Open wounds

Healing by secondary intention involves leaving wounds open to heal naturally, and relies on granulation tissue arising from the base of the wound to fill the tissue deficit created by surgery.

Wounds left to heal by secondary intention include:1

  • Infected wounds and wounds at risk of infection- where closure is delayed to avoid closure over an infection
  • Dehisced wounds - where wound edges have broken down due to underlying infection and free drainage of exudate is required

Appropriate wound bed preparation is important in open surgical wounds and includes:2

  • Removal of necrotic or sloughy tissue, if any
  • Resolution of infection, if any
  • Maintenance of moisture balance
  • Advancement of wound margins

Dressing considerations for wounds left to heal by secondary intention include:3

  • Sterile
  • Easy to apply
  • Maintenance of a moist wound environment
  • Management of exudate
  • Debridement of sloughy tissue if present
  • Limited pain in situ and on removal

Gauze dressings can adhere to the wound bed and cause wound trauma and bleeding.4

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