Wound Healing by Intention

Question 1

What are the types of “intentions” for wound healing?

Answer 1

Primary, Secondary, and Tertiary Intention

Question 2

What is Primary Intention?

Answer 2

A wound that has minimal tissue loss and can be approximated with sutures, staples, or adhesives. They heal quickly in an uncomplicated, orderly progression with minimal scarring.

Question 3

Examples of wounds that heal via Primary Intention?

Answer 3

Surgical incisions, lacerations, punctures, and superficial and partial-thickness wounds

Question 4

What is Secondary Intention?

Answer 4

A wound that must close on their own due to significant tissue loss, irregular/nonviable wound margins, infection, or contamination that inhibit oustide approximation. Wound beds fill with layers of granulation tissue until approximation with surrounding skin until the wound contracts and scars.

Question 5

Examples of wounds that heal by Secondary Intention

Answer 5

Neuropathic/arterial/venous/pressure ulcers, most full-thickness wounds, and chronically inflamed wounds

Question 6

What is Tertiary Intention?

Answer 6

Wounds that must be left open initially due to risk of complications such as sepsis or dehiscence. Once risk factors have been alleviated, the wound is closed via primary intention methods.

Question 7

What is Tertiary Intention also referred to as?

Answer 7

Delayed Primary Intention Healing

Question 8

Examples of wounds that heal by Tertiary Intention

Answer 8

Wounds with significant edema, contamination from debris, at high risk for infection, and questionable vascular integrity

Question 9

Factors that influence wound healing (8)

Answer 9

1) Age
2) Co-morbidities
3) Edema
4) Harsh/inappropriate wound care
5) Infection
6) Lifestyle
7) Medication
8) Obesity