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Wound healing is a complex biological process where the skin or tissue repairs itself after injury. This process is vital to restore the normal function and integrity of tissues. Wound healing can be classified into three main types:

1. Primary Intention Healing (Healing by First Intention)

Definition:
This occurs when wound edges are directly apposed (brought together), usually by sutures, staples, or adhesive strips. It’s the fastest and most efficient healing process.

Examples:

• Surgical incisions
• Clean cuts with minimal tissue loss
• Paper cuts

Phases:

• Minimal inflammation
• Rapid epithelial regeneration
• Collagen remodeling and scar formation

Features:

• Little to no granulation tissue
• Minimal scarring
• Low infection risk

2. Secondary Intention Healing (Healing by Second Intention)

Definition:
This occurs when wound edges cannot be brought together. The wound heals by granulation, contraction, and epithelialization.

Examples:

• Large open wounds
• Ulcers
• Abscess cavities
• Traumatic injuries with tissue loss

Phases:

• Inflammatory response is more intense
• Granulation tissue fills the gap
• Myofibroblasts contract the wound edges
• Epithelial cells migrate from the wound margin

Features:

• Slower healing
• Prominent scar formation
• Higher risk of infection
• Often requires dressing changes or debridement

3. Tertiary Intention Healing (Delayed Primary Closure)

Definition:
A hybrid method where the wound is initially left open (e.g., due to contamination) and then closed after a delay of several days once the risk of infection is reduced.

Examples:

• Contaminated surgical wounds
• Traumatic wounds with high infection risk

Phases:

• Initial inflammatory phase
• Wound is cleaned and observed
• Closure performed after 3–5 days

Features:

• Combines advantages of primary and secondary healing
• Reduced infection risk
• Moderate scarring

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Key Factors Influencing Wound Healing

• Local factors: Infection, blood supply, wound size, foreign bodies, moisture
• Systemic factors: Diabetes, malnutrition, immunosuppression, medications (e.g., steroids), age
• Mechanical stress: Movement or pressure on the wound

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MCQ

What is false regarding the healing by primary intention? ( # Gen surgery Wound Healing)

A)Wound edges opposed.

B)Normal healing.

C)Usually done for dirty wounds

D)Minimal scar.

Ans-