Sutures and Wound Repair/ General Surgery (ABSA) Practice Test

What is the healing process called in which a wound is purposely left open and allowed to heal from the bottom upward?

1. Primary intention

2. Secondary intention

3. Tertiary intention

4. Delayed primary closure

The correct answer is: Secondary intention

The healing process in which a wound is intentionally left open to heal from the bottom upwards is known as secondary intention. This method is employed in situations where the wound is too large, contaminated, or has lost significant tissue, rendering primary closure infeasible. During secondary intention, the wound granulates as new tissue forms and fills in the space, gradually pulling the edges together as it heals. This process allows for natural tissue repair mechanisms to take place without surgical intervention to close the wound immediately. It generally leaves a scar that can be more pronounced than the one resulting from primary intention due to the larger area of skin that must regenerate. In contrast, primary intention involves closing the wound edges together with sutures, staples, or adhesive, resulting in minimal scarring and a quicker healing process. Tertiary intention or delayed primary closure refers to a strategy where a wound is initially left open and later closed surgically after a period to ensure that it is clean and free from infection.