ISSN 2398-2977      

Wound: secondary closure

pequis

Synonym(s): Delayed secondary closure


Introduction

  • Primary closure is delayed until granulation tissue   Wound: granulation 02  has formed in the wound.
  • Indication: wounds with significant swelling, contamination or evidence of infection, thus preventing primary closure.

Uses

  • Achieve greater functional and cosmetic result compared with second intention healing on the extremities.
  • Haired epithelium produced over wound bed.

Advantages

  • Decreased risk of subsequent infection compared with primary closure.
  • Reduces healing time and chances of scar tissue formation compared with second intention healing.

Disadvantages

  • Not suitable for severely contaminated/infected wounds, large skin defects, considerable associated soft tissue damage, necrotic debris, exudate or where wound debridement is necessarily inadequate to preserve vital structures.
  • Infection more likely than with second intention healing.
  • Tension on suture line greater than in wound closed by primary closure due to wound expansion and loss of skin elasticity.
  • Undermining skin edges and tension sutures usually required.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good, if criteria for secondary wound closure are satisfied before closure.

Further Reading

Publications

Refereed papers

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