After drainage of faecal peritonitis, a heavily contaminated midline abdominal wound is packed with saline gauze and reviewed daily. On postoperative day 5 the wound looks clean and healthy, and it is then sutured closed. This approach is best described as:

• A Primary intention healing
• B Secondary intention healing
• C Delayed primary closure, healing by tertiary intention ✓
• D Epithelialisation from retained adnexal elements

Explanation

Delayed primary closure means deliberately leaving a dirty or contaminated wound open for 3 to 5 days, confirming it remains uninfected, and then closing it surgically; this is healing by tertiary intention. It allows contaminated tissue to be declared viable and bacteria cleared before suturing, reducing dehiscence and infection compared with immediate closure. It differs from secondary intention, where the wound is never sutured and fills by granulation and contraction.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.