When choosing which intention to utilize, consider the possibility of a post-procedural infection occurring. Your selection is related to how the wound is presented. The four wound categories are listed from the lowest risk to the highest risk for developing an infection with wound closure.

Primary Intention

With selecting Primary Intention, it is acceptable to proceed with wound closure devices at that time of a full-thickness wound with sutures, staples, adhesive strips of tape, or maybe surgical glue. Closing the wound now, there is a low risk for infection as well as little concern for the wound’s edges separating due to tension on the incision line.

The advantages of closing by Primary Intention are low risk for infection, minimal scarring, and faster wound healing. A clean-contaminated wound is one where an organ has been entered but without any significant spillage of the organ’s contents. These surgical procedures might have been conducted as an urgent or emergent fashion.

Secondary Intention

Wound Closure by Secondary Intention is when the wound is not surgically closed either completely or partially. With time, the clinician will witness the wound bed filling in with more viable tissue, such as granulation tissue, and containing less non-viable tissue, such as slough or eschar.

Ultimately, the clinician will witness the epithelial covering of the wound bed. This can be a very slow process. Often the wound’s healing progress might be stuck in one of the phases of full thickness wound healing. These are the types of wounds that may be labeled chronic wounds, and the attending clinician may ask for a consultation by a wound care clinician.

Tertiary Intention

Tertiary Intention wound closure is often labeled as Delayed Primary Intention. With this type of wound closure, there was a planned period of time where the superficial layers of the wound were left open. If the situation allows, later these layers are closed in a similar fashion to what might have been performed initially in Primary Intention but now in a delayed fashion. Also, this delayed type of wound closure might include closing the wound bed using a skin graft, a skin flap, or a skin substitute.