Which statement correctly compares healing by primary, secondary, and tertiary intention, with examples?

• A. Secondary intention: edges not closed; heals by granulation and contraction.
• B. Tertiary intention: delayed primary closure with initial open healing.
• C. Primary intention: edges approximated and closed.
• D. Secondary intention: wound is closed with sutures.

Answer: (B)

Tertiary intention is about delayed primary closure: a wound is left open for a period to allow infection control and granulation tissue formation, then it is closed later with sutures. This approach combines initial open healing with a definitive closure later, reducing infection risk while aiming for a good functional and cosmetic outcome. An example is a contaminated surgical wound that is left open for a few days to drain and clean, then closed once the area is clean.

This description is the best fit because it captures the defining feature of tertiary intention—delayed closure after an initial period of open healing. The other statements describe aspects of the other healing types but don’t convey the delayed-closure idea. For instance, healing with edges not approximated and by granulation and contraction describes secondary intention, which is open and heals by granulation and contraction without planned later closure. Healing with edges approximated and closed describes primary intention, where the wound is closed early with sutures or staples. Saying a wound is closed with sutures for secondary intention is inaccurate, since secondary intention involves healing without early closure.