Objective To investigate the effect of the TIME clinical decision support tool (CDST) applied in management of incontinence-associated dermatitis (IAD) in critically ill patients with multiple injuries. Methods Three hundred critically ill patients hospitalized in the trauma intensive care unit in 2019 were assigned into a control group, receiving routine skin care, while 210 patients admitted in 2020 were treated as an intervention group and were given systematic, graded wound management based on the TIME-CDST involving 5 key elements: assess, bring, control, decide, and evaluate. Incidence of IAD and fungal rash, severity of IAD, area of skin involved and healing time were compared between the two groups. Results Compared with the control group, the intervention group had significantly lower incidence of IAD and fungal rash, smaller area of skin involved, milder IAD severity and shorter healing length (P＜0.05,P＜0.01). Conclusion TIME-CDST is useful for graded management of IAD in critically ill patients with multiple injuries, which can effectively reduce IAD and fungal rash, and shorten healing time.