A man returns to the emergency department (ED) after receiving 10 stitches for a knife wound while cleaning fish. The wound is now infected. The stitches are removed and the wound is cleaned and packed with gauze
The ED instructs the man to return the next day to remove the packing and resuture the wound. The nurse is aware that the wound will now heal by:
A) Late intention
B) Second intention
C) Third intention
D) First intention
Ans: C
Feedback: Third-intention healing, or secondary suture, is used for deep wounds that either have not been sutured early or that the suture break down and are re-sutured later, which is what happened in this case. Secondary suture brings the two opposing granulation surfaces back together; however, this usually results in a deeper and wider scar. These wounds are also packed postoperatively with moist gauze and covered with a dry sterile dressing. Option A is incorrect; late intention is a term that sounds good but is used simply to distract the unsure test-taker. This technique is frequently used by test writers. Option B is incorrect; second intention is when the wound is left open and the wound is filled will granular tissue. Option D is incorrect; first-intention wounds are made aseptically with a minimum of tissue destruction.
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