, supervision, final approval.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data Availability
Data availability is not applicable to this Letter to the Editor, as no datasets were generated or analyzed for this submission.
Clinical Trial Registration
Not applicable. This manuscript is a Letter to the Editor and does not report a clinical trial.
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