How long does secondary intention take

Tertiary wound healing, or healing by delayed primary closure, occurs when there is a need to delay the wound-closing process. This could be necessary if a doctor fears that they may trap infectious germs in a wound by closing it.

In these cases, they may allow the wound to drain or wait for the effects of other therapies to take place before closing the wound. There are several types of wounds, depending on factors such as the source of the wound and any underlying issues that may lead to it. The type may alter how doctors treat the wound or other factors in the healing process. Wounds are typically open or closed. A closed wound is an injury that does not break the surface of the skin but causes damage to the underlying tissues.

A bruise is a common example of this. On the other hand, open wounds break the surface of the skin and may also damage underlying tissues. Chronic wounds may also cause breakages in the skin that need to heal. These include bedsores, other pressure injuries, and diabetes-related ulcers. All wounds go through different healing processes, ranging from the initial wound reaction to the later stages of creating new skin. Simple wounds, such as those without extensive tissue damage or infection, take about 4—6 weeks to heal.

This does not include scar tissue, however, which takes longer to form and heal. The hemostasis phase occurs as the injury happens and is the first response from the body. The wound causes blood and other fluids to leave the body. The body responds by trying to stop this flow of blood. Affected blood vessels constrict to reduce blood flow.

As some research notes, platelets and thrombocytes in the blood start to clump together near the open wound, forming a fibrin network. This thickens the blood in the immediate area to help stop the bleeding. This newly formed clot also prevents germs from getting into the body. The platelets release chemicals that alert the surrounding cells to start the next process and heal the wound.

There is generally some inflammation in the area, as the immune cells rush to the damaged tissue. As the neutrophils leave after about three days, specialized macrophages enter the wound site and continue the debris cleanup.

Macrophages secrete proteins that orchestrate:. Macrophages also secrete growth factors like TGFs, cytokines, interleukin-1, tumor necrosis factor, and PDGF, which attract immune system cells and begin tissue repair. Now that the wound is clean, the proliferative phase which lasts days begins the process of filling and covering the wound with new skin. This phase of the wound healing process has 3 stages that operate in an overall and ongoing process: 1. Filling the wound 2. Contracting the wound margin 3.

Growing new skin over the wound or re-epithelialization. First, red granulation tissues fill the wound bed with connective tissues and new blood vessels.

Next, in contraction, the margins of the wound begin to pull to the center of the wound to close it up. Finally, epithelial cells come up from the wound bed and margins, and migrate until the whole wound is covered with new skin or epithelium. The remodeling or maturation phase of the wound healing process is where the wound bed slowly strengthens and gains flexibility.

The collagen deposit in normal wound healing reaches a peak in the 3rd week, and maximal tensile strength is usually achieved by the 12th week. Depending on the severity and type of wound, the remodeling stage can last from 21 days to 2 years. Primary wound healing occurs when the tissue surfaces are closed by stitches, staples, skin glue, or steri-strips. A surgical incision that is closed by stitches is a good example.

This sort of closure of the wound surfaces creates very little tissue loss, and makes the wound healing process as quick and easy as possible. Do not rub. Blot dry with sterile gauze, Q-tips, or cotton balls. Cover wound with white petrolatum e. If wound is draining, follow this layer with plain gauze. Lastly, apply wound tape or apply an adequately sized self-stick bandage e. This is continued daily until the wound has completely healed in. It is not known whether these dressings heal wounds at different rates.

To assess the effectiveness of dressings and topical agents on surgical wounds healing by secondary intention. All randomised controlled trials RCTs evaluating the effectiveness of dressings and topical agents for surgical wounds healing by secondary intention. Eligibility for inclusion was confirmed by two reviewers who independently judged the methodological quality of the trials according to the Dutch Cochrane Centre list of factors relating to internal and external validity.

Two reviewers summarised data from eligible studies using a data extraction sheet, any disagreements were referred to a third reviewer. Fourteen reports of 13 RCTs on dressings or topical agents for postoperative wounds healing by secondary intention were identified.