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
References [+]
- Vermeulen H, Ubbink D, Goossens A, de Vos R, Legemate D. Dressings and topical agents for surgical wounds healing by secondary intention. Cochrane Database Syst Rev. 2004(2):CD003554.
- Schultz GS, Sibbald RG, Falanga V, et al. Wound bed preparation: a systematic approach to wound management. Wound Repair Regen. 2003;11 Suppl 1:S1-S28.
- Vuolo JC. Assessment and management of surgical wounds in clinical practice. Nurs Stand. 2006;20(52):46-56; quiz 58.
- Foster L, Moore P. The application of a cellulose-based fibre dressing in surgical wounds. J Wound Care. 1997;6(10):469-473.