A small surgical incision is cleanly closed with sutures shortly after injury.

• A. Wound closure by granulation
• B. Primary intention healing
• C. Secondary intention healing
• D. Tertiary (delayed primary) healing

Answer: (B)

This scenario demonstrates healing by primary intention. When wound edges are cleanly approximated and closed soon after injury, the tissue loss is minimal and the edges are brought together tightly, allowing rapid epithelialization across the incision with only a thin scar. Because the wound is closed early, there’s less exposed tissue to infection, less granulation tissue to form, and less overall inflammation, leading to faster healing and stronger initial wound integrity.

In contrast, healing by secondary intention occurs when edges cannot be approximated or there is significant tissue loss; the wound heals from the bottom up through granulation tissue, contraction, and later epithelialization, resulting in longer healing time and more scarring. Tertiary (delayed primary) healing involves leaving a wound open for a period to allow contamination or edema to resolve, then closing it later, combining elements of both approaches.