Healing by secondary intention

Abstract

Healing by secondary intention is a time-honored alternative to primary reconstruction of cutaneous wounds. In fact, there are situations in which this may be the preferred approach. An understanding of wound healing is fundamental to making surgical decisions regarding repair of any wound, particularly those in which healing is allowed to occur by secondary intention (or granulation). Preoperative patient education is important. It serves to allay the anxiety and concerns patients tend to have regarding an open wound, to insure that there will be adequate wound care to effect an uneventful and timely course of healing, and to preoperatively identify those patients who for several reasons may not be good candidates for secondary intention healing. Although granulation is a reasonable alternative for managing cutaneous wounds of the head and neck, selection of appropriate location and size reliably produces results that are both functionally and cosmetically acceptable. Perhaps the most attractive aspect of secondary intention healing is that virtually any time during the healing process, one has the option to surgically reconstruct the residual defect.