A 28-year-old farmer presents 8 hours after a contaminated farm implement injury to the forearm with devitalised tissue and visible soil contamination. After thorough debridement, the wound is dressed and inspected daily, and sutures are placed on day 4 when it appears clean. This closure strategy is termed:

• A Primary intention
• B Secondary intention
• C Epithelialisation under a dressing
• D Tertiary (delayed primary) intention ✓

Explanation

Delayed primary or tertiary closure means leaving a contaminated wound open for several days of observation and dressing changes, then closing it once bacterial counts are low and the bed is clean. It combines the low infection rate of open management with the faster healing and better scar of primary closure. Secondary intention would mean letting the wound granulate and contract without suturing at all.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.