Which type of wound healing occurs when a wound is left open and heals from the inside out?

• A. Primary intention healing
• B. Secondary intention healing
• C. Tertiary intention healing
• D. Wound closure by primary means

Answer: (B)

When a wound is left open and heals from the inside out, healing is happening by secondary intention. In this pattern, the wound edges aren’t brought together, and tissue loss means the defect fills in from the bottom with granulation tissue, then contracts as myofibroblasts pull the edges together, and finally epithelial cells migrate in from the margins to re-epithelialize the surface. This process takes longer and tends to produce a larger scar and a higher risk of infection compared with wounds closed primarily. By contrast, primary intention involves immediate closure with approximated edges, while tertiary intention is delayed closure after initial opening to reduce contamination, then closing later.